British Journal of Occupational Therapy

Role-emerging placements are increasingly used to help occupational therapy students develop the skills, knowledge, and attributes needed to become the therapists of tomorrow. Whilst literature on role-emerging placements is growing, studies have tended to be general placement evaluations, with only a limited number exploring students' experiences in detail.

This study used interpretative phenomenological analysis to gain a deeper understanding of how five MSc pre-registration occupational therapy students experienced and ascribed meaning to their role-emerging placements.

The role-emerging placements acted as a strong catalyst for the students' ontological development (that is, their understanding of self and development of ways of being and enacting occupational therapy practice). Through engaging in challenging and autonomous learning experiences, students developed deeper insights into who they were becoming as professionals, leading to a professional identity of their own making.

Having to continually reflect on and verbalize the core essence and contribution of occupational therapy, students developed clarity of understanding about the uniqueness of the profession. This is important in light of the historical difficulty occupational therapists have had in articulating their unique role and professional identity.

In this exploratory study, the clinical reasoning process followed by occupational therapists in determining whether their clients' spiritual occupations were health promoting or manifestations of a psychiatric illness is described. There has been limited investigation in this regard in existing literature.

A qualitative multiple case study design was used. Five occupational therapists working in different mental health care settings were interviewed using semi-structured interviews. Review of relevant documents and field-notes also provided important data sources.

Three themes emerged from thematic analysis, namely ‘Clinical Reasoning: complex, dynamic and multi-layered’; ‘Multiple resources: people as key’; and ‘Rewarding and challenging experience’. ‘Underground practice’ emerged as a strategy that helped participants to navigate around contextual barriers in order to ensure client-centredness when addressing spiritual occupational needs within a mental healthcare setting.

Spiritual occupational engagements should be examined in conjunction with individual clients' own process of meaning-making, implications for health to the client and others within the healthcare setting, and by taking the broader occupational narrative of the person, as well as relevant cultural norms and expectations, into consideration.

Health and social care agencies are encouraged to provide child-centred services that respond to needs that change over time. There is evidence that occupational therapists are concerned about how to respond to issues of harmful behaviour in the home environment whilst promoting child development. This study explored occupational therapists' experiences regarding harmful behaviour and the safety of children with Autistic Spectrum Disorder.

Seven community occupational therapists, employed by a local authority and working in social care, participated in two focus groups.

An inductive thematic analysis identified five broad themes. These were: ‘assessment is complex’, ‘child development and the home environment’, ‘importance of family-centred services’, ‘the need for additional services’, and ‘management of the disabled facilities grant’.

Local authority occupational therapists prioritize supporting families to keep children safe. It is necessary to adapt the home to reduce hazards and for alternative interventions to be made available to address behavioural and sensory needs. Services such as sensory integration are lacking, and where they are available access is difficult. It is common for disabled facilities grants to fund adaptations; however, management of grants could be improved to meet the needs of these children and their families.

This paper evaluates audits and feedback as methods to increase implementation of evidence in stroke rehabilitation.

The study used an action research approach and theories of knowledge translation. A sample of 22 occupational therapists participated from two Danish hospitals that admitted stroke patients. Data collection methods included audits of occupational therapy medical records, documentations of daily practice, and collaborative discussions. Active feedback and discussions of the findings took place, at a group level in four local clinical audits. Data analysis of daily self-reported recordings and audits was descriptive. Audit data were analysed using descriptive statistics. A phenomenological hermeneutical interpretive methodology was used for analysing qualitative data.

Audits and feedback were based on clear standards and contextual developing action plans. Daily practice in both settings adapted to the clinical guidelines. Implementations of the standardized assessment tools seemed to be the most successful.

The effects of audit and feedback profited from the active participation of the therapists, as well as local gatekeepers having formal responsibilities for implementing change. The process was strengthened by providing the audits and feedback more than once. The effect of audits and feedback was positively influenced by being in line with current conceptual frameworks, local policies, and values.

Information is currently lacking on the provision of occupational therapy for care home residents with stroke. The aim of this study was to identify current routine occupational therapy practice for this stroke population.

A questionnaire targeting qualified occupational therapists with work experience in a care home setting was designed, piloted, and transferred to an online survey. An invitation to participate was distributed via three of the College of Occupational Therapists Specialist Sections, social networking sites, and flyers at conferences.

Responses were analysed from 114 respondents representing the United Kingdom, the majority (72%) of whom were employed by the National Health Service. Ninety-two respondents (81%) had delivered occupational therapy to a care home resident with stroke in the last year but only 16% were ‘stroke specialists’. The most common aims of intervention were to: maintain participation in activities of daily living, improve posture and positioning, and provide training. Non-standardized assessment was the most common form of assessment used. The functional approach was most frequently adopted. The most frequently provided intervention was ‘seating and positioning’.

Occupational therapy is available to some stroke survivors in care homes; however, interventions are not commonly evidence based and are not routinely delivered by stroke specialists.