OTalk

#OTalk – 9th June 2020 – The Occupational Therapy role in Epilepsy assessment and intervention

This week @GarroneJuliana is hosting.

I thought the topic of the role of Occupational Therapy in epilepsy would be a valuable one to discuss. Throughout my MSc it was not discussed in great detail and I would love for people to share ideas with one another on this topic. As part of my education I completed a research project (thematic analysis) looking at quality of life in youth with epilepsy. It was a valuable project that opened my eyes to the various areas where OT can be involved with those who have epilepsy. It highlighted how a range of occupations can be impacted by a diagnosis of epilepsy. Additionally, I am currently completing a Community Development placement at an Epilepsy non-profit in Canada. Our project is to create a “Personalized Seizure Plan” focusing on how an individual’s occupations are impacted by epilepsy so they can education their caregivers, teachers, health care professionals, etc.

 

Epilepsy and its varied seizure types effect the physical, social, emotional, spiritual, recreational and vocational functioning of individuals and their families (Clerico, 1989). Occupational therapists can help find out why people have problems with activities of daily living and teach them ways of adapting or compensating for the problems (Epilepsy Foundation). In addition to the physical and social implications of epilepsy, epilepsy affects cognition, mood, affect, memory and attention (Motamedi & Meador, 2003).

 

I believe Occupational Therapists should be a necessary health care professional involved in the care of those with epilepsy. Our role as client-centered practitioners can be utilized extensively in this area. Advocating for ourselves as clinicians in epilepsy care, as well as our clients is vital.

 

Questions:

  1. What does quality of life mean to you?
  2. What is your understanding of the OT role in epilepsy care?
  3. How can we promote a need for OTs to work with this population?
  4. What occupations are most affected by epilepsy?
  5. Does the OT role differ when comparing the broad range of epilepsy types?
  6. How can we advocate for the role of OT in epilepsy?

 

Thank you for your time!

-Juliana

OTalk

#OTalk 26th May 2020 – How important is Posture Management?

This week Lauren Osborne @LaurenOsborneOT is hosting here is what she had to say,

I’ve just completed my MSc in Rehabilitation and Posture Management and my dissertation was a scoping review looking at “What is the evidence for 24 hour posture management?”. I concluded from the literature that posture management is a pre-requisite to occupational performance and therefore, I feel that it should be central to our work as OTs when working with people with complex physical disabilities. I would like to see it as part of the pre-registration OT training and to develop national guidance and NICE guidelines. I believe that posture management is a safeguarding and human rights issue because the people who need it are unable to change position independently and therefore rely on others to protect their body shape from distortion caused by gravity, which can have devastating effects through the development of skeletal deformities and contractures, leading to compromised respiration, digestion etc.
My questions for the discussion are:
1. What is your understanding of the term 24 hour posture management?
2. Did your pre-reg course include any training on posture management and/or positioning for people with complex physical disabilities?
3. How confident would you feel to assess a person for postural seating or night-time positioning equipment?
4. When assessing people’s ADLs, do you consider their posture e.g. can they sit unsupported to use their hands freely? Can they hold their head up to see?
5. If someone is unable to sit upright with their arms free and hold their head up, how can we as OTs best support them to engage in activity?
6. What could you do in your setting to increase awareness and knowledge of the importance of posture management?
OTalk

#OTalk – 28th April 2020 – Groupwork in Dementia Care

Therapeutic groups can have many benefits if they are well considered and maintain a person-centred approach (Beynon-Pindar, 2017). Enabling meaningful activity for those with dementia will prevent occupational deprivation (Harmer & Orrell, 2008), minimize boredom (Welton, 2013) and enhance pleasure and quality of life (Vernooij-Dassen, 2007). Groupwork is a dynamic and cost-effective tool in Occupational Therapy practice, for both intervention and evaluation (Creek & Lougher, 2011).

Co-production is the collaboration between people who run a service and the people who they support. Co-production gives service users, family members and carers more control in the care and support they receive (SCIE, 2015). Co-production acknowledges that the individuals using services have knowledge and experience of how services can be improved – recognizing people as assets and equal partnerships (Boyle, Slay & Stephens, 2010).

I recently started my role-emerging placement, where I am working with Older Adults, the majority of whom have Dementia. The task / expectation was for me to plan, implement and evaluate a group with this client group. I have spent the first few weeks scoping the placement, getting to know the client group and understanding their needs and preferences (the essential first step of planning a group!)

It is important to consider that the carers of those with Dementia are also the client. Interventions for dementia affect family carers as well as the client themselves, indicating that clinical decision-making needs to be informed by the impact on carers’ quality of life too (Oyebode et al., 2019). 

To ensure carers can fully engage in providing dementia care, they deserve to receive support and have their needs addressed. Looking after family carers can be done by maximizing their abilities and minimizing their burden (Wesson et al., 2017).

Unfortunately, due to the current situation (COVID-19), things have had to change in terms of the placement – I am now going to be completing written detailed plan of what I would have done. I am passionate as ever about working with people with dementia and their carers. 

I am so interested to hear your thoughts and experiences of planning and implementing groups – whichever client group it has been with – all knowledge and advice is welcomed!

Thank you to Margaret (margaret@ot360.co.uk) for our in-depth discussions and your help in writing this, it is very much appreciated!

Questions:

  1. To start as an OT, what skills do you believe are essential in researching, planning and delivering a successful group?
  1. How do you ensure your groups are different from other non OT led groups that may be being delivered in a service?
  1. How have you noticed participating in group work can make a difference with people with dementia and/or their carers?
  1. How did you measure the difference being part of a group has meant to people?
  1. Meaningful activity’ is at the heart of what we do, what has been the content of the sessions when you have delivered groups for either people with dementia and/or their carers?
  1. To finish in general what are the positives of delivering group work with people who have Dementia and/or their carers?

References

Beynon-Pindar, C. (2017). Group work in Occupational Therapy: Generic Versus Specialist Practice. Occupational Therapy Evidence in Practice for Mental Health, 59.

Boyle, D., Slay, J., & Stephens, L. (2010). Public Services Inside Out: Putting Co-production into Practice. London: New Economics Fooundation.

Creek, J., & Lougher, L. (2011). Occupational therapy and mental health. Elsevier Health Sciences.

Finlay, L (2002). Groupwork in J. Creek (ed) Occupational Therapy and Mental Health. Edinburgh: Churchill Livingstone

Harmer, B. J., & Orrell, M. (2008). What is meaningful activity for people with dementia living in care homes? A comparison of the views of older people with dementia, staff and family carers. Aging and Mental health, 12(5), 548-558.

Oyebode, J. R., Pini, S., Ingleson, E., Megson, M., Horton, M., Clare, L., … & Wright, P. (2019). Development of an item pool for a needs-based measure of quality of life of carers of a family member with Dementia. The Patient-Patient-Centered Outcomes Research, 12(1), 125-136.

SCIE. (2015). Co-production in Social Care: What is it and how to do it.

Vernooij-Dassen, M. J. F. J. (2007). Meaningful activities for people with dementia.

Wesson, V., Chiu, M., Feldman, R., Nelles, L. J., & Sadavoy, J. (2017). Dementia and caregiving.

Post Chat Updates:

Online transcript from HealCare#

PDF of transcript: #OTalk Healthcare Social Media Transcript April 28th 2020

The Numbers

2.259M Impressions
476 Tweets
72 Participants

#OTalk Participants

OTalk

#OTalk 14th April – Social Prescribing and the future of Occupational Therapy

This week @adamjacksonot is hosting this is what he has to say.

Hi, I’m Adam – A little bit about me… I’m a 3rd year student at the University of Derby, finishing this June.  I have been on quite a varied placement set, including:  Rampton Hospital, Kingsmill Hospital – Stroke Unit and Ash Green Specialist Community Learning Disability Service.

My interest in Social Prescribing (SP) began when it was briefly mentioned in our first year at University – later sharing an edit of a particular diagram of The Social Prescribing Process that now has just over 42,000 twitter impressions.  This created quite a conversation around the understanding of SP and OT and thus began my curiosity in OTs potential role.

My current literature review and research proposal is looking at the current Evidence-base and Outcome Measures used to gauge the efficacy of Social Prescribing schemes and exploring OT’s potential contribution in supporting the evidence-base and sustainability of this ever-growing healthcare agenda.  

Hopefully this OTalk can develop our understanding of its current application in practice and gather thoughts on the potential role or implication for future Occupational Therapy practice.

Social Prescribing

  • ….is a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services.​
  • Recognising that people’s health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.​
  • ….can involve a variety of activities which are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports.​

Kingsfund (2019)

Social Prescribing is not a new concept, as such – nor is it exclusively eluding Occupational Therapy –  RCOT have long been campaigning for the voice of Occupational Therapists to be heard within Social Prescribing and there are examples of success when Occupational Science and Occupational Therapy involvement is supporting the development of the agenda (for example; Salford Prescribing Hub).  However, almost consistently, current literature and research into Social Prescribing schemes, does not yet acknowledge or involve Occupational Therapy or Occupational Science.   Instead, concluding that whilst continually perceived as beneficial by the patient, lacks a solid evidence base or outcome measure – in turn questioning it’s sustainability.

Though Occupational Therapy was not initially listed as a profession to be funded under Social Prescribing schemes within Primary care (NHS England, 2019), there has been a lot of recent movement towards including and developing the role of Occupational Therapy in Social Prescribing.  This included the ‘Driving Social Prescribing Forward: AHPs Framework’, followed by the ‘Public Health England: Social Prescribing AHP Strategic Framework’.  `Most recent change saw OT being formally named in the new GP Contract (Department of Health and Social Care, 2020) – allowing for Primary Care funding of Occupational Therapists to potentially support and develop SP Schemes within them.

Alongside this, there is also growing conversation and change within OT curriculum in the UK, to explore and adapt to this changing landscape of healthcare.  Canadian and Australian Occupational Therapy has led the way on developing and analysing the opportunities Social Justice and Community (or Social) Occupational Therapy can provide – creating intervention on a Public Health level in response to personalised care and preventative care agendas, as mentioned by WFOT.

Thew et al (2017) highlighted the potential for Social Prescribing as an Emerging Role within Occupational Therapy.  Is this change of approach in mainstream health services, an opportunity to see the return and resurrection of core Occupational Therapy practice?

Questions I would like to consider:

  1. What is your/ your teams current understanding a) Social Prescribing and b) it’s link/relationship with Occupational Therapy?
  1. What are your experiences with Social Prescribing Services/ Agenda; either directly or indirectly? (ie working within a scheme or come across it in training, conferences, education etc)
  1. As the interest in OT for Public Health grows and Community or Social level Occupational Therapy increases; Do you think Occupational Therapy is able to rise to the challenge, and why – if not, what are the barriers?
  1. There appears to be little research, if any literature at all, on Occupational Therapists within Social Prescribing Services – Why do you think this is?
  1. Occupational focus and Holistic practice are at the core of Occupational Therapy profession.  How do you think the ‘shifting and sharing’ of this knowledge and evidence base will shape the future of Occupational Therapy practice?

References

Department of Health and Social Care (2020) 15 Billion to Deliver Government Commitment for 50 Million more General Practice Appointments, Available: https://www.gov.uk/government/news/15-billion-to-deliver-government-commitment-for-50-million-more-general-practice-appointments (Accessed: 21/02/20)

Dyson B (2014) The University of York Centre for Reviews and Dissemination. Evidence to inform the commissioning of social prescribing, Available: http://www.york.ac.uk/media/crd/ Ev%20briefing_social_prescribing.pdf  (Accessed: 21/02/20)

NHS England (2014) Five-year forward view, Available at: https://www.england.nhs.uk/wp-content/uploads/2014/10/ 5yfv-web.pdf (accessed 23/11/19)

NHS England (2019) Social prescribing link workers: Reference guide for primary care networks, Available: https://www.england.nhs.uk/wp-content/uploads/2019/07/pcn-reference-guide-social-prescribing.pdf (accessed:21/02/20)

Thew M et Al (2017) Social prescribing: An emerging area for occupational therapy, British Journal of Occupational Therapy, Vol. 80(9) 523–524, DOI: 10.1177/0308022617700905 

Kingsfund (2019) What is Social Prescribing? Available: https://www.kingsfund.org.uk/publications/social-prescribing, (accessed 23/11/19)

Post Chat Updates:

Online transcript from HealthCare# 

PDF of Transcript: #OTalk Healthcare Social Media Transcript April 14th 2020

The Numbers

1.937M Impressions
521 Tweets
77 Participants

#OTalk Participants

OTalk

#OTalk Research 7th April 2020 Overcoming Barriers to Engaging in Research

This weeks OTalk Research is hosted by Suzanne Simpson @SimpsonResearch here is what she had to say. 

 

During my time at my first NHS trust I developed an interest in the invisible injuries patient’s experience as a result of an acquired brain injury (ABI) thanks to some inspiring colleagues. As a band 6 I developed my knowledge and skills in cognitive assessment and intervention alongside neuropsychologists and experienced occupational therapists. I started to see the inequality in the care available to those with physical impairments compared to cognitive impairments, with the latter often missed by the multi-disciplinary team or not able to access appropriate rehabilitation (Benedictus et al, 2010; Turner-Stokes, 2003; Sinclair et al, 2014). My interest in ABI and cognitive impairments continued as I worked for other trusts eventually leading to me working at The Walton Centre. 

One afternoon in 2015 my therapy manager asked whether any staff members would be interested in applying for a part time funded MRes. My thought: ‘I can’t; I’m not clever enough’ as I had flashbacks to my undergraduate days. With lots of encouragement and support from the team I applied, was interviewed and I was offered one of only two funded places. The bulk of the course focused on the completion of a research project requiring full NHS ethical approval. I chose to carry out a feasibility study exploring the use of a cognitive functional screening tool I’d developed. The outcome of the study was that the tool required development to establish its validity and reliability. However within The Walton Centre the tool is used by members of the MDT (Vascular Nurses, Trauma Therapy Coordinator) in collaboration with the occupational therapists on the ward to inform referral for further functional assessment. From a personal perspective I loved the experience of leading my own research and changing practice, I wanted more! The research bug had well and truly taken hold. I graduated from Edge Hill University with a Masters in Clinical and Health Research in 2018.

Fast forward to March 2020. I’m working in a unique and innovative new role implementing evidence based practice and influencing service developments with the aim to improve the psychological wellbeing of people living with motor neurone disease. Alongside this role I’m the trust’s Making Every Contact Count Lead, supporting staff to help our patients lead healthier lives. Both roles use a lot of the skills I developed during my MRes. I’m proud to say I currently hold an honorary research associate role with Liverpool University and I was awarded a National Institute for Health Research NHS Research & Development North West Bridging Scheme. I’m involved with the North West Coast Applied Research Collaboration and I’m contributing to their work around social prescribing an area I’ve developed a keen interest in. Alongside Salford University Occupational Therapy they are supporting me to build an application for a doctoral fellowship.

In 2019 the Royal College of Occupational Therapists published the RCOT Research and Development Strategy 2019–2024. In recognition of the changing landscape the strategy states that ‘it is crucial that we use evidence-based interventions, robustly evidence the impact and the cost-effectiveness of our services, and continue to expand the evidence base, particularly as the scope and nature of practice evolves. Engaging in and with research is therefore central to the role of every occupational therapist in the UK, wherever they work.’

There is considerable evidence of the challenges that occupational therapists face when trying to engage in research and these have been discussed in previous #OTalk Research chats.   There is however less evidence of how to overcome such challenges.  This #OTalk Research chat will explore some very practical approaches through my own individual journey with the hope of inspiring and generating creative solutions to support others.  You never know you might catch the research bug too. 

Questions:

  1. What is inspiring/what inspired you to get involved in research?
  2. How did you take your ideas or clinical questions forward?
  3. How have you overcome the challenges in your own areas?
  4. What helped i.e. who/what/how/when?
  5. What have you learned that might help others?
  6. What would be your one top tip to any occupational therapist considering involvement in research? 

 

Post Chat Updates:

Online Transcript from HealthCare#

PDF of transcript: #OTalk Healthcare Social Media Transcript April 7th 2020

The Numbers

2.640M Impressions
464 Tweets
63 Participants

#OTalk Participants