Occupation based practice

Background: Literature review coupled with needs assessment data indicated that collaborative practices between teachers and occupational therapists might not be happening consistently and may be in need of improvement. Further research is needed to determine elementary teachers’ perceptions of the value of collaboration with occupational therapists in order to ensure maximum benefit for the students. Purpose: This Capstone Project focused on identifying elementary teachers’ perceptions of the value of collaboration with occupational therapists and validating the need for improved occupational therapy supports in the school environment. Theoretical Framework: This Capstone Project was guided by the National Interprofessional Competency Framework (NICF), which is composed of six domains: role clarification, patient/client/family/community-centeredness, team functioning, collaborative leadership, interprofessional communication, and interprofessional conflict resolution. Methods: An a...

The Occupation-Based Practice (OBP) is a central core of occupational therapy (OT).It refers to using a meaningful occupation based on the client's interests, needs, health and participation in daily life. This study aimed to explore the facilitators of implementing OBP among Iranian occupational therapists. Fourteen occupational therapists participated in this study. Data were collected through semi-structured interviews, and the sampling method was purposeful. The interviews were continued until data saturation was reached, and data were recorded and transcribed verbatim. Data were analyzed through qualitative content analysis using constant comparative analysis. Our analysis explored two themes: Factors attributed to context, and factors attributed to therapists. The first theme consisted of three subthemes: Educational programs of OT department, public information about OBP and clinical setting compatible with OBP. The second theme also contained three subthemes including: P...

Introduction: Midwifery care based on the professional ethics leads to mothers' increased prosperity and satisfaction. This study was performed to compare the effect of integration of two teaching approaches, rolemodeling and narration methods, on the midwifery students' performance in professional ethics in Qom University of Medical Sciences. Methods: This quasi-experimental before-and after-two group study was performed on all midwifery students (N=36) assigned randomly to the experiment or control groups. All were enrolled in Maternal Child Health Course, as a clinical rotation. For the experiment group, professional ethics issues were taught by role-modeling and narrative methods, while the control one experienced only the role-modeling technique. Students' performances in professional ethics in both groups were assessed before and after the instruction using a researcher-made observation checklist (score range: 0-27). Data were analyzed using independent t and paired t-tests. Results: Mean scores of students' performance in control group was improved significantly in post test (16.85±1.39) compared to the pretest (12.34±1.42) results (t=.71, p=.001). Also in the experiment group, post test scores (20.85±2.39) were significantly different from the pretest (11.96±1.89) findings (t=.82, p=.001). Independent t test implied that the difference of post test scores in two groups was significant (t=0.8, P=0.000). Conclusion: Although both methods were effective in improving students' performance in professional ethics in clinical setting, a blend of two methods (narration and role modeling) was more effective than role modeling alone. It is recommended that role-modeling and narration methods be used in teaching ethical issues to midwifery students.

Postmodern movement emerged in the 1960s as a reaction against modernism, the most important differences which distinguished it from previous periods were its attitude to the reality and critical attitude towards the certainty of science and truth. In this view, reality differs for individuals and is determined by the perception, culture and language. In this view, each person's perception of reality is the product of his attitude to the life, so the existence of an absolute reality is rejected. Postmodern culture does not represent a systematic and pervasive theory because every individual or culture measures reality in its own way; so they can be understood by their own criteria, not by a standard and objective one. People also use language to construct their inner realities, so each person's words and manner of speech reflect the internalized realities and their perceptions of reality. Based on what has been said, deconstruction can be considered one of the most important postmodern manifestations that has influenced not only on aesthetics discourses but also in the sciences such as psychology in the last three decades of the twentieth century. This approach seeks to eliminate and abolish universal principles and emphasizes diversity, plurality, differences, contradiction and relativity. Accordingly, postmodern psychotherapy also came under the influence of postmodern philosophy. Social constructivism is a postmodern view of therapy that believes reality is not outside to be found; it is built within each of us and socially constructed through the interaction of culture, perception, and language. So everyone is personally and actively involved in making his own reality. The purpose of this paper is to study and investigate the impact of the features proposed in postmodernism on postmodern art therapy in an analytical and theoretical way. The main question is to find in what extent postmodern art therapy is related to the concepts in postmodernism. In this study, it is assumed that the concepts discussed in postmodern philosophy are specifically applied to the postmodern art therapy. The results of this study confirm that the deconstruction of social structures and internalized narratives, the importance of multiple realities, the importance of social aspect of art, group and discourse-based activities, pluralism, the importance of audience interpretation, the use of metaphor and etchings as well as the use of different medias in creation of artworks are among the most important features that have been introduced and applied in postmodern art therapy. Postmodern art therapy began as a means of combating social conditions, with the idea that individuals are influenced not only by their childhood experiences in the family, but also by culture, ethnic, race, gender, politic and other issues in the life. In this context, art was used as a means of expressing multiple realities to establish mutual discourses and communication as well as identifying and eliminating the dominant narratives of life. In this way according to post modern art therapy all people have the ability to lead their own lives in ways that are both satisfying and socially productive.

Introduction: Curriculum of Ph.D. of social work in Iran was first approved in 2003 and in 2006 the University of social welfare and rehabilitation sciences admitted first Ph.D. students. This curriculum has not revised since its approval. Due to the widespread social changes over these years in Iran, especially in the social health and social policy area, the Ph.D. program is not sufficiently responsive to the needs of the society and students. In this regard, it is essential to analyze the stakeholders' feedback on the necessary revision of the curriculum. Methods: A directed content analysis was used in this study. Twelve participants who were teachers, Ph.D. graduates and Ph.D. students of social work at the time of this study were recruited and interviewed through purposive sampling. Results: Participants recommended several objectives and responsibilities for social work Ph.D. graduates such as policy-making, leadership, and programming, critical theory and theory developing, practicing theoretical and field education and supervision, research, and clinical interventions. The most important inclusion criteria for admission in the Ph.D. of social work were having and a bachelor's and master's degree in social work and have a background career experience. Participants also emphasized on practical and internship courses. Conclusions: It is recommended to consider policy-making, leadership, and programming, critical theory and theory developing, practicing theoretical and field education and supervision, research, and clinical interventions as key responsibilities of a social work Ph.D. student. Accordingly, persons with appropriate academic and career background should be admitted to this program. Appropriate teaching methods and practices and internship courses are essential for the Ph.D. curriculum of social work.

The Occupation-Based Practice (OBP) is a central core of occupational therapy (OT).It refers to using a meaningful occupation based on the client's interests, needs, health and participation in daily life. This study aimed to explore the facilitators of implementing OBP among Iranian occupational therapists. Fourteen occupational therapists participated in this study. Data were collected through semi-structured interviews, and the sampling method was purposeful. The interviews were continued until data saturation was reached, and data were recorded and transcribed verbatim. Data were analyzed through qualitative content analysis using constant comparative analysis. Our analysis explored two themes: Factors attributed to context, and factors attributed to therapists. The first theme consisted of three subthemes: Educational programs of OT department, public information about OBP and clinical setting compatible with OBP. The second theme also contained three subthemes including: P...

Background: Research shows that there are many barriers to the implementation of occupation-based practice amongst occupational therapy practitioners. One barrier that requires a more in-depth review is the process of interprofessional and intraprofessional collaboration amongst staff in skilled nursing facilities. Purpose: The purpose of this research project was to examine how interprofessional and intraprofessional collaboration influence occupational therapists and occupational therapy assistant’s ability to provide occupation-based practice in skilled nursing facilities. Theoretical Framework: The frameworks utilized throughout this study included the National Interprofessional Competency Framework and the Occupational Therapy Intervention Process Model (OTIPM). Methods: This study utilized a qualitative case study design to understand how staff within skilled nursing facilities viewed the impact of intra- and interprofessional collaboration has on occupation-based practice. Pa...

Introduction: Midwifery care based on the professional ethics leads to mothers' increased prosperity and satisfaction. This study was performed to compare the effect of integration of two teaching approaches, rolemodeling and narration methods, on the midwifery students' performance in professional ethics in Qom University of Medical Sciences. Methods: This quasi-experimental before-and after-two group study was performed on all midwifery students (N=36) assigned randomly to the experiment or control groups. All were enrolled in Maternal Child Health Course, as a clinical rotation. For the experiment group, professional ethics issues were taught by role-modeling and narrative methods, while the control one experienced only the role-modeling technique. Students' performances in professional ethics in both groups were assessed before and after the instruction using a researcher-made observation checklist (score range: 0-27). Data were analyzed using independent t and paired t-tests. Results: Mean scores of students' performance in control group was improved significantly in post test (16.85±1.39) compared to the pretest (12.34±1.42) results (t=.71, p=.001). Also in the experiment group, post test scores (20.85±2.39) were significantly different from the pretest (11.96±1.89) findings (t=.82, p=.001). Independent t test implied that the difference of post test scores in two groups was significant (t=0.8, P=0.000). Conclusion: Although both methods were effective in improving students' performance in professional ethics in clinical setting, a blend of two methods (narration and role modeling) was more effective than role modeling alone. It is recommended that role-modeling and narration methods be used in teaching ethical issues to midwifery students.

Introduction: There is a scarcity reports on the situation of psychotherapy as an effective treatment for mental illness and interpersonal problems in Iran. Aim: The study aimed to explore the situation of psychotherapy in Iran. Method: The present qualitative study was performed using conventional content analysis in 2017. The current sample included 13 experts in psychotherapy. A semi-structured interview was used for data collection. All interviews were audio recorded and subsequently transcribed. Qualitative analysis using constant comparisons was performed for transcribed interviews. Results: Two main categories were emerged to describe situation of psychotherapy in Iran: challenges and opportunities. Additionally, specific subcategories within each main category were documented. The challenges category described the problems in psychotherapy education and services delivery including lack of coordination in training and lack of insurance coverage. The opportunities category als...

Introduction: Midwifery care based on the professional ethics leads to mothers' increased prosperity and satisfaction. This study was performed to compare the effect of integration of two teaching approaches, rolemodeling and narration methods, on the midwifery students' performance in professional ethics in Qom University of Medical Sciences. Methods: This quasi-experimental before-and after-two group study was performed on all midwifery students (N=36) assigned randomly to the experiment or control groups. All were enrolled in Maternal Child Health Course, as a clinical rotation. For the experiment group, professional ethics issues were taught by role-modeling and narrative methods, while the control one experienced only the role-modeling technique. Students' performances in professional ethics in both groups were assessed before and after the instruction using a researcher-made observation checklist (score range: 0-27). Data were analyzed using independent t and paired t-tests. Results: Mean scores of students' performance in control group was improved significantly in post test (16.85±1.39) compared to the pretest (12.34±1.42) results (t=.71, p=.001). Also in the experiment group, post test scores (20.85±2.39) were significantly different from the pretest (11.96±1.89) findings (t=.82, p=.001). Independent t test implied that the difference of post test scores in two groups was significant (t=0.8, P=0.000). Conclusion: Although both methods were effective in improving students' performance in professional ethics in clinical setting, a blend of two methods (narration and role modeling) was more effective than role modeling alone. It is recommended that role-modeling and narration methods be used in teaching ethical issues to midwifery students.

Background and Objective: A significant proportion of spinal cord injuries and physical-motor disabilities are caused by road traffic crashes. The aim of this study was to explore the lived experiences of people with disability due to traffic accidents. Materials and Methods: This study was conducted using a qualitative phenomenological approach. The participants were a purposive sample of physical-motor disabled people due to road traffic injuries referred to the rehabilitation centers in East Azerbaijan, Iran. Data were collected using individual in-depth interviews and analyzed with a thematic analysis including holistic, selective and detailed approaches. Results: The main theme extracted from the experience of the participants was "captive of destiny" with three sub-themes including 'surrender of fate', 'living behind the fence' and 'drowning in disability and need'. Accordingly, participants considered themselves as the victims of destiny and believed living with disability is like living behind the fences of loneliness, frustration, regret, fear of future, pity and inefficiency. Conclusion: This study revealed that spinal cord disability imposed irreversible restrictions on the participants' lives, so that as dependent people, they needed support from others and, were desperate to recover their lost power, found them in the fate prison. Social support and empowerment of these people to overcome disability can improve their mental health and help them return to a normal life.

Background and Objectives: Improving the psychological states of physically disabled individuals can make their lives easier. The purpose of this study was to examine the effectiveness of psychodramas group therapy onassertiveness, self-acceptance, and the spirit of gratitude among physically disabled people in Isfahan. Materials and Methods: The research method was quasi-experimental with experimental and control groups with a pretest-posttest design. The statistical population of the study consisted of all physically disabled people in Isfahan Disabled People's Association in 2020. Of them, forty subjects were conveniently selected and randomly assigned in two groups (each group 20 persons). The experimental group received eight ninety-minute sessions of psychodrama group therapy while the control group recieved no intervention. To collect information, three questionnaires were used: self-acceptance scale of Gambrill and Ritchie, assertiveness scale of Chamberlain and Haga, and gratitude scale of McCullough. Data were analyzed by descriptive statistics (means and standard deviation) and inferential statistics (multivariate analysis of covariance). Results: The results showed that psychotherapy group therapy had a significant effect on assertiveness (p<0.001, F=16.54), self-acceptance (p<0.001, F=210.62), and gratitude (p<0.001, F=33.44) of people with physical disabilities. Conclusion: Psychodrama method was effective in improving assertiveness, unconditional acceptance, and gratitude in people with physical disabilities in Isfahan. Therefore, this method can be considered to improve the mentioned variables among the physically disabled people.

Introduction: Curriculum of Ph.D. of social work in Iran was first approved in 2003 and in 2006 the University of social welfare and rehabilitation sciences admitted first Ph.D. students. This curriculum has not revised since its approval. Due to the widespread social changes over these years in Iran, especially in the social health and social policy area, the Ph.D. program is not sufficiently responsive to the needs of the society and students. In this regard, it is essential to analyze the stakeholders’ feedback on the necessary revision of the curriculum. Methods: A directed content analysis was used in this study. Twelve participants who were teachers, Ph.D. graduates and Ph.D. students of social work at the time of this study were recruited and interviewed through purposive sampling. Results: Participants recommended several objectives and responsibilities for social work Ph.D. graduates such as policy-making, leadership, and programming, critical theory and theory developing, ...

Introduction: Self-learning is an appropriate method for continuing medical education programs and has been used in many countries. In order to evaluate new method of selflearning in CME (Continuing Medical Education) programs, this study was conducted to determine the viewpoints of CME participants about the quality of books, questions, and teaching method of self-learning in Isfahan University of Medical Sciences. Methods: In a descriptive cross-sectional study, 3712 physicians among the ones participating in CME programs of Isfahan University of Medical Sciences in 2004-2005, were selected through census sampling. The data collection tool was a questionnaire containing demographic questions and 39 items asking about self-learning method, quality of the books and questions which was distributed along with the book at the time of registration for self-learning. The data was analyzed by SPSS software using frequency distribution, mean, standard deviation, t-test, ANOVA, and linear r...

Objective: The elderly population in Iran is growing. Aging is a natural phenomenon that causes changes in brain structures, including the frontal lobe and its connections, which are responsible for the brain’s executive functions. These structural changes lead to problems in cognitive and physical functioning. Older people face problems such as decreased performance in daily activities of life and participation in social activities. In cognitive orientation to the daily occupational performance approach, the participants learn to improve their motor performance using cognitive strategies. The effectiveness of this approach has been reported in stroke, Traumatic Brain Injury (TBI), and some childhood disorders. This study aimed to investigate this approach’s feasibility and its effect on the Iranian elderly without cognitive problems. Materials & Methods: A single-subject study A-B design with follow-up was conducted. The participants were two older adults referred to Ramsar Health ...

Background
While legitimate practice tools have been the subject of debate within the profession, little attention has been paid to psychological frames of reference (PFsOR). Hence, this article explores the ways psychological theories and therapies shape occupation-based practice in mental health settings.

Methodology
Narrative inquiry methods and thematic analysis were used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years.

Findings
Respondents found it difficult to hold onto their occupational focus in the psychology-dominated world of mental health practice. The main themes to emerge were (i) tension between occupation and psychology; (ii) overwhelming pressures to adopt PFsOR; (iii) resistance to PFsOR; and (iv) using PFsOR to enhance professional repertoires. Findings pointed to the need to ensure PFsOR include occupational considerations for occupation-based practice in mental health.

Conclusion
A occupation-based perspective means balancing PFsOR with occupation-based considerations, so service-user issues are holistically addressed. There is a need to critically review occupational therapists' use of PFsOR lest their most visible practical actions appear psychologically based rather than occupation based.

Objective: The elderly population in Iran is growing. Aging is a natural phenomenon that causes changes in brain structures, including the frontal lobe and its connections, which are responsible for the brain’s executive functions. These structural changes lead to problems in cognitive and physical functioning. Older people face problems such as decreased performance in daily activities of life and participation in social activities. In cognitive orientation to the daily occupational performance approach, the participants learn to improve their motor performance using cognitive strategies. The effectiveness of this approach has been reported in stroke, Traumatic Brain Injury (TBI), and some childhood disorders. This study aimed to investigate this approach’s feasibility and its effect on the Iranian elderly without cognitive problems.
Materials & Methods: A single-subject study A-B design with follow-up was conducted. The participants were two older adults referred to Ramsar Health Center, Ramsar City, Iran. Before the intervention, to examine the participants’ cognitive status, we used Digit Span Forward to measure attention and Digit Span Backwards and Digit Symbol to measure working memory. The participants’ executive function was also assessed by the Wisconsin Card Sorting Test and Independence in Activity of Daily Living (ADL) with Functional Independent Measure (FIM). Each participant selected three functional goals by Canadian Occupational Performance Measure (COPM) for the focus of the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention. After two weeks of evaluating participants’ performance on selected goals using the Performance Quality Rating Scale (PQRS) to determine baseline performance, the intervention period began. During this period, a total of 8 to 10 sessions were held for each participant. In these sessions, the participants were first taught global problem-solving strategies (Goal, Plan, Do, Check), and then they were introduced to domain-specific strategies and their importance in executing activities. Afterward, through guided discovery during implementation, they were directed to use these strategies in their execution by guided discovery. During this period, the participant’s performance on the selected goals was assessed five times by the PQRS. At the end of the intervention, to evaluate the long-term impact of the intervention, the participant’s performance on the selected goals was re-evaluated by the PQRS three times.
Results: The PQRS results showed that the performance of the first participant in each of the three selected activities improved. The results of the PQRS for the second participant showed a significant improvement in performance on the two selected goals. However, one of the selected goals did not show a significant change, which may be related to this goal’s nature. Participants’ net scores in FIM and COPM showed improved performance and satisfaction on selective goals, and performance independence remained constant.
Conclusion: The CO-OP approach is feasible in the Iranian elderly population, and the preliminary results indicate the positive impact of this approach on improving the performance in the trained goals. However, given the study limitations in interpreting the results, it is recommended that future studies with a larger sample size be conducted to evaluate the effectiveness and efficacy of this approach. It is also recommended to use alternative tools instead of PQRS to evaluate the results, given the different cultural contexts.

Introduction
This paper explores the way dominant discourses, and their associated practice knowledge dimensions, shape personal paradigms and occupation-based practice in mental health workplaces.

Method
Narrative inquiry methods and narrative thematic analysis was used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years.

Findings
The main narrative themes to emerge were (i) living with the biomedical practice knowledge discourse, (ii) living with the psychological practice knowledge discourse and (iii) reflection as a strategy for maintaining occupation-based practice. These discourses created the need to reflect on practice and adopt strategies to avoid the marginalisation of occupational perspectives and occupation-based practice. The strategies used to cope with these discourses varied from acceptance and embracing of other discourses to resistance and rejection.

Conclusion
This paper demonstrates that in some mental health workplaces there is a danger that occupational perspectives and occupation-based practice can become marginalised. Making visible the different discourses in mental health practice allows occupational therapists to analyse, better understand, and live with the tensions in their professional lives. This requires professional support strategies to be in place to maintain occupation-based practices and retain practitioners in the workforce.

Objectives Occupation has been used as an essential core of therapy in Occupational therapy (OT) paradigm from its beginning. Besides primary emphasis of OT pioneers; the OT practitioners do not care about using it seriously yet. So, this study was designed to explore the current method of delivering occupational therapy services among Iranian occupational therapists.
Materials & Methods The qualitative conventional content analysis with purposeful sampling method was used in this study. 14 occupational therapists participated in this study. Semi structured interviews were used for data gathering. The data gathering continued until reaching data saturation. The interviews were analyzed through constant comparative analysis using MAXQDA 2007 software.
Results The interviews analysis revealed 66 codes that resulted to six sub themes and three themes including: Occupation based OT (occupation based assessment and planning –hard working circumstances for occupation based therapists), technique based OT (inattention to occupation based practice- top down approach to assessment and planning-inattention to client-centered practice) and combined occupation and techniques based OT (assessment and planning with combined approach)
Conclusion It seems that the Iranian occupational therapists have deviated from their philosophical paradigm (occupation based practice) and tended to technique based OT. Lots of possible reasons such as contextual barriers, non-acceptance from clients’ perspective and educational challenges are considered in this issue. Therefore, the policy makers ought to plan and supervise to solve these challenges and to facilitate implementing occupation based practice.