Process of Occupational Therapy Flashcards
1
Q
OT Process
A
- referral
- screening
- evaluation
- intervention
- outcomes
2
Q
Referral
A
- request for OT services (order or consultation)
- can be highly specific like a resting hand splint
- can be very general like an eval for a developmental delay
3
Q
Screening
A
- brief and easy to administer
- used to determine the need for an in-depth evaluation
- info to understand client’s goals, needs, priorities, strengths, weaknesses
4
Q
Evaluation
A
Occupational Profile
- history of the client’s background and functional performance to guide intervention design
- initial information about the client, including the client’s age, gender, and reason for referral
- diagnosis and medical history
- prior living situation and level of function and social, educational, and vocational background;
- precautions that need to be adhered to
Analysis of Occupational Performance
- information gathered during the occupational profile the OT makes decisions regarding the analysis of occupational performance
- selecting specific assessment instruments to collect further information
OBSERVATION AND INTERVIEW ARE ESSENTIAL TO EVAL
5
Q
Standardization
A
- is uniform and well established
- ## always the same in content, administration and scoring
6
Q
Validity
A
to see if a tool measures what it was intended to measure
7
Q
Face validity
A
determines how well the tool appears “on the face it” to meet its purpose
ex.
8
Q
content validity
A
ex. does the content of a role checklist provide an adequate listing of roles)
9
Q
criterion validity (concurrent/predictive)
A
compares an assessment tool to another one with one that already has established validity
ex. So if I came up with my own version of the Barthel Index to measure Index, let’s call it the OT Dude Index, it should have a high degree of correlation with say, the Barthel Index, which is highly regarded as a reliable and valid tool for the level of independence for ADLs.
concurrent validity- compares the results of 2 instruments given at about the same time
predictive validity- compares the degree to which a tool can predict performance on future criteria
10
Q
reliability
A
measuring consistency and stability in an assessment tool
11
Q
interrater reliability
A
different raters using the same assessment will achieve the same results
12
Q
test-retest reliability
A
the same results will be obtained when eval is administered twice by the same administrator
13
Q
Intervention
A
- intervention plan
- intervention implementation
- intervention review
14
Q
Intervention plan
A
- develop plan
- consider potential discharge needs and plans
- recommend or refer to other professionals as needed
15
Q
intervention implementation
A
- determine/carry out OT intervention
- therapeutic use of occupations
- preparatory methods
- education and training
- advocacy
- group interventions
- monitor client’s response through eval and re-eval
16
Q
intervention review
A
- re-eval plan and implementation
- modify the plan as needed
- determine the need for continuing or discontinuing services
17
Q
discontinuing OT services
A
- client goals met
- The client reached a functional plateau
- the client does not require skilled services but reached the maximal benefit
- exacerbation of an illness or needs discharge to a higher level of care
- length of stay in the setting has expired and extension of stay is not possible
18
Q
Methods of task/activity analysis* (DOMAIN 1)
A
- specify the exact task (ex. not just dressing but donning a sweater)
- identify/know procedures, materials, and tools to complete the task
- analyze task/activity as performed under typical circumstances
- analyze task/activity to make all parts of the domain (client factors, performance skills/patterns, and contexts) are considered
- determine the frame of reference
19
Q
Grading an activity* (DOMAIN 3)
A
- determine what aspects can be changed along the sequence of performance
- identify performance skills/client factors that require intervention and strengths that support activity performance
- upgrade/downgrade difficulty level to meet the needs of the client and provide them the “just-right challenge”
20
Q
Learning principles and teaching methods (DOMAIN 2)*
A
Pg. 49-50
- knowing about these methods can help answer questions about health literacy
21
Q
Procedural reasoning*
A
- identifying OT problems, goal setting and treatment planning
- implementing treatment strategies (gathering/interpreting client data)
- OT PROCESS
22
Q
Interactive reasoning*
A
- focuses on the client as a person
- how a person deals w/ disease
- therapeutic relationship w/ therapist, individual, caregivers
- FEELINGS
23
Q
Narrative reasoning*
A
- focuses on the client’s story and process of change for future
- roles that were important to the client prior to illness
- valued activities that the client can perform now
- future activities that client values
- CLIENT’S STORY, EXPERIENCES AND VALUES
23
Q
Pragmatic reasoning*
A
- reimbursement, equipment, organizational culture
- context in which OT thinking occurs
- treatment environment and OT’s values, knowledge, abilities, and experiences
- EX. TIME CONSTRAINTS AND LIMITED BUDGETS/ FACTS
23
Conditional reasoning*
- ongoing revision of treatment
- current/future social contexts
- combination of interactive, procedural, and pragmatic reasoning
24
Group norms*
- norms can vary in different groups and can change as a group develops
- can be explicit/clearly verbalized (confidentiality is maintained by all groups members, aggression is not tolerated)
- can be nonexplicit and not verbalized (discussion topics can be taboo)
25
therapeutic norms*
- encourage self-reflection, self-disclosure, interaction
- emphasize the importance of being on time/ being well-prepared
- establish support and safety
- maintain confidentiality and respect
- group members are effective agents of change (don't put the group leader in an expert role)
26
directive leadership*
-parallel/project groups
- social, verbal, and engagement are limited
- leader provides group maintenance roles and feedback
- the goal is task accomplishment
27
facilitative leadership*
- egocentric group/ cooperative-basic
- leader collaborates with group members to select activities
- members/leaders share instruction
- group maintenance roles/feedback provided by members with leader facilitating process
- the goal is to have members acquire skills through experience
28
advisory leadership*
- cooperative-supportive and mature groups
- members skills and engagement is high
- members select and complete activities with leaders advice
- group maintenance roles are done by members independently
- feedback is a natural process
- goal is to have members understand and self-direct process
29
activity groups
- are more efficient
- social interaction
- interpersonal skills
- accountability
30
evaluation group*
- ASSESSING SKILLS/LIMITATIONS
- evaluating functional abilities
- PROVIDE SHORT-TERM TASKS (ONE SESSION AND REQUIRE INTERACTION
- works on interpersonal skills
- DON'T INTERVENE, OBSERVE AND REPORT MEMBERS INTERACTION
- activities are performed 1:1 (individually) for goal setting
- OT ROLE - (passive role) just observing
31
task-oriented groups*
- will see observable changes in behaviors
- this group produces a product/service
- develop AWARENESS AND GAIN INSIGHT while performing tasks
- GOAL OF THE GROUP IS TO LEARN FROM SOCIAL INTERACTIONS
- OT ROLE- (active role)organize, assist, suggest, feedback, facilitate
- ex. community garden, community service
32
thematic group*
- GAIN SKILLS, KNOWLEDGE, ATTITUDE FOR PERFORMING AN SPECIFIC ACTIVITY
- EX. cooking group, money management, job readiness
- structure is clearly defined
- occurs in a simulated environment
- OT ROLE- provide purposeful activity, feedback in a safe and supportive environment, teach specific skills, reinforce learning skills
33
topical group*
- similar to thematic group, BUT OCCURS IN NATURAL ENVIRONMENT
- ex. practicing money skills at a supermarket
34
developmental groups*
- 5 stages
- members will progress and develop through stages and build on previous skills
- members are on similar level of development
- focus on interaction and not the task
35
parallel group*
- members perform short-term tasks
- minimal social interaction
- OT ROLE- leader- provide purpose, structure, feedback
36
project group*
- members perform short-term tasks with some social
interaction (competition and cooperation)
- OT ROLE- leader
37
egocentric- cooperative*
- members work together on task that is multi-session (longer than project group)
- experimentation of group roles and responsibilities
- ex. communication, stress management
OT ROLE- less of an active leader, provide assistance as needed
38
cooperative*
- members share insight into feelings, values and common interests
- no end product
- group is more cohesive
- OT ROLE- adivsor/participant
39
Mature*
- cohesiveness and harmony of group is important to achieve group
- OT ROLE- group member
- ex. community garden
40
Instrumental group*
- MAINTAIN/PRESERVE LEVEL OF HEALTH FUNCTIONING
- no behavioral change
- assumes members are operating at highest level of function
- OT ROLE- select /design activity, supervises, assist as needed, nor effect change
- can be physical, cognitive or psychosocial
- ex. senior exercise, social isolation
41
airborne precautions*
- tuberculosis, rubeola virus (measles), varicella virus (chicken-pox)
- PPE- gowns, gloves, proper fitting mask
42
droplet precautions*
- mumps, rubella, pertussis, influenza
- PPE- gowns, gloves, proper fitting mask
43
contact precautions*
- methicillin-resistant staphylococcus aureus (MRSA), vancomycin-resistant
staphylococcus aureus (VRSA), vancomycin-resistant enterococcus, and clostridium difficile (C-diff)
- PPE- gowns and gloves
44
observation skills * (DOMAIN 2)
- observation of a person during occupational performance is important (the act of doing)
- observation should be done in different contexts (structured and unstructured)
- environmental contexts are important to observe
- can be used to assess physical/sociocultural supports or barriers
- use a structured tool for observation to increase reliability
- observations should be ongoing
- OTs should be aware of their own backgrounds
- this can influence their interpretations of observations
45
interviewing guidelines * (DOMAIN 2)
- explain purpose of interview
- establish rapport
- ask questions in organized, formal manner (can use COPM, OPHI)
- observe nonverbal communications
- gaps in info presented
- affect and mood
- physical mannerisms
- speech patterns/inflections
- listen before talking
- open-ended questions for discussion, follow-up questions should be specific
- comment in a limited manner
- answer personal questions in a direct and honest manner
- maintain confidentiality at all times
- lead and direct interview to achieve their purpose/goal
46
Developmental (child) considerations in evaluation* (DOMAIN 1)
- conduct family/teacher interviews and home/classroom observations
- consider appropriate developmental levels in selecting toys and assessments
- observe body postures- symmetries/asymmetries, stability of trunk, pelvis, hips during movement
- observe transitional movements- prone, supine, side-lying, quadruped, sitting, standing, kneeling
- assess quality of movements
- assess fine motor coordination
- proper positioning/adaptive equipment, seating, AT
- cognition
- psychosocial skills
- sensory processing
- visual/auditory
47
intervention planning* (DOMAIN 2)
- Plan should be based on a frame of reference
- collaborate w/ client, family, caregivers (use interpreter if there is a language barrier)
- prioritize problem areas
- intervention plan content
- long-term goals
- short-term goals
- intervention methods
- duration, frequency, number, and types of intervention sessions
- recommendations for additional OT services and referrals
- use of clinical reasoning
- evidence to support interventions
48
individual intervention*
- learning capacity of person
- need for privacy
- need for greater control of the environment
- difficulty or complexity of parts of domain (occupations, activity demands, performance skills, performance patterns)
- inappropriate behavior
49
group intervention*
- developing interpersonal skills
- engaging in socialization
- feedback from people going through similar situations
- being motivated by peers
- learning from others
- placing one's own condition into perspective
- developing normal group behavior for successful performance in shared occupations (work, leisure groups)
50
developmental (child) considerations in intervention (DOMAIN 2)
- consider/respect family's background
- activities must be age- appropriate
- play activities should be primary intervention
- family education
- provide consultation or direct treatment to facilitate school performance and achieve educational goals
- treatment to facilitate sensorimotor, cognitive and psychosocial development
- positioning equipment/ tech aides for home or school
- visual/auditory aides are easily understood
-
51
Don/doff on PPE
DON- GMG
DOFF- GGM
