Implications of the model of human occupation for intervention with native canadians

Indigenous Peoples and occupational therapy in Canada: A scoping review

Background. Calls to Action outlined by the Truth and Reconciliation Commission (TRC) necessitate critical reflection and urgent action to improve occupational therapy with Indigenous Peoples in Canada. Purpose. This scoping review aims to synthesize the literature related to Indigenous Peoples and occupational therapy practice, research, and education in Canada, and appraise empirical research using adapted Indigenous Health Research criteria. Method. A scoping review was conducted across published academic and grey literature with additional appraisal of empirical studies. Findings. A total of 6 themes emerged from 47 articles spanning from 1970 to 2020: recognizing colonial history, responding to the TRC, participating in personal and professional reflection, identifying Western ideologies, engaging in partnership in practice, and recognizing social and systemic barriers. Empirical studies met appraisal criteria inconsistently. Implications. To meaningfully engage in reconciliation, the profession of occupational therapy must generate Indigenous-led and relevant research, critically transform curricula, and address tensions between themes in practice.

Local Authority Occupational Therapy Services and Ethnic Minority Clients

An audit was conducted of all current cases on the register of a metropolitan district occupational therapy office by the physical disability team. The ethnic origin, language and religion of clients was established from the records and by direct enquiry. An analysis performed of presenting problems, service response and response times demonstrated that there were significant variations between ethnic groups in the use made of the service. No evidence was found of a systematic bias against the interests of ethnic minority groups in general, but a number of questions were raised. In particular, Asian clients were more likely to be referred by certain channels, to require major works and to waft longer for action.

The implications for service providers should be explored. There is also evidence of ethnic-specific needs. The existing literature relating to ethnicity and occupational therapy, most of which is based on the American experience, is of slight value to consideration of the needs of ethnic minority groups or service providers in the United Kingdom. Social factors, including poverty and housing conditions, affect both needs and outcomes. Future research using Improved ethnic monitoring data and the baseline Information of the 1991 census of population will enlarge the debate and permit service Improvements.

Investigation of Cross-Cultural Practice: Implications for Curriculum Development

A study was conducted to explore British occupational therapists' perceptions of cross-cultural practice. A qualitative research approach was used to explore both the concerns and difficulties therapists experience in cross-cultural clinical encounters, and the attitudes, skills and knowledge they feel are essential for the provision of culturally sensitive practice. One of the most significant study findings was the identified need for a phenomenological approach during initial assessment and ongoing service provision. This approach requires that therapists engage in a process of introspective analysis of their own cultural and socio-economic background and belief systems. Therapists need to understand the influence these systems have on their clinical perceptions and interactions. Based on the analysis of the data, recommendations for professional education and development in cultural awareness have been made.

Practical strategies for working with indigenous people living in Queensland, Australia

Internationally, occupational therapists have recognized the need to provide culturally appropriate services for indigenous people. This study explored experiences, perspectives and practical strategies of occupational therapists working with Aboriginal and Torres Strait Islander people living in rural and remote areas of Queensland, Australia. Semi-structured interviews were conducted with eight occupational therapists who had at least 12 months' experience providing services to Aboriginal and Torres Strait Islander people in health, rehabilitation or education services. Key themes identified in the data focused on strategies for facilitating effective communication with individuals and families, and collaborating with other service providers. The role of Aboriginal Liaison Officers or Indigenous Health Workers was emphasized by participating therapists. Participants identified resources that they perceived as useful in their practice, such as cross-cultural training and access to indigenous health workers. Other resources suggested for further development included information about learning styles of indigenous people and information about cultural variations between specific Aboriginal and Torres Strait Islander communities. The small number of participants limits generalizability of the findings. However, therapists can decide on the relevance of strategies to their own workplaces. Suggestions for further research focused on improving occupational therapy services for indigenous people in Australia. These include an investigation of therapy goals with indigenous people, and interviews with indigenous Australians and indigenous health workers about their experiences and perceptions of occupational therapy.

Lipids and psychosocial status in aboriginal persons with and at risk for Type 2 diabetes: implications for tertiary prevention

This study assessed psychosocial correlates of dyslipidemia, towards enabling improved tertiary prevention of macrovascular complications of diabetes mellitus (DM). We tested the hypothesis that psychosocial measures are related to high-density lipoprotein cholesterol (HDL-C) and triglyceride concentrations in a rural aboriginal population in British Columbia, Canada. Persons sampled were on-reserve registered Indians (n=198) with and at risk for Type 2 DM. Relationships between HDL-C and psychosocial variables were associated with glycemic status. For persons with diabetes and impaired glucose tolerance (n=44), quality of life and mastery were positively related (P<0.001), and depression inversely related (P<0.001), to HDL-C. An apparent lack of effect of behavior suggests the influence of emotional pathways involving autonomic-neuroendocrine axes. We recommend assessing mental health, and promoting mastery and diabetes quality of life through empowerment oriented diabetes management strategies, in negotiating culturally acceptable treatment of diabetic dyslipidemia for aboriginal people.

Derivation and pilot assessment of a health promotion program for Mandarin-speaking Chinese older adults

As the percentage of older adults of diverse ethnicities increases in the United States, the call for culturally sensitive health care service strategies that target the special needs of older people grows. The present report describes methods used to adapt a health care program so that it would better meet the needs of a group of well, older Mandarin-speaking Chinese residents of Los Angeles. The specific qualitative research procedures that we used to adapt the treatment program are described, along with the particular adaptations that emerged. Additionally, outcomes from a randomized pilot experiment are presented that are consistent with the notion that the adapted program was effective in reducing health-related declines among older Mandarin-speaking men and women. The overall outcome of this project is in agreement with other reports in the health care literature that address the importance of providing culturally sensitive health care service for elders.

The immigrant client: issues in developing culturally sensitive practice

A new challenge to the client-centred approach of occupational therapy emerges as therapists consider how best to meet the needs of the culturally different client How culture is conceptualized carries considerable implication for the ways in which this challenge may be met. Occupational therapy literature is building a body of knowledge concerning the sociocultural implications of practice. Ethnographic studies in the social sciences, which emphasize the complexity of the relationship between culture, environment and health experiences, contribute to the further development of an understanding of the immigrant client, and provide direction for both clinical practice and research.