Clinical Reasoning Process In OT Flashcards
FOUR BASIC ELEMENTS OF FRAMES OF REFERENCE
Focus
Basic assumption
Function-disability continuum
Postulates of change
‘Focus’ element of FOR
clearly defined domain, scope, or focus of concern in occupational therapy. It is usually defined in the frame of reference
‘Basic assumptions’ of FOR
the guiding beliefs that lead the clinical reasoning process. They are the ideas and concepts that explain possible explanations for the patterns of performance and participation observed. They are often not clearly defined and must be critically explored to effectively apply the frame of reference.
Function-disability continuum
the expectation of what is normal or the best outcome versus what is a poor or limited outcome within the scope of a theory. The continuum is often described in terms of function, especially when the focus of the frame of reference is based in occupation. (for example: behaviors that are interfering or inhibiting functional performance, thus limiting occupational engagement)
Postulates of change
explanations offered within frames of reference about what is needed to cause change. These explanations are often described in terms of occupational engagement and participation, especially when the focus of the frame of reference is based in occupation
OT frames of reference allow occupational therapy practitioners to
be collaborative in their clinical reasoning and to be reflective in their clinical practice and offer heuristic tools that add rigor and evidence to clinical reasoning
the assimilation of perspectives of key individuals in the clinical reasoning process. The client is the essential “key individual” in collaborative reasoning, and other key individuals may include the client’s family, members of the health care or educational team and employers.
Collaborative reasoning
involves interaction and communication between varied professionals and the clients receiving health care
Interprofessional collaborative practice
Core ideals associated with interprofessional collaborative practice include:
Client and family centeredness
Community-oriented care
Relationship-focused service delivery
Skills needed to work effectively in interprofessional contexts:
Ability to clearly articulate the unique nature of occupation and the value of occupation to support:
•Performance
•Participation
•Health
•Well-being
These are all consistent with evidence-based practice standards
embeds intervention consistently by all family members and service providers throughout the day rather than in individual isolated therapy sessions
interprofessional team-guided strategy
looks beyond child function to include aspects of family function
routines-based assessment process
functional and predictable schedules of the child and family.
•In this approach, the family guides the selection of routines and contexts for intervention.
•The process is initiated in the evaluation process with the completion of a routines-based interview.
Family-guided routines
In interprofessional collaborative practice, the clinical reasoning process is essential and must be extended to provide care that is:
Respectful of the entire team
Puts the client’s priorities above those of the individual practitioners
