RICHES Cabarrus College of Health Sciences
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Fostering Parent to Foster Child Relationships-One Play Session at a Time: Development of a Workshop for Easing Transitions and Improving Behaviors
Get PDFThis report includes a review of literature to support development of a workshop to teach strategies for building relationships between foster parents and the children in their care. A search of the literature included locating peer-reviewed, evidence-based literature demonstrating how behaviors exhibited by foster children can make relationship building with the foster parents difficult. Successful strategies from the literature was reviewed to find supporting evidence for creation of the workshop. The literature provided evidence that abused and neglected children demonstrate poor behaviors that will affect their development, contribute to attachment issues with family and peers, produce sensory deficits, and children will demonstrate difficulty with self-regulation. It was found when foster parents and foster children do not establish a strong relationship, the risk is higher for multiple placements for the child. Evidence suggest there are benefits for teaching strategies to enhance relationships in the foster care home through group parent trainings, with and without the foster child present. Participants completed a survey before and after the workshop was presented. Strategies found to be most beneficial based on the participant feedback were calming activities, role playing, break time cards, and ideas for starting open ended conversations with the children in their care. These strategies were provided to participants in a booklet they could reference. The report provides evidence and support for the involvement of occupational therapists to implement use of their knowledge with childhood trauma in the foster care community. Occupational therapy practitioners use meaningful activities such as play to promote physical and mental health and well-being (AOTA, 2015). It was found that through task analysis, occupational therapists can identify the factors that may be causing the poor behaviors in these children. They have the knowledge and skills to work with parents and children to improve successful performance in the home, school, and community (AOT A, 2015). Recommendations discussed were: • Occupational therapists can use knowledge of mental health, client-centered and evidence based practice, and clinical skills to enter the emerging practice of working with foster parents and the children they care for to improve relationship outcomes. • Application of the strategies identified in the literature can be implemented through playgroups and parent training in the foster care community
Program Implementation of using Bathing Checklist to Increase Client Performance During Bathing, Specifically with Home Health Aides
Get PDFThe bathing checklist program was implemented for five months in a home health care setting with clients who received occupational therapy and home health aide services. This program\u27s main intention was to help clients become more independent with bathing by the occupational therapy discharge utilizing the home health aide to achieve this goal. The bathing checklist complied of 18 steps of bathing and an educational sheet to inform the client and caregivers of the program. At occupational therapy discharge, the bathing checklist was removed from the home for data collection. From the participating clients, IO out of 11 were more independent with bathing by occupational therapy discharge compared to the start of home health services. All of the clients reported that the bathing checklist was helpful and provided a visual guide. None of the clients demonstrated completion of the 18 steps of bathing by discharge. The home health aide was found to be compliant with following a supporter role during bathing, compared to the previous active assistant role. The Outcome and Assessment Information Set (OASIS) for the bathing score in the 3rd yearly quarter was 73.17% and in the 4th quarter it was 74.07% with a .9% difference. There is not a significant difference in the 3rd and 4th quarter OASIS bathing score to determine whether the bathing checklist made a branch wide progression. The bathing checklist was found to be success on an individual basis and a great visual aid for the client, home health aide and the occupational therapy team
Preparing Now for Successful Living in the Future
Get PDFPurpose: The main purpose of this capstone project was to develop an introductory community education for how to prepare and seek out solutions that will enable the aging adult to increase their choices about where they live with age. It targets baby boomers within Durham County, ages 52-70 as they consider retirement, might be recently retired, considering relocation, or caring for loved ones. The secondary purpose of this capstone project was to facilitate increased awareness of how occupational and physical therapists can more routinely educate and provide resources for clients in order to promote productive aging. Procedures: The method for establishing the community education involved the use of research literature, internet research, resources and insight from healthcare professionals in the acute care setting. The education included clarification for the term aging in place, which means being able to have choices to live and function where we want as we age (Wiles, Leibing, Guberman, Reeve, & Allen, 2011); an understanding of approaches such as regular exercise, good health management, financial planning, home modifications and falls prevention to facilitate independence with age; an explanation of how home modifications, and proper home assessments by occupational therapists can impact aging in place; and local and global resources to facilitate self-advocacy. To gain insight into acquired information and understanding before the education and after, pre and post surveys were created to go along with the community education. Once the education was developed, it was presented to the Duke adult inpatient acute care physical and occupational therapists for constructive feedback about the community education. In order to understand the therapists\u27 perception and gain qualitative feedback about the community education, data was collected using a Professional Feedback Survey to gain insight to the therapists\u27 perception of relevance and possible use with clients as well as gain valuable suggestions and feedback to improve the content of the overall education. Results: Based on the Professional Feedback Survey, the information was both relevant and valuable to respondents both professionally and personally. Respondents indicated that the community education had valuable content that facilitated an increased awareness of options and resources to promote aging in place. Additionally, respondents identified ways to incorporate education and resources into daily interactions with their clients especially for discharge planning; this supports that the respondents gained an increased awareness for how to incorporate the information in daily interactions with clients. Lastly respondents gave valuable suggestions for improving the content and delivery of the information including being mindful of the reading level of the audience, facilitating more of a discussion format and expanding the audience through an online education. Recommendations: Recommendations for how to move forward would be to offer the education to senior centers in the community using more of a discussion format; as well as online to expand the audience and facilitate increased awareness for actions that can be taken to ensure better aging in place. Offering the education to aging adults in the community, might impact a shift in the mindset of the audience by increasing the awareness of solutions and equipping the aging adult with resources for taking action to ensure they have increased options for aging in place. Additionally, improving the understanding of how occupational therapy can increase function with age to both the client as well as the healthcare providers might lead to increased occupational therapy referrals by healthcare providers and a demand for services on the part of the clients: this can result in greater opportunities for occupational therapists to provide home assessments, facilitate implementation of necessary modifications and contribute to outcome measures that might influence improved reimbursement for occupational therapy services and covered services for the customers. Occupational therapy\u27s success with improving the ability of the aging client to function in their homes with age, places the profession in a position to lead the education and discussion for how to age in place. Ideally an aging in place series presented to the community led by occupational therapists in collaboration with key healthcare professionals can help to promote improved health and safety for aging adults
Mild Traumatic Brain Injury and Post-Concussion Syndrome: An Analysis of the Implications for Occupational Therapy
Get PDFExecutive Summary Background: Mild traumatic brain injuries (mTBI) occur more than one million times a year in the United States. Approximately 15% of those injuries result in persistent side effects, known as postconcussion syndrome (PCS), which can last up to a year or longer. Common long-term effects include headache, dizziness, fatigue, irritability, sleep disturbance, poor concentration, visual disturbances, memory difficulty, and intolerance of stress, emotion or alcohol. (Dean, O\u27Neill & Sterr, 2012; Legome, 2015) Project Purpose: This project aims to promote occupational therapy practitioner awareness of mTBI/PCS and the implications for occupational therapy treatment by writing an article that is worthy of publication in a professional magazine with a positive peer review feedback response. Methodology: Writing the article required research on publication guidelines and tips for scholarly writing prior to research on symptoms and long-term side effects of mTBI and PCS, and compiling facts to support the need for awareness and OT intervention to address the impact these symptoms and side effects have on engagement in meaningful occupations. A literature review table and summary was completed to help synthesize the information and provide a gateway to writing the article. Upon completion of writing the article, feedback was requested via a short online survey from two occupational therapists and two medical doctors regarding fluency and sophistication of the article and synthesis of information. Outcomes: Overall, there was an 89% positive response from all four survey respondents. The respondents indicated that more detail regarding outcomes of early intervention and cognitive intervention, and providing statistically significant evidence would have been a beneficial addition to the article in order to provide further support for OT intervention for mTBI and PCS and to provide further background information and details for better reader understanding. Otherwise, the article was easy to follow and comprehend and provided sufficient information regarding the implications for OT in the treatment of mTBI and PCS. Conclusions and Recommendations: Overall, there is evidence to support occupational therapy intervention to address the various cognitive, visual and vestibular symptoms of mTBI and PCS. There is a potential window of opportunity for occupational therapy to provide early intervention and identify those that may be at risk for more persistent PCS symptoms. Furthermore, occupational therapy possesses a plethora of intervention approaches that can be individualized and utilized to address the specific needs and deficits of each client experiencing mTBI and PCS. Further research studies regarding the efficacy of occupational therapy treatment of the common symptoms and long-term side effects experienced by those with mTBI and PCS would be beneficial for evidence-based practice among the profession. Additionally, with the rising awareness of the potential dangers of sport-related head injuries, occupational therapy could use supportive evidence to advocate for our profession to headline in the treatment and recovery of mTBI and PCS
Best Practice Guidelines for Therapeutic Intervention of Disruptive Behaviors in the Preschool and Kindergarten Classrooms for All Peers in the Regular Education Environment for Academic Success
Get PDFAwareness of disruptive behavior in the classroom and how it effects the academic learning environment has become a concern for parents and educators as the classroom sizes continue to grow. By identifying techniques to better manage classroom behavior, we can reduce teacher and student stress and increase opportunities for academic success. The purpose of this study is to provide a good understanding of what disruptive behavior is and the role the occupational therapist can play, to provide educators with behavior management techniques that can be implemented into the kindergarten and preschool environment, to identify how disruptive behavior is affecting the classroom environment, and improve teacher competence for handling disruptive behavior. By utilizing pre and post informative video questionnaires from kindergarten and preschool teachers in the Hoke County North Carolina school system, information was gathered and assessed to provide insight into the objectives. In conclusion, the occupational therapist can help to train the teacher in behavior management techniques and implementation. Behavior Specific Praise BSP, responsive teaching, and/or positive expectations have been identified as being effective techniques to manage disruptive behavior. These techniques teach the child to deal with their feelings in positive ways and foster a healthy relationship between the student and the teacher. Education on these techniques has helped to improve teacher confidence with handling disruptive behavior
Sensory Closet Program Design for Alzheimer\u27s and Dementia Population
Get PDFBackground: The prevalence of individuals with Alzheimer\u27s and dementia is growing exponentially in long term care facilities, with restraints and seclusion becoming the method of intervention when behaviors arise (American Occupational Therapy Association, 2015). North Carolina is moving to decrease the amount of physical restraints and psychotropic medication usage in long term care to decrease harm caused to the residents. Project Purpose: This project intends to design a sensory integration closet program for use in a long-term care facility to facilitate a decrease in behavior outbursts and correlating psychotropic medication usage in residents with Alzheimer\u27s disease and dementia. Coinciding training with the program will provide an evidenced-based justification, and will prove to be practical with effective interventions, for the use of sensory integrative strategies to address behavioral outbursts and/or reduction in use of psychotropic medications with Alzheimer\u27s and dementia patients. Design: Preceding research of utilization of sensory integration with relation to Alzheimer\u27s and dementia was evaluated. Designated sensory closet space and funding was determined in collaboration with the occupational therapist and facility administration. The sensory closet was organized according sense in which to be addressed, with options available to intervene in the client\u27s room if unable to transport to the sensory closet space. A record was placed in the sensory closet cataloguing and outlining each resident, how to implement each sensory intervention, and a chart to document if the intervention was successful in decreasing the behavior. An informative in-service was held at a long-term care facility with 33 direct-patient care staff members in attendance, with education including background on Alzheimer\u27s and dementia, physiological changes of the brain, and the benefits of a sensory integrative approach with management of behaviors. Upon completion of the educational training, data was collected from each participant analyzing the evidenced based approach, the overall effectiveness of the design, and the practicality for use with their clients. Results: Based on the data collected from participants in attendance, 100% of the participants responded favorably to the appropriate design of the sensory closet and the diversity of the interventions provided within the closet Identical data suggests the education was relevant to the content of the sensory closet program, and current evidence supports justification of sensory interventions in the management of behavioral outbursts and/or reduction of psychotropic medication usage in Alzheimer\u27s and dementia patients. Conversely, 21.2% of participants consider the sensory closet program too time consuming. Participants\u27 feedback suggests inclusion of a visual aide for the sensory closet would prove beneficial, and the education should be extended to families of participating residents. Significance Alzheimer\u27s disease and dementia affect all areas of daily activities, leisure and social participation, sensory perceptual skills, emotional regulation, and cognition. Occupational therapy has the unique ability to create an individualized sensory plan for these individuals to decrease the occurrence of behavior outbursts and related psychotropic medication usage within long term care. Future considerations of the sensory closet program include hosting educational sessions in a smaller setting to increase dialogue between trainer and staff. In addition, educational training will be extended to the responsible party of the facility resident
A Guide for Occupational Therapy Professionals using Budding Occupational Therapy Strategies: A Nature Approach
Get PDFThe purpose of Budding Occupational Therapy Strategies: A Nature Approach was to develop a guide with sample activities and explanations to better understand why and how nature works. The guide provides a sample of nature based activities for occupational therapists working with children with sensory processing disorders to better understand how simple it is to incorporate natural materials and natural environments into treatment sessions to improve a child\u27s occupational performance. The activities integrate plants, animals, the outdoors and everyday materials into treatment planning to improve performance skills by addressing the various components of the occupational therapy practice framework (OTPF). The guide was developed using Person Environment Occupation Model (PEO), Model of Human Occupation (MOHO), Ecology of Human Performance (EHP) and Sensory Integration theory (SI) with a desire to relate all activities back to the occupational therapy practice framework (OTPF). These are well-known and respected models and theories in occupational therapy practice. The guide was then presented to 10 occupational therapy practitioners and 1 parent in person and recorded for distribution to an additional 17 practitioners electronically. Out of 28 possible surveys, 17 pre-test and post-test surveys were returned. Based on the results, it is concluded that the guide was successful in increasing practitioner\u27s opinions on the benefits and use of nature for occupational therapy intervention. All of the practitioners demonstrated an increase in understanding and desire to use nature in therapy. Participants reported that lack of nature in their setting is a result of weather, demands and policies of the setting that are out of their control, insurance and budget constraints. Many of the practitioners reported learning new ideas for treatment interventions that were easy to implement. One practitioner shared the importance of these concepts being used across the lifespan. Based on a literature review and feedback from occupational therapy practitioners, it was concluded that the guide was effective by increasing experienced occupational therapists desire to incorporate nature into their treatment sessions. It provided specific, yet simple, treatment strategies for immediate use in practice. Further research is needed to determine the effectiveness of occupational therapy interventions (i.e. play in nature) to reach functional outcomes by increasing performance skills in a controlled study; however, a known barrier to nature research is the inability to control environmental variables and the variety of differences in sensory processing disorder
The Impact of the LSVT Big Program on Perceptions of Fall Risks and Safety for Clients With Parkinson\u27s Disease
Get PDFParkinson\u27s Disease is a common, neurodegenerative condition that can be a disabling, often causing injury and impairing quality of life. The purpose of this study was to determine the effectiveness of the LSVT program by increase safety and decrease falls for clients with Parkinson\u27s Disease. Using the Modified Falls Efficacy Scale, consisting of fourteen occupations performed inside and outside the home rated their confidence levels on a visual 0 analog scale of 0-10. Data was collected from therapists on most used and top five assessments along with the benefits of the MFES when completing the interventions and plan of care. The 0 MFES was distributed to 22 participants. Of those, 14 remained and finished the program :) 3 successfully. The hypothesis was that the participants in the LSVT program who completed it in :) four weeks would improve their overall confidence and safety as well as reduce falls. The 0 results showed a positive correlation in confidence levels; showing a significant increase after performing a regimented exercise for four weeks. The therapist rated their top five assessments used and liked as well as rated on a scale of 0-10 how beneficial using the MFES would be for them in the future. A significant correlation was found with a therapist score rating five and higher in all areas. This establishes the benefits of MFES to assess and recommend a plan of care (POC)
Occupational Needs of Female Ex-Offenders During Community Reentry
Get PDFPurpose: The objective of the capstone project was to identify the most significant areas of occupation in which female ex-offenders participate and to determine ways in which occupational therapy could benefit the participants of Transitional Options for Women (TOFW), a transitional housing program that provides a safe environment and eight-step life-skills program for ex-offenders. This objective reflected a need in assisting the staff of TOFW in understanding areas of occupation the participants utilize and rely on during their transition from prison or jail into the community. The project was completed through provision of a community resource manual reflecting identified areas of occupation to enhance the participant\u27s transition. Procedures: To assess the objectives, research on the criminal justice system, reasons for recidivism, identified needs, and typical behaviors of ex-offenders after release from incarceration were explored using multiple online search tools. The selected literature was then reviewed with relevant areas of occupational need as they affect and relate to community reentry. Next, local community resources were identified which correlated with the critical areas of occupation from the literature. The resources were organized in a binder according to areas of need and arranged in order of priority as suggested in the literature. An introduction to the manual was created to educated the staff and participants of the related role of occupational therapy, literature review findings, and organization of the manual for ease in usage. A staff and participant survey was developed. Training on the purpose and use of the community resource manual was completed with TOFW staff and any available participants. Then the survey was provided to the staff and participants of TOFW to obtain feedback on the usefulness of the community resource manual. Finally, a follow-up consultation was offered to the staff of TOFW to respond to questions after review of the community resource manual. Results Results indicate that a community resource manual would be very or extremely useful to staff and participants at TOFW and that information in the community resource manual was very easy to understand. Results :further reveal the resources in the community resource manual met the needs of the user at least very well. All survey respondents reported they were likely to use the community resource manual in the future and were at least moderately satisfied with the community resource manual. There were no reported changes suggested for improvement. Conclusions: In summary, occupational needs of ex-offenders transitioning from prison or jail into the community were found to encompass the majority of the instrumental activities of daily living (IADL) from the Occupational Therapy Practice Framework: Domain and Process (3rd Edition) (OTPF, III) (American Occupational Therapy Association, 2014), as determined through a review of the literature. Providing TOFW the fusion of research findings in the form of an overview of the literature and community resource manual was determined to be helpful, easy to use and understand, and met the needs of the staff and participants who responded
Reaping the Rewards of Gardening: A One Day Workshop Demonstrating the Holistic Effects of Incorporating Horticulture and Gardening into Long Term Care Facilities
Get PDFAs the American population continues to age the number of individuals ages 60 and over that will need full-time care will eventually outweigh the number of people 15 and under needing care. The total cost of care for the elderly individual will continue to rise due to an increased need for assist in institutional care. The elderly entering institutional care will experience physical, mental, emotional, and social changes that will influence their overall health and wellbeing. These changes can potentially start a domino effect that can lead to multiple comorbidities and global decline in abilities. Finding ways to promote positive change and improve overall health and wellbeing of the aged individual will be an important step in lowering the total health care cost. The purpose of this capstone project was to design a one day workshop that would demonstrate the importance of incorporating gardening into long-term facilities. The goal was to educate the participants in how to promote positive health outcomes in the geriatric population through integrating gardening into the long-term care facility both indoors and outdoors so that all residents could participate. Within this educational presentation, information on how to expand the gardening concept to promote the development of other activities was included. Other areas addressed were consideration of safety precautions, information on cost and expense, possible activity ideas, and activity analysis. The desired outcome of this workshop was to go beyond the confines of simple gardening to help the audience think outside the box to areas such as benefits to the facility as well as promoting resident involvement