CHC 2: How to use theory to guide evaluation

• Why use theory to guide practice?


  -guide EBP and selection of assessments and interventions

  -give language to articulate occupational needs of cl.

  -provides resources for knowledge

  -helps match cl. needs and goals with provision of therapy
• Where do you start with a cl. as an OT?

  begin (and end) with occupational performance
• Theory:


  describes, explains, predicts behavior; helps us understand relationships among concepts or events
• Occupation-based models:


  help explain PEO relationship
• FOR:


  -guide plan of action for a specific domain of concern

  -directly applied to address cl. factors of clinical concern

  -"Link between theory and practice"

  (when possible, includes the remediation of occupational performance areas, patterns, and skills)
• Domain:


  "scope of practice" to include focus and factors addressed by an OT
• List 5 main areas of domain:

  occupations

  performance skills

  performance patterns

  context/ environment

  client factors
• Skills (w/in domain)


  therapeutic use of self, clinical reasoning, activity analysis, knowledge of activity demands
• Process:


  -methods of providing the domain of OT services
• process can be the...


  OT evaluation, intervention, and targeted outcomes
• What are the 7 areas of occupation under the OTPF's domain?


  ADLs

  IADLs

  Education

  Work

  Leisure

  Play

  Social Participation
• 3 components of performance skills:

  motor skills

  process skills

  communication/ interaction skills
• 3 types of performance pattern skills

  habits

  routines

  roles
• Domain - environment categories:

  physical and social
• Domain - contexts:


  cultural

  personal

  virtual

  temporal
• Domain - client factors


  values, beliefs, and spirituality

  body functions

  body structures
• Process - Evaluation


  - clients occupational abilities

  - clients needs

  - determination about services

  - determining about provision of services
• Process - Intervention: OT services are divided into what 6 categories?


  occupations and activities

  interventions to support occupations

  education and training

  advocacy

  group interventions

  virtual interventions
• Theoruy:


  process of understaning
• Model of practice/ OT theories:


  application of theory to OT practice
• Frames of References (meaning what?):

  link of theory to intervention strategy
• Tool (flow of theory):

  understanding of info and implementation of treatment
• list 3 frames of reference:

  biomechanical

  sensorimotor

  rehabilitation
• List 3 OT based models:

  EHP

  MOHO

  PEO
• List scientific theories (general)

  biology, psychology, kinesiology, sociology, Rx
• Germ theory:


  microorganisms produce infections; before hand washing was widely accepted; surgeons would go from room to room without sanitizing
• Top down & bottom-up approach:


  Theory of practice

  occupation-based models

  domain

  process

  FORs
• What FOR are used for musculoskeletal dysfunction?

  biomechanical and rehabilitation
• Biomechanical rehabilitation continuum


  usually starts with biomechanical then changes to rehabilitation (can also go back to biomechanical)
• Biomechanical FOR =


  establish, restore; remediation, approach to intervention,
• Rehabilitation FOR =


  Modify; adaptation and compensation

  approach to intervention
• Establish, Restore =


  an approach to intervention
• Focus of biomechanical FOR:

  focus on restoring functional abilities
• Basic concepts of motion-kinetics and Kinematics:

  ROM

  strength

  endurance, AND

  force,

  leverage,

  torque
• What is the key to successfully using the biomechanical approach is linking the ...


  underlying impairment to the occupational performance deficit
• Intervention bridges the _______-______ _____.

  short-term gap
• interventions with biomechanical: (Examples)


  motor learning

  task-oriented training

  cognitive retraining

  bobath/ NDT

  PNF

  Brunnstrum

  Modalities
• Modify:


  compensatory and adaptive approach to intervention
• Emphasis in modify:


  emphasis on strengths, NOT limitations with ultimate goal of Cl. best potential
• List the FOR you would use with the problem listed:

  
  

  motion


  Biomechanical (FOR) or rehabilitation model (FOR)