British Journal of Occupational Therapy

Since the 1960s, there has been substantial research outside the United Kingdom (UK) on recruitment to occupational therapy education. Recent UK studies have explored the characteristics of mature students (Craik and Alderman 1998), first-year students (Craik et al 2001) and students with a first degree (Craik and Napthine 2001). Based on these studies, a semi-structured, self-report, postal questionnaire gathered data from 50 students who entered the BSc(Hons) Occupational Therapy course at Brunel University, London, via the Universities and Colleges Admissions Service for the UK (UCAS) clearing system.

The students tended to be younger and were more likely to be female and Caucasian and to have similar or higher academic qualifications than standard-entry students at the same university. The majority first became aware of occupational therapy through previous work in a health care setting, although some did so while researching allied health professions. Although one-third originally had physiotherapy as their first career choice, 92% now considered that occupational therapy was what they wanted to do. The principal reason for applying through the clearing system was timing, with some applicants deciding late in the academic year to study occupational therapy. These findings add further weight to the need to promote the profession.

The purpose of this study was to determine the knowledge base surrounding hemianopia and to collate the rehabilitation principles offered by members of the National Association of Neurological Occupational Therapists (NANOT). A questionnaire was sent to 250 randomly selected members of NANOT. The completed questionnaires (n = 120) represented approximately a quarter of the total number of NANOT members at the time of the study.

The mean post-registration time of the respondents was 11 years (SD 0.6). All United Kingdom geographical areas apart from Northern Ireland and the Isle of Man were represented. A wide range of clinical areas was also represented.

The results showed that 92% of the respondents provided an accurate definition of hemianopia as the loss of half of the visual field. However, 48.3% reported that they were not testing every individual with a stroke for hemianopia. A third of the respondents stated that 80–100% of individuals with hemianopia always needed occupational therapy to compensate. The respondents also rated their understanding of eight neurovisual terms and, out of a total possible score of 80 (full understanding of terms), the mean score was 41 (SD 2.9).

The occupational therapist's role in the assessment/rehabilitation of hemianopia emerged in four categories: education, compensation, assessment of effects and diagnosis. Even if individuals were made aware of their hemianopia, 62% of the respondents reported that there were resulting problems in the individual's engagement in occupation (aspects of self-care, productivity and leisure).

These results are discussed in the context of the available literature and conclusions are drawn. A recommendation is made to improve the awareness and rehabilitation of individuals with hemianopia by occupational therapists.

The College of Occupational Therapists' recent document, A Strategy for Modernising Occupational Therapy Services in Local Health and Social Care Communities - a Consultation (COT 2002), has provoked debate within the profession on the future delivery of occupational therapy services across health and social care. This seems an appropriate time to reflect on events of 30 years ago when, following the initial separation of health and social services, the profession was faced with the dilemma as to where occupational therapists should be located. This paper looks at the events and issues influencing the profession's decisions then, using a grounded theory approach and drawing on literature and documentation.

At that time, discussions raised concerns about the division of skills, adherence to the ethical code and the status within the profession of occupational therapists working in local authorities. The profession's immaturity, lack of autonomy and medical orientation were key factors in influencing its response, which focused on drawing all occupational therapists into the health service. Despite lengthy discussions and consultations, the profession could not influence events and some local authority occupational therapists automatically became part of the newly set-up social services departments. Analysis reveals a possible missed opportunity to establish a firm foundation for occupational therapy in social services, the consequences of which are still evident today.

AIDS Dementia Complex (ADC) is a subcortical dementia often associated with HIV disease. Despite undergoing numerous assessments of cognition and function to determine their need for personal care assistance, there is limited information on how individuals with ADC view their functional and cognitive impairments and the subsequent effect on their lifestyle. This study investigated issues of concern to clients with ADC in order to provide a greater understanding of the psychological effect of the loss of functional ability.

A qualitative design was used to explore individuals' experience of ADC and clarify their insight and perception regarding the loss of function. The participants were selected by the use of purposeful sampling techniques. Information was obtained through semi-structured interviews and analysed using an analytic induction method. Five main themes were identified as being important in relation to the perception of functional ability.

Discrepancies emerged between the insights of individuals with ADC regarding their level of function and their need for assistance and support with activities of daily living, compared with those of the health care workers involved in their care. Health care workers need to have an awareness of the insight that individuals with ADC may have into their functional ability when addressing issues of supported accommodation and level of assistance required.

The Canadian Occupational Performance Measure (COPM) is a client-centred outcome measure designed for use by occupational therapists to demonstrate change in a client's self-perception of occupational performance over the course of occupational therapy. A review of the literature indicated that there had been limited research into the use of the COPM in mental health practice. The aim of this study was to formulate an occupational therapy assessment form based on the Canadian Model of Occupational Performance and incorporating the COPM and to evaluate its effectiveness in mental health practice.

A qualitative approach was used in this two-phase study with seven occupational therapists working in mental health practice. First, semi-structured interviews were completed to gain occupational therapists' reflections on the use of the COPM. Headings were then collated to devise an occupational therapy assessment form that incorporated the Canadian Model of Occupational Performance and the COPM. The second phase involved piloting the form in a variety of mental health settings. The form was evaluated by a second interview to highlight the factors that facilitated or hindered the use of the form in mental health practice.

This study indicates that the combination of the COPM with other assessment categories based on the Canadian Model of Occupational Performance has produced an occupational therapy assessment form that can be used in mental health practice.