Therapists' perceptions of pediatric occupational therapy interventions in self-care

La posture éducative, une pièce maîtresse au service de l’éducation thérapeutique du patient !

Introduction : La posture éducative est considérée par plusieurs auteurs comme la pierre angulaire pour le développement des compétences des professionnels de santé en éducation thérapeutique du patient (ETP) et plus largement l’intégration de cette ETP dans les pratiques professionnelles. Cependant, le terme reste à clarifier au vu des constats de définition polysémique ou tout simplement d’absence de définition. Objectifs/contributions : Cet article décrit les enjeux autour de la définition, de la reconnaissance et du développement du concept de posture éducative. L’article propose également une caractérisation pragmatique du concept organisée autour de 7 dimensions : la relation au temps (le bon moment, le temps qu’il faut), les bénéfices de la pratique d’ETP (bien-être des professionnels de santé), les émotions et sentiments (qualité des échanges, partage), le caractère professionnel de l’ETP (compétences biomédicales et éducatives requises), l’approche globale et interdisciplinaire (complexité de la personne, intérêt d’un travail d’équipe), le caractère éducatif de la relation de soins (éducation intégrée aux soins) et la dimension éthique (réflexion jugée indispensable). Discussion/conclusion : Cette étude ouvre des perspectives de transformations des formations professionnelles, ainsi que des recherches orientées sur les interventions pédagogiques pour faire de cette posture éducative un objet d’apprentissage à part entière.

From therapeutic patient education principles to educative attitude: the perceptions of health care professionals - a pragmatic approach for defining competencies and resources

Educative attitude is an essential, if implicit, aspect of training to acquire competency in therapeutic patient education (TPE). With multiple (or nonexistent) definitions in the literature, however, the concept needs clarification. The primary aim of this study was to analyze the representations and transformations experienced by health care professionals in the course of TPE training in order to characterize educative attitude. We conducted an exploratory qualitative study using several narrative research-based tools with participants of two TPE continuing education courses. We then performed an inductive thematic analysis. Thirty-three people participated in the study; the majority were women (n=29), nurses (n=17) working in a hospital setting (n=28). Seven categories of statements were identified: time-related ("the right moment, how much time it takes"), the benefits of TPE (to health care professionals' personal well-being), emotions and feelings (quality of exchanges, sharing), the professional nature of TPE (educational competencies required), the holistic, interdisciplinary approach (complexity of the person and value of teamwork), the educational nature of the care relationship (education an integral part of care) and the ethical dimension (introspection essential). The first three components appear fairly innovative, at least in formulation. The study's originality rests primarily in its choice of participants - highly motivated novices who expressed themselves in a completely nontheoretical way. Health models see attitude as critical for adopting a behavior. Best TPE practices should encourage personal work on this, opening professionals to the social, experiential and emotional aspects of managing chronic illness.

A profile of canadian pediatric occupational therapy practice

PURPOSE

This study established a current profile of Canadian pediatric occupational therapy practice in terms of theories/practice models, assessments, and interventions.

METHOD

Respondents were 272 members of the Canadian Association of Occupational Therapists who indicated that pediatrics was their primary area of clinical practice. A purpose-designed survey was mailed to participants.

RESULTS

The response rate was adequate at 27.2% (n = 272/1,000). The primary client groups seen by pediatric therapists were developmental delay, learning disability, neurology, and those requiring rehabilitation. Sensory Integration and Client-Centred Practice were the most frequently utilized theories/practice models. The most commonly used assessments were the Developmental Test of Visual Motor Integration, Peabody Developmental Motor Scales, Bruininks-Oseretsky Test of Motor Proficiency, and the Sensory Profile. The most frequently used intervention techniques with pediatric clients were the instruction of parents/caregivers and children; assistive devices, adaptive equipment, and technology; activities of daily living/self-care skills; and environmental modification/access/structuring/adaptation.

CONCLUSIONS

Pediatric occupational therapists mainly used theories/ practice models that focused on three areas: Client-Centred practice, practice-oriented theories, and several theories/practice models based on occupation. Interventions focused on teaching, activities unique to occupational therapy, and on the functional needs of the client.

A survey of paediatric occupational therapists in the United Kingdom

The purpose of this study was to examine the work of paediatric occupational therapists in the UK, and to compare the results with similar surveys carried out in the US, Australia and Canada. A postal questionnaire survey was sent to 212 members of the National Association of Paediatric Occupational Therapists. Questions were asked about a wide range of issues pertinent to paediatric practice. The results showed that data collected in the UK are similar to those from the three other countries-- for example, in the unique areas of work, such as assessment for adaptive equipment, training in activities of daily living and fine motor skills training, and that there is also some overlap with other disciplines. The study had some limitations in terms of respondents accessed and scope of questions asked. It highlighted a number of areas for further research, one being to identify what undergraduate teaching needs to be made available to students who want to work with children. Several conclusions are drawn, principally that children's occupational therapists tend to remain in the specialization for several years and make good use of postgraduate courses to enhance their practice.