Process of Occupational Therapy Flashcards

1
Q

OT Process

A
  • referral
  • screening
  • evaluation
  • intervention
  • outcomes
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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
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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
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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

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5
Q

Standardization

A
  • is uniform and well established
  • ## always the same in content, administration and scoring
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6
Q

Validity

A

to see if a tool measures what it was intended to measure

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7
Q

Face validity

A

determines how well the tool appears “on the face it” to meet its purpose

ex.

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8
Q

content validity

A

ex. does the content of a role checklist provide an adequate listing of roles)

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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

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10
Q

reliability

A

measuring consistency and stability in an assessment tool

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11
Q

interrater reliability

A

different raters using the same assessment will achieve the same results

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12
Q

test-retest reliability

A

the same results will be obtained when eval is administered twice by the same administrator

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13
Q

Intervention

A
  • intervention plan
  • intervention implementation
  • intervention review
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14
Q

Intervention plan

A
  • develop plan
  • consider potential discharge needs and plans
  • recommend or refer to other professionals as needed
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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
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16
Q

intervention review

A
  • re-eval plan and implementation
  • modify the plan as needed
  • determine the need for continuing or discontinuing services
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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
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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
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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”
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20
Q

Learning principles and teaching methods (DOMAIN 2)*

A

Pg. 49-50

  • knowing about these methods can help answer questions about health literacy
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21
Q

Procedural reasoning*

A
  • identifying OT problems, goal setting and treatment planning
  • implementing treatment strategies (gathering/interpreting client data)
  • OT PROCESS
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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
Q

Conditional reasoning*

A
  • ongoing revision of treatment
  • current/future social contexts
  • combination of interactive, procedural, and pragmatic reasoning
24
Q

Group norms*

A
  • 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
Q

therapeutic norms*

A
  • 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
Q

directive leadership*

A

-parallel/project groups
- social, verbal, and engagement are limited
- leader provides group maintenance roles and feedback
- the goal is task accomplishment

27
Q

facilitative leadership*

A
  • 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
Q

advisory leadership*

A
  • 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
Q

activity groups

A
  • are more efficient
  • social interaction
  • interpersonal skills
  • accountability
30
Q

evaluation group*

A
  • 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
Q

task-oriented groups*

A
  • 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
Q

thematic group*

A
  • 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
Q

topical group*

A
  • similar to thematic group, BUT OCCURS IN NATURAL ENVIRONMENT
  • ex. practicing money skills at a supermarket
34
Q

developmental groups*

A
  • 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
Q

parallel group*

A
  • members perform short-term tasks
  • minimal social interaction
  • OT ROLE- leader- provide purpose, structure, feedback
36
Q

project group*

A
  • members perform short-term tasks with some social
    interaction (competition and cooperation)
  • OT ROLE- leader
37
Q

egocentric- cooperative*

A
  • 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
Q

cooperative*

A
  • members share insight into feelings, values and common interests
  • no end product
  • group is more cohesive
  • OT ROLE- adivsor/participant
39
Q

Mature*

A
  • cohesiveness and harmony of group is important to achieve group
  • OT ROLE- group member
  • ex. community garden
40
Q

Instrumental group*

A
  • 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
Q

airborne precautions*

A
  • tuberculosis, rubeola virus (measles), varicella virus (chicken-pox)
  • PPE- gowns, gloves, proper fitting mask
42
Q

droplet precautions*

A
  • mumps, rubella, pertussis, influenza
  • PPE- gowns, gloves, proper fitting mask
43
Q

contact precautions*

A
  • methicillin-resistant staphylococcus aureus (MRSA), vancomycin-resistant
    staphylococcus aureus (VRSA), vancomycin-resistant enterococcus, and clostridium difficile (C-diff)
  • PPE- gowns and gloves
44
Q

observation skills * (DOMAIN 2)

A
  • 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
Q

interviewing guidelines * (DOMAIN 2)

A
  • 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
Q

Developmental (child) considerations in evaluation* (DOMAIN 1)

A
  • 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
Q

intervention planning* (DOMAIN 2)

A
  • 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
Q

individual intervention*

A
  • 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
Q

group intervention*

A
  • 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
Q

developmental (child) considerations in intervention (DOMAIN 2)

A
  • 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
Q

Don/doff on PPE

A

DON- GMG

DOFF- GGM