2012 Scholarly Projects Dr. Gail Bass Christa Haas & Meghan Lyle
A Wellness Program for the Transition into a Wheelchair
Allison Kalb & Diana Huettl
An Occupational Therapy-Based Education Program for Caregivers of Individuals with Cerebral Palsy in Ghana: A Culturally Conscious Perspective
Chanaé Jones & Brittany Mayer
Understanding Culture by Strengthening Education and Social Participation through Sociolinguistic Registers for Client of Low-Socioeconomic Status Developing an Occupational Therapy Community/client Wellness Program
Dr. LaVonne Fox Lindsey Wolsky & Lindsey Sauer
Dr. Anne Haskins Mike Nelson & Elizabeth Schleicher Steven L. Huft, MOTS and Izaak P. Schafer, MOTS
Motivation: An Occupational Therapy Guide for Young Male Clients with Spinal Cord Injuries Role Transitioning For Athletes Coping with Injury and Occupational Loss
Dr. Debra Hanson Stephanie Blonigen & Danielle Schepers
Bringing occupation to Long Term Care settings
Johanna Meister & Sarah Averett
Riding the Wave: A Guide for Implementing Biofeedback in Occupation-Based Interventions in a Rehabilitative Setting Resource Manual for Occupational Therapists: Providing Transportation Related Resources to the Elderly Living in Poverty in North Dakota
Professor Breann Lamborn Amanda Ralston & Luke Wavra
Dr. Mandy Meyer Chelsey Edwards & Amy Ferguson Amanda Rositas & Kathryn Zavoral
Embracing Life with ALS: The Role of Occupational Therapy from Diagnosis to End of Life Care Caring for Individuals with Fibrodysplasia Ossificans Progressiva (FOP): A Treatment Manual for Occupational Therapists.
Dr. Jan Stube Erika Swirzcki & Andrea Young
An Occupation-Based Protocol Designed for Women with Cardiac Conditions.
Amanda Myklebust & Cody Link
A Community-Based Occupational Therapy Wellness Program for Adult Clients Following Traumatic Brain Injury
Nicole Likewise & Theresa Podio Greg Holubok & Andrea Hensrud
Growing occupational identity: The use of agricultural entrepreneurship for young adults with disabilities to successfully enter, adapt, or inhabit the worker role A Lifetime of Work: A Guide to Health Promotion and Wellness on the Farm
Crystal Brecht & Jenna McGregor
Illness Management and Recovery: Role of Occupational Therapy
Dr. Carla Wilhite
Dr. Sonia Zimmerman
Dr. Gail Bass Christa Haas & Meghan Lyle
A Wellness Program for the Transition into a Wheelchair
Allison Kalb & Diana Huettl
An Occupational Therapy-Based Education Program for Caregivers of Individuals with Cerebral Palsy in Ghana: A Culturally Conscious Perspective
A PHYSICAL WELLNESS PROGRAM FOR INDIVIDUALS TRANSITIONING TO A WHEELCHAIR. Christa Haas, Meghan Lyle, & Advisor: Dr. Gail Bass, Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202 Purpose: The purpose of this project was to create a wellness program for individuals confined to a wheelchair for mobility to prevent commonly experienced secondary medical complications and disruption to engagement in meaningful occupations (Matuska, Giles-Heinz, Flinn, Neighbor, & Bass-Haugen, 2003). Methods: A literature review was conducted to identify limitations for individuals confined to wheelchairs for mobility including functional deficits, health complications, and benefits of wellness education. Currently there is little wellness research with the population of individuals confined to wheelchairs for mobility; therefore there is a need for wellness program education for patients and therapists to reach best outcomes. Product: A wellness program manual was created to address secondary complications and diminished occupational participation. The Occupational Therapy Practice Framework: Domain and Process (AOTA, 2008) was used to ensure that all eight areas of occupation were included in the manual. These include activities of daily living, instrumental activities of daily living, sleep and rest, education, work, leisure, play, and social participation. The product was designed for use by occupational therapists and the manual pages were designed to be duplicated by therapists for use as handouts for clients and caregivers to facilitate program compliance or home programs. Therapists should use this product as a guide and pages should be adjusted according to each client‟s needs. Although the product has wellness in the title, the manual has a physical wellness focus instead of addressing each of these aspects individually. Conclusions: It is expected that by including wellness programming with individuals transitioning into the use of a wheelchair for mobility, secondary health complications and limited occupational engagement will be prevented.
An Occupational Therapy-based Education Program for Caregivers of Individuals with Cerebral Palsy in Ghana: A Culturally Conscious Perspective. Allison Kalb, MOTS; Diana Huettl, MOTS; & Advisor: Gail Bass, PhD, OTR/L, Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202. Introduction: Individuals with cerebral palsy (CP) are able to lead functional, productive, and fulfilling lives when provided the opportunity. In the country of Ghana, the prevalence of CP is estimated to be one out of every 300 births (Purple Field Productions [PFP], 2011), however, a lack of education about CP and other disabilities, limited access to healthcare services, and scarce resources hamper the Ghanaian people‟s opportunities for habilitation (Reynolds, 2010; Tinney, Chiodo, Haig, & Wiredu, 2007). In addition, cultural beliefs and societal attitudes toward people with disabilities in Ghana pose a barrier for those individuals to fully participate in occupation. According to the World Federation of Occupational Therapy (WFOT), occupational therapists have a responsibility and an opportunity to address occupational injustices through the development of programs for underserved populations (WFOT, 2006). Occupational therapy (OT) is an established element in the treatment of impairments and symptoms associated with CP (Steultjens et al., 2004). Often OT intervention includes parent or caregiver education. Because of the lack of access to medical care and therapy services, as well as the stigma related with disability, much of the care of individuals with CP is up to family members or informal caregivers. These caregivers often do not have access to the training or resources they need (Tinney et al., 2007). Purpose: The purpose of this program is to enable caregivers in Ghana with the training and knowledge of the basic skills and assistive devices to more effectively care for individuals with CP while enabling those with CP to engage in occupations more independently. It is also intended to empower the caregivers to pass on the skills and knowledge to other caregivers in their communities. Methodology: A review of literature was conducted including use of professional journals, textbooks, and organizational websites. Topics investigated were Ghana; disability culture, provision of healthcare and resources, and CP in Ghana; OT interventions for individuals with CP; and adult education principles. In addition, data from a needs assessment was obtained to
provide a personal perspective for content of the product and targeted audience. Three compatible Canadian occupational behavioral models guided the literature review and development of the product: Person-Environment-Occupation Model, Canadian Model of Occupational Performance and Engagement, and the Canadian Model of Client-Centered Enablement
Dr. LaVonne Fox Chanaé Jones & Brittany Mayer Lindsey Wolsky & Lindsey Sauer
Understanding Culture by Strengthening Education and Social Participation through Sociolinguistic Registers for Client of Low-Socioeconomic Status Developing an Occupational Therapy Community/client Wellness Program
Developing an Occupational Therapy Community/Client Wellness Program. Lindsey Wolsky, MOTS, Lindsey Sauer, MOTS, & Advisor: LaVonne Fox, Ph.D, OTR/L. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202. Health promotion is gaining more recognition with the increase of chronic diseases worldwide and the growing elderly population in the United States. The World Health Organization (2011) places a particular emphasis on health promotion as well as preventative care. The role of occupational therapy fits directly with this emphasis. The American Occupational Therapy Association (2008) identified occupational therapy‟s roles to include promotion of healthy lifestyle, use of occupation as a means to improve health and provide services to both individuals and populations. Problem: Although health promotion and prevention is well within the realm of occupational therapy, Flannery and Barry (2003) found that only 54 percent of occupational therapists reported involvement with health promotion. The most common barriers to health promotion included limited resources, lack of knowledge and structure, and the presence of role confusion (Flannery & Barry, 2003; Casey, 2000). Of the 54 percent of occupational therapists who reported involvement with health promotion, none indicated community affiliation (Flannery & Barry, 2003). However, it was found that the community setting was the most appropriate for occupational therapists to implement health promotion. Methodology: A comprehensive literature review was conducted to identify if there was a need for training occupational therapists regarding community health promotion and prevention programs. Emphasis was placed on implementation and locating funding sources. Additional literature was researched to identify an appropriate theoretical basis regarding adult learning principles and strategies to ensure the appropriate delivery of information to the audience. Anticipated Results: Developing Occupational Therapy Community/client Wellness Programs workshop was designed to educate occupational therapists on the process of designing and implementing a community-based health promotion program. The workshop will also provide education on locating and accessing funding for such a program. The workshop is designed from a facilitator‟s perspective so anyone could take the information and provide the workshop. Additional resources, information and learning activities are included and are based on Knowles‟s (1980) adult learning theory.
EDUCATING AND COMMUNICATING THROUGH SOCIOLINGUISTIC REGISTERS: ADOLESCENT CLIENT. Brittany Mayer, MOTS, Chanaé Jones, B.S. MOTS & Advisor: LaVonne Fox, PhD, OTR/L. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202. PROBLEM: Currently tests such as the SAT (Scholastic Assessment Test) and ACT (American College Testing), as well as employment use what is identified as formal sociolinguistic register (Joos, 1967 & Payne, 2005). Payne (2005) built upon Joos‟ (1967) definition and presented five registers: frozen, formal, consultative, casual, and intimates. Formal register is defined as; oneway participation, no interruption such as is seen with introductions between stangers. Technical vocabulary; “fuzzy semantics" or exact definitions are important. Montano-Harmon (1991) found that many minority and poor students do not have access to formal register at home but rather tend to rely primarily in the causal/informal register. According to Joos (1967), “one can go one sociolinguistic register down in the same conversation and that is socially accepted, but to drop two registers or more in the same conversation is thought to be socially offensive” (p. 27). If adolescents of low- socioeconomic status not have access to the formal register in the home environment, they may be placed at a significant disadvantage.
METHODOLOGY: A comprehensive literature review was conducted to explore the relationship between low- socioeconomic status, culture, family dynamics, sociolinguistic registers/communication, and education. For this scholarly project the focus was placed on the areas of occupation, specifically education and communication with activities or occupations arranged into categories. “All people need to be able or enabled to engage in the occupations of their need and choice, to grow through what they do, and to experience independence or interdependence, equality, participation, security, health, and well-being” (Wilcock & Townsend, 2008, p. 198). RESULTS: The result of the literature review is the development of Educating &Communicating through Sociolinguistic Registers: Adolescent Clients. This guide has been developed for use with adolescent clients 13-17 years-old. The scholarly project itself was guided by using the Ecological Model. The purpose of this scholarly project was two-fold: 1. Develop a guide designed to strengthen the adolescent‟s use and comfort with formal register, to strengthen their confidence in the occupation of education and transfer to the occupation of employment resulting in more success with these endeavors. 2. Strengthen the occupational therapist‟s communication skills with the adolescent client in a school, community, or mental health setting. The aim is to enhance their therapeutic-use-of-self and intervention approaches in these settings to ensure client centered care. Methods include leaning about sociolinguistic registers, culture, family dynamics and how to implement these resources. CONCLUSIONS: Although there are many factors that influence an adolescent‟s success or not in society, there are very few an individual clinician has the ability to control. Due to the challenge of addressing these needs, Educating & Communicating through Sociolinguistic vii Registers: Adolescent Clients was developed using the Ecological Model. The one area that can be influenced is how occupational therapists communicate with clients both orally and written. When adolescents are not able to adequately use the formal register, such as in conversation or writing skills, they are not able to participate in areas of occupation such as formal/informal education and communication. It is essential that they are able to independently participate in these areas of occupation to fulfill their role as family members, adolescents, successful students, and society as well. Occupational therapy (OT) can play a significant role in addressing these needs of adolescents. The guide can serve as a resource regarding sociolinguistic registers, cultural competency, and understanding low-socioeconomic status. It will be made available to practicing occupational therapists as a resources and reference
Dr. Anne Haskins Mike Nelson & Elizabeth Schleicher Steven L. Huft, MOTS and Izaak P. Schafer, MOTS
Motivation: An Occupational Therapy Guide for Young Male Clients with Spinal Cord Injuries Role Transitioning For Athletes Coping with Injury and Occupational Loss
Motivation: An Occupational Therapy Guide for Young Male Clients with Spinal Cord Injuries Michael A. Nelson, MOTS, Elizabeth M. Schleicher, MOTS, & Anne M. Haskins, PhD, OTR/L University of North Dakota School of Medicine & Health Sciences, Department of Occupational Therapy, 2751 2 nd Ave N. Hyslop 210,Grand Forks, ND 58202 Introduction: According to the Center for Disease Control and Prevention (2010), males account for approximately 80% of those who endure a spinal cord injury (SCI). Most newly diagnosed clients with spinal cord injuries are between the ages of 15-35 years (50%-70%) (CDC, 2010). Occupational therapists often work with clients who have sustained a SCI. It is in the best interest of the occupational therapy profession to address the psychosocial impact motivation can have on client‟s recovery. Problem: Wahman, Biguet, and Levi (2006) indicated that motivation is a key factor in increasing client participation in activities. By engaging in activities, clients are either improving or maintaining health and preventing secondary conditions. According to research findings, a major problem for clients with SCIs in therapy was participation lack of motivation (Chan et al., 2000; Craig et al., 2009; Kennedy, Evans, & Sandhu, 2009; Lohne & Severinsson, 2004), which ultimately leads to lack of occupational engagement and subsequent recovery. Despite the documented importance of motivation, there is limited established occupational therapy guidelines for using motivation as an intervention for clients who have sustained a SCI. Purpose: The purpose of this project is to explain the role that motivation has in recovery and develop a guide for occupational therapists to address motivation in young male clients following a SCI to assist in heightening clients‟ engagement in occupation and recovery. Methods: A thorough literature review was conducted to explore the physical and psychological effects of clients who sustained a SCI, the role of motivation in the recovery of clients with SCIs, and theoretical foundation of motivation and occupational engagement. Using
available evidence and occupational therapy theoretical models, the authors designed an intervention guide for occupation therapists to use when working with young males with SCIs. Results: The guide was developed based on two occupational therapy theoretical models, the Model of Human Occupation (MOHO) and Occupational Adaptation (OA). The guide utilizes three assessments to assess motivation and function related to sustaining a SCI. These assessments include the Functional Independence Measure (FIM®), Volitional Questionnaire (VQ), and General Self-Efficacy Scale (GSE). From the assessment results, concepts were created in order to address lack of motivation. As found in the literature review, five concepts positively impact client motivation. These concepts were: Social Support, Therapeutic Relationship, Hope, Peer-Mentoring, and Competitive/Game-Based Interventions. Furthermore, the authors of this guide developed interventions to explore each concept in order to increase motivation. Conclusion: Existing evidence has indicated the benefits of addressing motivation. In return, a clinician‟s guide for occupational therapists to address motivation in SCI recovery will increase client‟s participation in activities to increase overall quality of life.
Role Transitioning For Athletes Coping with Injury and Occupational Loss Steven L. Huft, MOTS and Izaak P. Schafer, MOTS Purpose: The purpose of this scholarly project was to develop an occupational therapy based intervention program for persons who are experiencing changes in their role as athletes. These transitions may include return to sport following an injury, unanticipated retirement from sport, or anticipated retirement from sport. Methods: A thorough literature search and review was conducted using the following research databases: CINAHL, Google Scholar, PubMed, and PsycINFO. Evidence from the occupational therapy, physical therapy, athletic training and psychology professions was reviewed regarding the prevalence of injury in varying sports contexts, athletes‟ ability to transition during role changes or interruption, injury rehabilitation, career termination and programs available to address the aforementioned factors. Research findings have indicated a need for programming that targets promotion of an athletes‟ healthy adjustment to life within and out of athletics. For example, following an injury, athletes may be physically ready to return to competitive sports but not mentally/psychologically prepared. This lack of readiness has also been documented in those transitioning out of sports. There is a lack of published programming available to address athletes‟ psychological and physical needs for role transitioning, transitioning out of sport, transitioning to a different level of sport, injury intervention, and prevention of unhealthy lifestyles that may accompany retirement from sport. Results: Based on available evidence and theoretical literature, a program was created to address athletes‟ psychological and physical needs during periods of transition and injury. The Occupational Adaptation model and Self-Determination Theory were utilized as the foundation for the development of this program. The product includes a number of assessments, which are the Athletic Identity Measurement Scale (AIMS), Canadian Occupational Performance Measure (COPM), Brief COPE, Life Roles Inventory, and Disabilities of the Arm, Shoulder, and Hand (DASH). These assessments will be used to measure and understand the athlete‟s perspective of readiness to return back to sport or transition out of sport, ability to cope, and self-identification of life roles. The goal of this program is to ensure the athletes‟ transition is a healthy process, that the athlete is physically and mentally ready to return to his or her sport, or to facilitate a healthy transition out of competitive athletics. The final product of this project is a program, in the form of a manual, that occupational therapists can use during the rehabilitation process to guide the physical and psychological rehabilitation of the athlete. Interventions may include the athlete‟s development of coping skills, promotion of healthy social supports, setting realistic expectations and goals, maintenance of open lines of communication between coaches, family, rehabilitation team members and teammates, and recognition of components of identity outside of sport. ix Conclusion: This program is intended for implementation in sports medicine facilities, outpatient clinics, hospitals, high school, collegiate, and professional athletic teams. The program is anticipated to promote healthy transition both physically and psychologically following injury, career termination from sports, and developing healthy lifestyle habits after participation in competitive athletics.
Dr. Debra Hanson Stephanie Blonigen & Danielle Schepers
Bringing occupation to Long Term Care settings
Bringing Occupation to Long-Term-Care Settings. Danielle Schepers, Stephanie Blonigen, & Dr. Debra Hanson, Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202. Purpose: As a person enters a long-term-care (LTC) facility, they lose their home, independence, possessions and routine (O‟Sullivan, 2004). Adopting a meaningful occupational or social role may improve psychological well-being in elders (Keung Yuen, Huang, Burik, & Smith, 2008). There is a need for resources to support the use of occupations as treatment modalities in LTC settings. The purpose of this scholarly project is to address this need. Methods: A literature review was conducted using AOTA, AJOT, OT Practice, CINAHL, SCOPUS, and PubMed on topics relating to the populations served in LTC, and types of OT intervention used in LTC. Issues concerning occupation-based treatment, resources and contexts that support occupation-based practice, the Model of Human Occupation (MOHO), and occupation-based assessments were explored. Results: Occupation-based kits were developed to enhance the OT practitioner‟s ability to provide intervention ideas based on the needs and interests of the client. A manual was developed which provides practitioners with a resource for providing assessment and intervention guided by theory. Two case studies were developed in conjunction with occupation kits to guide the practitioner in appropriate use of the product. Conclusion: The challenge for today‟s clinician is to encourage meaningful, purposeful occupation while meeting the needs of the health care system such as coping with increasing caseloads and institutional pressures (Rogers, 2007; Zimmerer-Branum & Nelson, 1995). To overcome these barriers, a manual was developed to guide implementation of occupation-based intervention via occupation-based kits. This manual is an organized, easy to use, quick reference tool to enhance clinicians‟ ability to provide meaningful occupation-based intervention to clients in LTC settings.
Professor Breann Lamborn Johanna Meister & Sarah Averett Amanda Ralston & Luke Wavra
Riding the Wave: A Guide for Implementing Biofeedback in Occupation-Based Interventions in a Rehabilitative Setting Resource Manual for Occupational Therapists: Providing Transportation Related Resources to the Elderly Living in Poverty in North Dakota
RIDE THE WAVE: A GUIDE FOR IMPLEMENTING BIOFEEDBACK IN OCCUPATION-BASED INTERVENTIONS IN A REHABLITATION SETTING. Sarah Averett, MOTS and Johanna Meister, MOTS & Advisor: Breann Lamborn, MPA. University of North Dakota School of Medicine & Health Sciences, Department of Occupational Therapy, 2751 2nd Ave N. Hyslop 210,Grand Forks, ND 58202 Historical and current research studying EMG biofeedback has shown this method to be an effective adjunct to occupational therapy intervention. Utilizing EMG biofeedback has been shown through research as effective in improving functional gains. The use of biofeedback allows an individual to visualize unseen physiological processes which are unique to each individual and provide better understanding of otherwise unseen functions (Laurenção, Battistella, Moran de Britto, Tsukimoto, & Mayizaki, 2008). An extensive literature review and students‟ observations of clinical occupational therapy practice led the investigators to conclude that EMG biofeedback was a viable treatment method which has not been utilized to the full potential. The purpose of the scholarly project was to determine the effectiveness of EMG biofeedback through research and develop a resource guide for occupational therapists interested in implementing this method into treatment in a rehabilitative setting. The product developed consisted of eight sections which were selected to provide an overview of EMG biofeedback information and pertinent resources to assist an individual in determining how this method could be implemented during occupation-based interventions.
Resource Manual: Providing Transportation Related Resources to the Elderly Living in Poverty in North Dakota. Amanda Ralston, MOTS, Lukas Wavra, MOTS & Breann Lamborn, MPA. University of North Dakota School of Medicine & Health Sciences, Department of Occupational Therapy, 2751 2 nd Ave N. Hyslop 210,Grand Forks, ND 58202 Between the ages of 65 and 74, 9% of elderly individuals live in poverty in the United States (Forum, 2010). This poverty rate increases to 11% in elderly individuals who are 75 years of age or older (Forum, 2010). In rural areas, the effects of poverty may be even more pronounced than in urban areas secondary to the societal limitations that exist within some small rural communities; rural areas in North Dakota routinely face both the effects of poverty and the societal limitations. These limitations may include a lack of public transportation or services available to the general public. Due to limited urban areas and a low population, North Dakota has experienced rural depopulation over the past few decades (North Dakota State Data Center, 2012). With more of North Dakota‟s younger citizen moving to urban areas, the state has had to cut funding to the rural communities, resulting in greater difficulties for the elderly individuals who continue to reside in those areas (North Dakota State Data Center, 2012). With the growing trend of rural depopulation, the low occurrence of elderly individuals relocating to urban areas, and the increasing elderly population in North Dakota, further research needs to be conducted regarding the elderly living in poverty in North Dakota (North Dakota State Data Center, 2012). In addition, occupational therapists who work in rural areas with limited community resources may experience a greater demand for services and requests to provide services outside traditional areas of expertise [i.e. advocating for transportation in rural areas] (Payne, 2005; Vissing, 1996). The overall goal of the resource manual is to provide a practical, user-friendly, theoretical model-driven occupational approach using the Occupational Adaptation model for occupational therapists who must advocate for transportation related services for elderly individuals who live in poverty in North Dakota. The process that was used to guide this scholarly project started with an extensive literature review to determine the need for occupational therapy advocacy regarding services for individuals who live in poverty. Upon researching credible websites, government websites, documents, and research articles the scholarly project developed into a resource tool for occupational therapist to provide information related to transportation for elderly clients living in poverty in rural areas. The title of the project was named „Resource Manual: Providing Transportation Related Resources to the Elderly Living in Poverty in North Dakota’. The literature review provided information that helped narrow the authors occupation-based focus to transportation related services due to a lack of information regarding poverty and transportation related services. To further narrow the scope of the project, the authors chose to focus specifically on elderly individuals living in poverty in North Dakota as these individuals do not have the same access to healthcare as those who are not living in poverty (Horton & Johnson, 2010). It is here that the problem identified the need for the resource manual; occupational therapists must advocate for their elderly patients who are living in poverty in order for them to obtain the necessary resources for the occupation of transportation. Further, due to the absence of available research specific to North Dakota, this gap in the literature review suggested to the authors that many occupational therapists may not have adequate resources available to be able to efficiently and effectively advocate for their elderly clients living in poverty in North Dakota; the importance of a resource manual related to transportation was apparent. The product for this scholarly project is a resource manual for occupational therapists, which can be available in digital copy, to provide transportation related resources to elderly individuals who live in poverty in North Dakota. This resource manual addresses a serious need for elderly individuals, living in poverty in North Dakota, who are seeking occupational therapy services; advocacy and low to no-cost available resources were identified as optimum sources of information. The original concept for this scholarly project originated from mutual interested of both the authors, which was advocacy and poverty, along with recommendations from faculty in the OT department who have identified this need in their own work with clients. Upon conducting further research, it was evident that there was ample research that had been done on the occupational therapy role of advocacy in general, but information related to low or no-cost (i.e. client-centered) care to individuals who live in poverty in North Dakota, that also focused on transportation, was sparse to non-existent. The Occupational Adaptation (OA) model was selected to help guide the authors in identifying best-practice techniques while keeping the client-centered focus in their design; all aspects of the individual were taken into consideration including physical, mental, emotional, and psychosocial aspects of the elderly individual. The OA model was explained in detail in the literature review in order to provide the reader with a sufficient understanding of the main concepts and language of the model in order to be able to apply the model appropriately. The product then utilized the information from the literature review and simplified the main concepts and language of the model into an easy to read format so that it could be used as a quick reference for a therapist who is working with a client. The OA model information in the product was centered around helping the client achieve relative mastery by allowing them to become their own agent of change; for those therapists who are interested, the detailed explanation of main concepts can be located in the literature review. Therapists may become overwhelmed when advocating for transportation related services as this topic is not a traditional or everyday issue for most occupational therapists. This resource manual serves to assist therapists by acting as a reference guide for free or low cost services related to transportation for elderly individuals living in poverty in North Dakota. This manual was designed with a client-centered focus by utilizing free or low cost services that the occupational therapist can access for the client prior to referring the client to a costly vision exam or full driving evaluation. In rural areas, occupational therapists may experience
increased intervention demands outside their traditional areas of practice (Payne, 2005; Vissing, 1996). This resource manual allows occupational therapists to educate themselves in directing their focus toward available, convenient, and credible resources explained in detail, including implementation and purpose via the manual.
Dr. Mandy Meyer Chelsey Edwards & Amy Ferguson Amanda Rositas & Kathryn Zavoral
Embracing Life with ALS: The Role of Occupational Therapy from Diagnosis to End of Life Care Caring for Individuals with Fibrodysplasia Ossificans Progressiva (FOP): A Treatment Manual for Occupational Therapists.
Caring for Individuals with Fibrodysplasia Ossificans Progressiva (FOP):A Treatment Manual for Occupational Therapists. Amanda Rositas, MOT, Kathryn Zavoral, MOT, and Advisor: Mandy Meyer, Ph.D. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND 58202 The purpose of this scholarly project is to provide a guide to be utilized by occupational therapists to enhance the treatment for individuals diagnosed with Fibrodysplasia Ossificans Progressiva. Fibrodysplasia Ossificans Progressiva is a rare disabling genetic disorder that results in ossification of the soft tissues. There is a lack of research and literature on therapeutic intervention for those with a diagnosis of Fibrodysplasia Ossificans Progressiva. The manual consists of an overview of Fibrodysplasia Ossificans Progressiva, treatment guidelines, assessments, and interventions for various occupations. A literature review was completed to determine what Fibrodysplasia Ossificans Progressiva is, the severity of the disease, and what research was available for occupational therapists regarding this disease. This lead to a further review of current research regarding the role of occupational therapists with an individual diagnosed with a rare disease It is recommended that further research be done regarding occupational therapy treatment for individuals with Fibrodysplasia Ossificans Progressiva. More evidence-based research is needed to ensure quality treatment is provided for individuals diagnosed with Fibrodysplasia Ossificans Progressiva. Providing occupational therapists with this manual would give them important guidelines to consider when providing therapy to individual‟s with Fibrodysplasia Ossificans Progressiva. Through implementation of this manual, it is anticipated that more occupational therapists will feel they have resources available to allow them to provide quality care to those diagnosed with Fibrodysplasia Ossificans Progressiva.
Embracing Life with ALS: The Role of Occupational Therapy from Diagnosis to End-of-Life Care. Chelsey Edwards, Amy Ferguson, and Advisor: Mandy Meyer, Ph.D. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND 58202 Objective: The purpose of this scholarly project was to develop a comprehensive document that describes the role of the occupational therapist in working with clients and families affected by Amyotrophic Lateral Sclerosis (ALS) from diagnosis to end-of-life care. Methods: A literature review was conducted using the AJOT, PubMed, CINAHL, and OT SEARCH databases. Information was gathered regarding current literature of ALS, the disease process, occupational therapy‟s role in ALS treatment, caregiver‟s role in end-of-life care, assistive technology, palliative care options, and additional support strategies. Additional ALS material was gathered from the ALS Association‟s information manuals. Results: Designed from the perspective of the Canadian Model of Occupational Performance-Enablement, the product, “Embracing Life with ALS: The Role of Occupational Therapy from Diagnosis to End-of-Life Care” was created. Conclusions: As there is minimal research to describe the role of the occupational therapist in ALS care, it is recommended that further research be completed in this area. In addition, the implementation and documentation of this product is recommended for further development and improvement.
Dr. Jan Stube Erika Swirzcki & Andrea Young
An Occupation-Based Protocol Designed for Women with Cardiac Conditions.
An Occupation-Based Protocol Designed for Women with Cardiac Conditions. Erika Swirzcki, Andrea Young & Jan Stube, Ph.D., OTR/L, Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202
Coronary heart disease is the leading cause of death in women worldwide as well as the number one cause of death in the United States (American Heart Association [AHA], 2010). Women are not adequately represented when entering phase II of cardiac rehabilitation due to the numerous barriers that they may experience. The purpose of this scholarly project was to help meet women‟s unique needs and facilitate their return to meaningful life roles and occupations after experiencing a cardiac event. This protocol provides guidelines for occupational therapists to use during phase II of cardiac rehabilitation and addresses the implementation of occupation-based treatment. Elements of the protocol include: evidence-based occupational therapy assessments, a home evaluation, as well as group-based intervention sessions and individual reflective assignments on stress and anxiety management, assertive communication with others, activity MET-level modification, and home environment adaptation. Analysis of findings from the literature review revealed several factors that are important to the process of cardiac rehabilitation for women including: quality of life, psychosocial, physical, and social aspects as well as consideration of barriers. The literature review highlighted certain barriers that women experienced when entering cardiac rehabilitation such as: lack of physician referrals, availability of services, and transportation (Rolfe Sutton, Landry, Sternberg, & Price, 2010). The social context was found to be highly important for women with cardiac conditions and who attend cardiac rehabilitation. Peer, professional and family support also helped encourage and motivate women to continue participating in a cardiac rehabilitation program. The Ecology of Human Performance (EHP) was utilized in development of the protocol because it places emphasis on environment and varying contexts that play an important role in the lives of women with cardiac conditions. Social contexts and home environments were the leading contextual considerations for occupation-based activities suggested in the protocol. Occupational therapists have the potential to play a significant role in Phase II of cardiac rehabilitation.
Dr. Carla Wilhite Nicole Likewise & Theresa Podio Greg Holubok & Andrea Hensrud
Growing occupational identity: The use of agricultural entrepreneurship for young adults with disabilities to successfully enter, adapt, or inhabit the worker role A Lifetime of Work: A Guide to Health Promotion and Wellness on the Farm
A Lifetime of Work: A Guide to Health Promotion and Wellness on the Farm . Andrea Hensrud, MOTS; Gregory Holubok, MOTS and Advisor: Carla Wilhite, MNM, OTR/L. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202 The purpose of this project is to develop a guide to health promotion, wellness and adapting to life changes on the farm from an occupational therapy perspective to enhance quality of life for aging farmers and rural community dwellers. The authors completed a focused literature review on topics related to health promotion, wellness, adapting to life changes, making changes and aging in place. Data was collected through an extensive study of relevant information through professional journals, clinical text books, class discussion and related state and national associations. Upon completion of the review of literature, it was determined that older adults would benefit from resources guiding their continued participation within their own contexts resulting in an increase in quality of life. The guide to health promotion and wellness is designed within the foundation of the Ecology of Human Performance (EHP) model and the Seven Dimensions of Wellness model for aging individuals on the farm. EHP provided a framework for interventions of adapting/modify, altering/ preventing (further problems) within the environment by looking at the person, task, context, and person-context-task interaction. The Seven Dimensions of Wellness (Witmer and Sweeney, 1992) encompasses a greater depth of the experience of the individual in all dimensions of his or her life. These dimensions include: social, emotional, spiritual, environmental, occupational, intellectual, and physical dimension. The Seven Dimensions of Wellness is being used within the product as a way to incorporate the holistic view of our consumers and provided a deeper resulting guide is a selfassessment tool to be used by farmers to promote longevity while living on the farm. It addresses issues related to aging in place,
how to survey the farm, and the importance of accessibility and participation within a chosen context. The guide is designed to be disseminated directly to working farmers, or provided by other healthcare and non-healthcare professionals working with farmers. This guide is tool for aging individuals, family/caregivers, and related professions working within the rural community. The goals of the guide are two-fold: (1) To increase the quality of life in aging farmers by empowering them to make the appropriate changes necessary to successfully age in place, and (2) to be used by all disciplines/professions in a variety of contexts working with aging farmers.
GROWING OCCUPATIONAL IDENTITY: THE USE OF AGRICULTURAL ENTREPRENEURSHIP FOR YOUNG ADULTS WITH DISABILITIES TO SUCCESSFULLY ENTER, ADAPT, OR INHABIT THE ROLE OF WORKER. Nicole Likewise, MOTS, Theresa Podio, MOTS and Advisor: Carla Wilhite, OTD, OTR. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202 “We know what we are, but not what we may be.” – William Shakespeare Purpose: The purpose of this project was to develop a grant proposal in order to obtain funding for the development of an entrepreneurial program for young adults with disabilities transitioning into adulthood in rural Wyoming. Through participation in the program young adults would have the opportunity to pursue entrepreneurship in sustainable agriculture while concurrently developing an occupational identity. Methods: A selected literature review was conducted to identify the scope of the problem and identify what, if any, programs are currently being offered to assist youth transition to the worker role. Partnerships were developed with key stakeholders in developing the proposal; resulting in a grant application to the Western Sustainable Agriculture, Research, and Education program. Conclusions: There are limited opportunities for young adults with disabilities transitioning to adulthood in rural Wyoming to develop a meaningful occupational identity in a worker role. Entrepreneurial endeavors in sustainable agriculture are a viable alternative to establish this identity, promote economic independence and promote community wellness.
Dr. Sonia Zimmerman Crystal Brecht & Jenna McGregor
Illness Management and Recovery: Role of Occupational Therapy
Illness Management and Recovery: The Role of Occupational Therapy. Crystal Brecht, MOTS, Jenna McGregor, MOTS and Advisor: Sonia Zimmerman, Ph.D., OTR/L. Department of Occupational Therapy, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road, Grand Forks, ND 58202 Purpose: The Illness Management and Recovery (IMR) model is a collaborative program that focuses on living with a chronic mental illness by educating the client on management techniques that will facilitate goal setting toward recovery (Mueser et al., 2006).The purpose of this scholarly project was to review the occupational therapy (OT) literature and determine the role of OT in IMR programs. Method: A comprehensive review was conducted on occupational therapy interventions appropriate for inclusion in the IMR modules. Sources utilized for the review included: United States and international OT journals, OT textbooks, and other publications authored by OTs from the years 2002 to 2011.The strength of the literature within each module was evaluated and the determination made that a need exists for a guide establishing and supporting the role of OT in IMR implementation. Results: The review of the literature indicated limited researched evidence showing implementation of OT in the IMR model; however, there were indications and evidence to suggest OTs may have a role within the IMR model. There is evidence supporting the role of OT within each modules, however there is limited support within „Using Medication Effectively, Reducing Relapse, and Getting Your Needs Met in the Mental Health System.‟ The lack of evidence can limit the role of OT within the mental health system. This can also be problematic for OT practitioners and managers as there will not be a clear understanding of the role of OT and the profession‟s scope of practice. Therefore, two guideline documents were developed for OT practitioners and non-OT managers to define the role of OT in IMR model programming.
Conclusions The guideline documents justify the need for OT services to managers who may or may not be OTs; further, the documents provide direction to OT practitioners as service providers in IMR model programming. The guidelines serve to enhance support for the role of OT in IMR implementation and provide guidance during the intervention process within the 10 modules for practicing OTs who are members of the IMR recovery team.
