#OTalk 10th Dec 2019 The importance of evidence-based practice in OT

This week #OTalk will be hosted by Susan Griffiths – @SusanGriffiths5  here is what she had to say;

The use of evidence-based practice has become increasingly important in occupational therapy practice.  As occupational therapists we all want to provide occupation-based interventions for our clients that actually work. However, in reality this is challenging especially in the UK where the NHS services are underfunded and yet we are still expected to deliver evidence-based interventions on limited resources.

This has got me wondering what interventions is everyone using in practice. I know in my workplace, the OTs are using a mixture of OT interventions but not all of them are supported by research evidence (at least not yet).

In a society where we are under pressure to provide evidence based interventions on increasingly limited resources, why do we as OTs still persists in using interventions that have limited evidence? So, with this in mind, I would like to invite you all join me in a discussion where the following questions will be asked:

  1. What evidence-based interventions are you currently using in practice?
  2. What are or have been the challenges or barriers to providing evidence-based interventions?
  3. What interventions are you using that you know has limited or emerging evidence and why?
  4. Should we only be using evidence-based interventions?
  5. What can we do to increase the evidence for occupation-based interventions in our daily practice?

#OTalk Research 3rd Dec 2019 – Inclusive research for people who lack capacity to consent

This month’s #OTalk Research will be hosted by Dr Naomi Gallant (@naomi_gallant) on the important topic of how we can include people who lack capacity to provide informed consent in our research. Here’s what Naomi has to say:

 

The Mental Capacity Act (2005) stipulates that in order for a person to be deemed to have the mental capacity to make a decision they must be able to:
understand the decision they are making and the information relevant to it
retain the information relevant to the decision
weigh up or use the information to inform the decision making
– and be able to communicate their decision (by any means)

(https://www.hra.nhs.uk/planning-and-improving-research/policies-standards-legislation/mental-capacity-act/)

 

One of the most important principles of the assessing mental capacity is that each assessment is decision and time specific. Somebody may have the capacity to understand, retain, weigh up and communicate what they would like to eat or drink in a set moment but may not be able to use the same thought processes to make the decision about a discharge plan home from hospital. The ability to make any decision can also fluctuate.

Understanding and retaining the information needed to make an informed decision to participate in research can be a complicated one! As a group, people who lack capacity to consent to participate in research are often excluded. As clinicians we may be familiar with the MCA principles and feel confident performing mental capacity assessments. Researchers on the other hand, may not all have the clinical experience and so assessing capacity becomes a cumbersome part of recruiting participants for research. Consequently, there is a huge gap of important people’s voices in important research projects.

 

I’d like to explore the following questions in the Twitter Chat:

 

1) Which groups of people may be excluded from research due to lack of capacity?
2) What are people’s experiences of including people who lack capacity to consent in research and what barriers did you experience?
3) How can we overcome the barriers to including people in our research who lack capacity to consent, particularly when inviting them to participate?
4) What research methods can be more inclusive for people who lack capacity to consent to participation?
5) What can we offer as researchers who are Occupational Therapists to include more people who lack capacity to consent?

#OTalk 26th Nov 2019 – Driving After a Stroke

The RCOT Specialist Section Neurological Practice (SSNP) Stroke Forum welcomes you to the #OTalk on driving after stroke and invites you to participate in a tweet chat on driving following stroke. The chat will include the meaning of driving to us, the assessment of driving ability, methods of rehabilitation, and adjusting to life without returning to drive.

Driving is an occupation that, to many of us, represents a means of independence. This can include the independence to travel to work, to visit our family and friends, to support our everyday lives such as travelling to the supermarket, and to undertake our leisure activities. Much of our domestic and social lives are supported by us being able to drive and losing this ability would be highly likely to significantly impact on our lives.

In the UK, following a stroke, people are not permitted to drive for at least one month. After this time, people must not drive if there are enduring physical and cognitive limitations. Doctors may give the go-ahead for returning to driving if they consider that the person’s abilities are adequate. When there is uncertainty around a person’s abilities, a referral may be made to a driving assessment service where the person will be tested with a combination of physical and cognitive assessments and an on-road test.

As stroke is a condition where varying degrees of recovery is possible, rehabilitation may be a means to improve a person’s ability to increase the chance of returning to drive. Rehabilitation to improve independence in most occupations usually includes the practice of that occupation, but this is not possible with driving as people cannot legally drive before being assessed as competent. Thus, occupational therapy must depend on indirect methods of assessment and rehabilitation towards an outcome that is not guaranteed of returning to drive.

Please consider the following questions:

  1. What does the occupation of driving mean to you?
  2. How do you determine whether somebody can resume driving following the first month after stroke or whether testing at an official assessment service is required?
  3. How do you rehabilitate a person’s driving?
  4. How can occupational therapy help those who do not return to driving?

 

We hope the conversation resulting from the above questions will help us to understand different perspectives on driving after stroke and to discover methods which occupational therapists use to assess driving ability, to provide rehabilitation and to work towards developing alternatives to driving.

#OTalk 19th Nov 2019 Sex work and Occupational Therapy.

This week Rachel Rules ‪@_rachelOT and ‬ ‪ Rebecca Twinley‬ ‪@RebeccaTwinley‬ will be leading the chat,  here is what she had to say…

Sex work holds a ‘provocative place in the social psyche’(McCray, Wesely, & Rasche, 2011), yet sex work is a more commonplace role than society recognises. It is predicted that 40-42 million people engage in sex as work globally (Fondation Scelles, 2016), however, there are complications in making this estimate due to the covert nature of sex workand the actual amount is likely much higher. Sex workers are a diverse community from a range of socioeconomic backgrounds – this community encompasses women, men, transgender and gender-diverse individuals – and ways of engaging in sex as work are equally as varied.

In the search for Occupational Therapy literature related to this community of people, it was found that there is a dearth of research from an occupational perspective. Though, Ecklund, Arana, Henning, Lopez, Patel and Varnell’s (2018) phenomenological study explores the facilitators and barriers to occupational participation for six female exotic dancers leaving the sex industry and recognises the role of the Occupational Therapist in working with this population.

When considering the promotion of health through occupation, the stigma that sex workers face can greatly contribute to marginalisation and alienation in society (Open Society Foundations, 2019). This can affect access to health care services and if a person chooses to leave sex work, future working roles.

When considering the lives of sex workers as occupational beings, it is useful to consider the concept of the ‘dark side of occupation’ (Twinley, 2013), in exploring the unexplored and ensuring that people and their occupations are not ‘censored’ or ‘condemned’.

The aim of this #OTalk is simply to encourage thinking about Occupational Therapists’ knowledge, pre-conceptions andabilities in working holistically with sex workers.

This #Otalk differs, in that I have invited the sex workers of twitter to engage in the latter part of the talk, in the hope of capturing their experiences of accessing mainstream healthand social care services and to learn how we can improve our services and approach.

Questions.
1. What is your current knowledge and understanding of sex as work?

2. Do you believe that discussing sex work is within your remit as an Occupational Therapist?

3. Are you aware of any non-mainstream or sex worker specific services in your community that you could signpost sex workers to, if they wished to access them?

4. What do you perceive the Occupational Therapy role to be in working with sex workers in your community?

5. The following two questions are directed at people who engage in sex as work – Do you have any experiences to share in accessing ‘mainstream’ health and social careservices (for both physical and mental health)? Do you disclose your work?

6. Is there anything that you think could be improved? What would you like health and social care professionals to know?

Post Chat Updates:

Online Transcript: #OTalk Transcript from www.symplur.com/healthcare-hashtags/OTalk

PDF of transcript: #OTalk 19 Nov 2019

The Numbers

1.579M Impressions
472 Tweets
76 Participants

#OTalk Participants

References.

Eckland, E., Arana, J., Henning, L., Lopez, J., Patel., R. & Varnell, J. (2018) Exploring the role of occupational therapy with women leaving the sex industry. American Journal of Occupational Therapy, 72, 1.

Fondation Scelles (2016) Prostitution. Exploitation, persecution, repression. Retrieved from https://www.fondationscelles.org/pdf/RM4/1_Book_Prostitution_Exploitation_Persecution_Repression_Fondation_Scelles_ENG.pdf

McCray, K., Wesely, J. K., & Rasche, C. E. (2011). Rehab retrospect: Former prostitutes and the (re)construction of deviance. Deviant Behavior, 32(8), 743–768.

Open Society Foundations (2019). Understanding Sex Work in an Open Society. Retrieved from https://www.opensocietyfoundations.org/explainers/understanding-sex-work-open-society

Twinley, R. (2013) The dark side of occupation: a concept for consideration. Australian Occupational Therapy Journal, 60(4), 301-303.

 

#OTalk Research 5th Nov 2019 – Innovation – Do Occupational Therapists have a role to play?

This talk will be hosted by Dr Karen Bell, R&D Manager, NHS Ayrshire and Arran @RDAyrshire and Jenny Preston @preston_jenny will support on the #OTalk account.

Innovation – Do Occupational Therapists have a role to play?

Health care innovation is defined by NHS Chief Executives as

“An idea, service or product new to the NHS or applied in a way that is new to the NHS which significantly improves the quality of health and care wherever it is applied”.1 

Innovation is part of a complex landscape of drivers to improve the care that health and social care providers deliver. More familiar drivers are quality improvement programmes, NICE guidelines, research and development projects. In the last few years innovation has become a buzz word in the NHS with a number of large scale initiatives such as the Industrial Centre for Artificial Intelligence Research in Digital Diagnostics (ICAIRD) in Scotland. Artificial intelligence to streamline review processes and aid diagnostics along with Precision Medicine are increasingly touted as being the future game changers for the health service. 

However the NHS still faces huge challenges – a shrinking, more elderly workforce, an increasingly frail population with complex multi-morbidities and a drive to deliver care in a home or community environment and the questions remains what role if any can innovation play in tackling these issues and how can staff be involved given the service pressures that they face?

NHS England includes Innovation within Chapter 3 of their NHS Long Term Plan2 with the following commitments:

  • We will speed up the pipeline for developing innovations in the NHS, so that proven and affordable innovations get to patients faster. 
  • Uptake of proven, affordable innovations will be accelerated through a new Medtech funding mandate. 
  • We will invest in spreading innovation between organisations.
  • As UK-led innovations are proven as ‘ready for spread’ in England, we will support their global export through the work of Healthcare UK. 

The Catalyst for Health and Social Care Innovation in Scotland3 is a collaboration between NHS Boards, Integrated Joint Boards and Innovators to develop solutions for service delivery problems. The focus is on identifying priorities that are important, doable, of value and benefit and that there is an opportunity to develop and deliver solutions that can be adopted.

Occupational therapists are no strangers to innovation and routinely demonstrate innovative approaches to practice.  We have considerable experience in the use of technology enabled innovations both in the delivery of care and through environmental adaptation and modification.  Yet at times we don’t recognise our contribution to innovation or indeed acknowledge that our work is innovative.

This #OTalk will facilitate a discussion about what innovation means to occupational therapy research and practice.  In advance of the #OTalk you may wish to consider the following:

Questions

What does Innovation mean to you?

How do you feel about Innovation?

What are the limiting factors in developing an innovative workforce?

Do you have time to be innovative?

How likely is your service/practice to adopt innovation?

Post Chat updates:

Online transcript: OTalk Transcript from www.symplur.com/healthcare-hashtags

PDF of transcript: #OTalk 5 Nov 2019

The Numbers

2.196M Impressions
367 Tweets
56 Participants

#OTalk Participants

References

  1. NHS Chief Executive Innovation Review. Call for evidence and ideas. 2011
  2. NHS England (2019) The NHS Long Term Plan.  Department of Health and Social Care
  3. Catalyst for Health and Social Care Innovation in Scotland Phase One – Summary 2019. Funding, Investment and Partnering for Industry, NHS and Social Care. 

Happy Birthday to us OTalk is eight today! – Two OTalk internships opportunities up for grabs!

We are 8 today!!  Where did the time go as part of our celebrations we are recruiting one OT student intern and one Qualified or Retired Occupational Therapist intern to join our team.

8years

#OTalk is a community that welcomes students alongside practitioners and academics, recognising the vital role students can play in bringing fresh knowledge, innovation and enthusiasm to the community.  To foster this collaboration, in 2015 #OTalk introduced the position of Student Digital Leader.

This year we also want to open up the opportunity for a qualified or retired Occupational Therapists . These Intern roles offers the opportunity to become involved in the running of #OTalk for 6-12 months whilst receiving mentoring in digital leadership from the team.

Being part of the #OTalk team allows you to be creative, innovate and work as part of team. As a Intern these are some of the activities you could be involved in and be responsible for during your internship:

OTalk Project. As part of your internship we hope you would be able to contribute in an innovative way to the #OTalk community by undertaking some form of project. This will be agreed between yourself and the rest of the OTalk team after you join the team.

 OTalk Website – Transcript posting. To support the team in posting blog transcripts on the blog posts within 48 hours of a chat and sharing this with the #OTalk community on the social media platforms.

 OTalk Facebook. To monitor the facebook page, replying to comments and ensuring blogs have been shared within other relevant pages and groups (e.g. 4OT groups and Student Occupational Therapy groups/pages)

 OTalk Twitter – Promoting. To regularly tweet from OTalk and personal accounts to promote the chats and other related activities.

OTalk Twitter – Follows. To review follows on the OTalk Twitter account, block spam accounts and to follow back/create lists for the OTalk account.

 OTalk Twitter – Hosting. To host a minimum of one chat during the internship and to support an additional two chats with guest hosts (Training will be provided – more can be hosted as desired).

Promoting OTalk. To take and create opportunities to promote #OTalk and the benefits of professional social media use within university populations and regional/geographical networks.

 OTalk Experience Summary. Along with the OTalk crew,  write up an account of the experience of interning for publication.  This can be done in a range of ways and we are open to finding new and creative ways to share this experience Our first intern Kelly did this by displaying a poster at #COT2016 and our second Kirstie wrote a piece with Kelly for OTNews. Our last intern Caroline also Worte a reflection for OT news.

 OTalk Development, including becoming a charity.  Engagement in online team meetings to review chat effectiveness, suggest future development and feedback on the relevance of OTalk.  This year we would like to register as a charity, and be able to raise some funding, to help support OTalk, including the costs of running the website, and the team attending events to promote OTalk.

Interns ideally need to be:

  • UK or Ireland based
  • Excellent communicators
  • Familiar with the use of twitter
  • Familiar with the use of gmail, google calendars and google drive
  • Familiar with the use of skype
  • Familiar with wordpress blog editing dashboard
  • Able to create PDFs of transcripts and certificates
  • Available on Tuesday nights between 8pm – 9pm at least once a month
  • Available for 30 minutes on Thursday or Fridays to post chat transcript
  • Able to access the Internet and have a laptop/smartphone that will enable blog editing and twitter/Facebook access.
  • Passionate about the occupational therapy profession
  • Promoters of the positive application of social networking for professional development
  • Responsible and professional in their use of social media (social media accounts of applicants will be reviewed as part of the application process)
  • Engaging with CPD on a regular basis
  • Knowledge of setting up a charity and managing donations.

Training to use the relevant software will be provided so please still apply if you meet most of the outline above.

If you are interested in this position please send the following information to otalk.occhat@gmail.com:

A personal statement of no more than 500 words demonstrating your suitability for the internship.

A Biography of between 100-200 words (that includes your name and university/ area of work and a link to your LinkedIn profile) [Write this as if you are introducing yourself to the OTalk Community on the blog].

Your skype username.

The name and e-mail of a referee who can be contacted if you are invited to interview.

Please direct any queries to the our email or DM us on Twitter at @OTalk_

The closing date for applications is Tuesday 26th November 2019 at 23:59.

Shortlisted applicants will be invited to a skype interview in December and will invited to a Skype interview in January 2020.

#OTalk 29th October 2019 Yoga and Occupational Therapy

As always the chat will be live on twitter Tuesday 8pm UK time,  you can join in by using #OTalk,  This week Emily Kellett @EmilyKellett7 will be hosting this is what she had to say –

Yoga is becoming more a of ‘buzz word’ within the healthcare community and more frequently being explored by Occupational Therapists. I first found a love for yoga and mindfulness from a personal perspective and couldn’t believe the benefits my body and mind received – I just had to bring it in to my work!

Within my current role I support children and young people who experience significant sensory processing challenges which manifest as behaviours that challenge. Yoga naturally provides lots of yummy sensory information to our bodies including the increase of tactile information, body awareness and gentle movements which supports our central nervous system to reach a ‘calm and alert’ state.

This therefore, leads to better control over our emotions and thought processes through the inter-linking of body, mind and breath which can lead to improved confidence and self-esteem.

The powerful effect yoga has on calming the central nervous system (which is responsible for understanding how to process sensory information) can be transferred off the mat as well to help individuals within their daily lives.

Yoga is defined as a journey of self-discovery and empowerment; bringing the mind, body and soul together. It enables individuals to feel grounded and connected, creating a sense of control, not only over their own body and thoughts, but over situations in their life also which can be hugely empowering.

OT focuses on enabling individuals to engage in meaningful daily activities despite limitations in their physical, sensory and communication abilities. OT’s view individuals holistically, meaning they look at all aspects of their life, what is important to them and what barriers they may be facing which are preventing them from participating in such activities.

Therefore, yoga and OT both place emphasis on the ‘whole’ person and incorporate the use of the mind and body to enable individuals to live their life to the fullest.

Yoga not only develops our physical health by improving our co-ordination, balance, strength alongside our fine and gross motor skills; it also does a world of good for our mental and emotional wellbeing.

It can be done anywhere, by anyone, there is no time limit, expectations, demands or rules. It can be tailored to our individual needs at that time with faster and more energetic poses, as well as calming and more grounding positions.  It can positively impact on our levels of focus, attention, and stress management, as well as supporting an increased understanding of our bodies and knowing how to slow down and relax.

And finally, the big focus on breath in yoga allows our parasympathetic nervous system to come into play and calm our minds and bodies down; preparing us for rest and relaxation as well as supporting our digestion system to work effectively, giving us the nutrients we need to remain healthy!

So stretch, twist, explore and breathe and see how Yoga can benefit you!

The questions I would like to discuss are;

  • How do you think yoga and mindfulness techniques can be incorporated into your OT practice?
  • What are the barriers to introducing yoga and mindfulness as an OT?
  • How do you perceive yoga can influence occupational performance?
  • What evaluative tools would you use to measure the effectiveness of yoga and mindfulness within your OT practice?

POST CHAT

Online Transcript

#OTalk Healthcare Social Media Transcript October 29th 2019

The Numbers

651.332K Impressions
132 Tweets
24 Participants
106 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants