Catálogo de publicaciones - revistas

<jats:p> Background. According to the existential philosophers, meaning, purpose and choice are necessary for quality of life. Qualitative researchers exploring the perspectives of people who have experienced health crises have also identified the need for meaning, purpose and choice following life disruptions. Although espousing the importance of meaning in occupation, occupational therapy theory has been primarily preoccupied with purposeful occupations and thus appears inadequate to address issues of meaning within people's lives. Purpose. This paper proposes that the fundamental orientation of occupational therapy should be the contributions that occupation makes to meaning in people's lives, furthering the suggestion that occupation might be viewed as comprising dimensions of meaning: doing, being, belonging and becoming. Drawing upon perspectives and research from philosophers, social scientists and occupational therapists, this paper will argue for a renewed understanding of occupation in terms of dimensions of meaning rather than as divisible activities of self-care, productivity and leisure. Practice implications. Focusing on meaningful, rather than purposeful occupations more closely aligns the profession with its espoused aspiration to enable the enhancement of quality of life. </jats:p>

<jats:p> Background. In 1986, Estelle Breines argued that occupational therapy identity problems could be resolved by acquiring tools that enable therapists to analyze their profession in a sophisticated manner. Breines identified philosophical inquiry as one of these tools. Purpose. This study examined how pragmatism can provide a philosophical framework for occupational therapy practice and knowledge. Method. An analysis of a sample of occupational therapy literature, philosophy of pragmatism literature, and Slagle lectures delivered between 1955 and 1995 was completed. Themes underlying the assumptions, principles, and values articulated in the literature and the Slagle lectures were identified and compared. Results. Findings of the analysis indicate that some of the core assumptions, principles, and values of occupational therapy as identified in occupational therapy literature and the Slagle lectures are conceptually consistent with those of the philosophy of pragmatism. Practice Implications. Pragmatism may provide a philosophical framework to organize the knowledge and practice of occupational therapy and assist with clarifying the profession's identity. </jats:p>

<jats:p> Background. Occupational therapists propose that occupation is a basic human need across the lifespan. However, there is limited understanding of how occupation contributes to the end-of-life experience. </jats:p><jats:p> Purpose. The purpose of this study was to examine the embodied nature of occupation at end of life from the perspectives of Canadians 60 years of age or older who are diagnosed with a terminal illness. </jats:p><jats:p> Methods. The study adopted a phenomenological methodological approach to conduct semi-structured interviews with eight participants. </jats:p><jats:p> Findings. Six themes were identified. Participants described orientations toward occupations that involved: living with death, reworking everyday life, being guided by the will of the body, giving priority to relationships, attending to the small things, and engaging existential orientations. </jats:p><jats:p> Implications. This study contributes to knowledge about occupation at end of life and offers a starting point to guide practice that is attentive to the lived dimensions of occupation at end of life. </jats:p>

<jats:sec><jats:title>Background</jats:title><jats:p> Gender identity disorder and the process of transitioning involve both mental and physical health, yet there is virtually no discussion of transgender health care in occupational therapy. </jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p> This study draws on interviews with primary-care nurses and physicians about their experience with transgender health care, extending the insights gleaned there to make suggestions for occupational therapy practice with this population. </jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p> Semi-structured interviews were conducted with 12 primary care nurses and 9 physicians who had clinical experience with lesbian, gay, and bisexual patients. </jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p> Participants felt uncertain about transgender care, wanting more specialized knowledge. Collaborating with patients, acknowledging stigma, ensuring inclusive systems and procedures, navigating health care, and providing holistic care emerged as key elements for best practice. Advocacy was a crucial part of care provision. </jats:p></jats:sec><jats:sec><jats:title>Implications</jats:title><jats:p> Suggestions are provided for therapists to ensure that space and interactions are welcoming to transgender clients as well as suggestions for occupational therapy intervention in the transitioning process. </jats:p></jats:sec>

<jats:sec><jats:title>Background.</jats:title><jats:p> The Canadian Model of Occupational Performance and Engagement depicts individuals embedded within cultural environments that afford occupational possibilities. Culture pertains not solely to ethnicity or race but to any dimension of diversity, including class, gender, sexual orientation, and ability. </jats:p></jats:sec><jats:sec><jats:title>Purpose.</jats:title><jats:p> This paper highlights specific dimensions of cultural diversity and their relationships to occupational engagement and well-being. </jats:p></jats:sec><jats:sec><jats:title>Key issues.</jats:title><jats:p> Cultural variations constitute the basis for a socially constructed hierarchy of traits that significantly determine occupational opportunities and impact mental health and well-being. Cultural humility is an approach to redressing power imbalances in client-therapist relationships by incorporating critical self-evaluation and recognizing that cultural differences lie not within clients but within client-therapist relationships. </jats:p></jats:sec><jats:sec><jats:title>Implications.</jats:title><jats:p> It is proposed that theoretical relevance would be enhanced if culturally diverse perspectives were incorporated into theories of occupation. Cultural humility is advocated as an approach to theoretical development and in efforts to counter professional Eurocentrism, ethnocentrism, and intellectual colonialism. </jats:p></jats:sec>

<jats:sec><jats:title>Background.</jats:title><jats:p> Sexuality is an important dimension of one’s health and well-being. Studies show that occupational therapists regard clients’ sexual health as a legitimate domain of practice but do not adequately address it in their clinical work. </jats:p></jats:sec><jats:sec><jats:title>Purpose.</jats:title><jats:p> This study aims to describe occupational therapists’ perspectives regarding clients’ sexual health. </jats:p></jats:sec><jats:sec><jats:title>Method.</jats:title><jats:p> This exploratory study surveyed Canadian occupational therapists using an online questionnaire that collected information on beliefs, knowledge, comfort, barriers, and facilitators with regard to addressing sexuality. Descriptive analysis was conducted on questionnaire data, and content analysis was used to organize respondents’ comments. </jats:p></jats:sec><jats:sec><jats:title>Findings.</jats:title><jats:p> While most respondents believed that addressing sexuality was within their scope, few actually did so in practice. Participants reported comfort with sexuality but identified lack of knowledge as a barrier to addressing clients’ sexual health. </jats:p></jats:sec><jats:sec><jats:title>Implications.</jats:title><jats:p> This study provided a greater understanding of factors that require consideration for occupational therapists to effectively meet clients’ sexual health needs. </jats:p></jats:sec>

<jats:p> Background. The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life with corresponding implications on levels of distress. Purpose. To describe factors associated with high distress among community-dwelling older adults during the first lockdown and explore how occupational participation was managed. Methods. A mixed methods design whereby multivariate regression analysis of a survey ( N = 263) identified factors associated with high distress, as per the Impact of Events of Scale-Revised (IES-R). Follow-up interviews with a sub-sample of those surveyed who reflected a range of IES-R scores were conducted ( N = 32). Findings. Those with lower resilience and anxiety/depression had 6.84 and 4.09 greater odds respectively of high distress. From the interviews, the main theme, “Lost and Found,” and subthemes (Interruption and Disruption; Surving, not Thriving; Moving Forward, Finding Meaning) highlighted the process and corresponding stages, including adaptive strategies, by which participants navigated changes in their occupational participation. Implications. While the results suggest that many older adults, including those with high distress, were able to manage daily life under lockdown, some experienced ongoing challenges in doing so. Future studies should focus on those who experienced or who are at-higher risk for such challenges to identify supports that mitigate adverse consequences if another event of this magnitude occurs again. </jats:p>