Occupational-Based Activity Analysis PDF

Chapter 3 Step 2: Determine the Relevance and Importance to the Client: Occupation-Based Activity Analysis Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated. Thomas H. Occupation-Based Activity Analysis, Se...

Chapter 3 Step 2: Determine the Relevance and Importance to the Client: Occupation-Based Activity Analysis Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated. Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Determining Relevance and Importance We define ourselves by what we do. Each occupation is defined by our client’s: Goals Values Beliefs Needs Perceived utility of the occupation Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Values & Beliefs Values are defined as “acquired beliefs and commitments, derived from culture, about what is good, right and important to do” (Kielhofner, 2008). Beliefs are “cognitive content held as true to the client” (AOTA, 2014, p. S22). Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Specific Need or Utility Survival and meeting basic bodily needs are foundational to much of what we do every day. Providing for our basic needs (food, shelter, self care) We also use occupations to: Develop skill Meet personal needs Establish superiority Pass on information to children Establish order in families or households Express individual skill or pride Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Determining the Relevance and Importance Ask the client the following questions: In what ways is this activity important to you? How does engaging in this activity make you feel? In what ways do you need to this activity? Tell me about the experiences you have when engaged in this activity. How has limited ability to engage in this activity affected your life? Roles? Impacted others? How does this activity define who you are? (Hocking, 2001) Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Defining the Occupation In Chapter 2, the areas of occupation were defined as they are listed in the Framework. The first best step to an occupation-based activity analysis is asking the client: To define the occupation he or she wants or needs to do What defines successful participation for him or her How this occupation plays a part in his or her life Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Perceived Utility Occupations that we engage in define who we are: “occupational identity”. Activities fulfill roles. Thinking of occupations from this perspective—as being part of a person’s identity—can help you better analyze the demands of the activity. Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  The Occupational Profile To gain an understanding of how a client defines: An occupation The meaning and utility of an occupation Their values, beliefs, and spirituality In what form the occupation takes place Gather this information through an occupational profile. The occupational profile is part of the evaluation process. The profile is conducted through an interview. Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  The Occupational Profile, cont. Why the client is receiving services—what his or her concerns with daily life activities are Which occupation(s) he or she is having trouble with and which have been successful Which aspects of the client’s environment or contexts support or inhibit participation in the occupation(s) Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  The Occupational Profile, cont. What occupations the client has participated in the past, what he or she currently engages in, and what desired future occupations are What the client’s values and interests are What roles the client fulfills What the client’s patterns of daily activities are and how they have changed What the client’s priorities are and the desired outcomes Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Context & Environment Conditions that surround the client Some are external: Physical, social, virtual, cultural, temporal Some are internal: Personal Must understand context to understand performance Can inhibit or promote performance Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Context & Environment, cont. Contexts: Environments: Cultural Physical Personal Social Temporal Virtual Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Cultural Context The client’s customs, behavior standards, activity patterns and beliefs Influences their identity and activity choices Family traditions are part of the client’s culture Determine roles as well as expectations of the client’s actions How a person dresses, greets others, and acts toward strangers can change based on the cultural context Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Personal Context Inner traits; not physical health Age Gender Socioeconomic status Educational status Group membership Population membership Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Temporal Context Temporal: “location of occupational performance in time” Time related Stage of life Time of day, year Duration Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Virtual Context Virtual: “environment in which communication occurs by means of airways or computers and in an absence of physical contact.” Simulation of real environment Email, chat rooms, video conferencing, radio transmissions, remote monitoring Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Environments Physical Social Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Physical Environment Physical: Non-human aspects Accessibility Terrain Plants Animals Buildings Furniture Objects Sensory Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Social Environment Social: Availability and expectations of social groups/individuals Significant individuals Groups associated with roles Relationships with groups or organizations Social groups with norms, role expectations, social routines Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Performance Patterns Patterns of behavior that are habitual or routine Habits: Automatic behaviors—dominating or helpful Routines: Patterns of behavior Rituals: Symbolic actions Roles: Set of behaviors expected Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Case Example: Ryan Ryan is a 17-year-old male who was involved in a motor vehicle accident 6 months ago. He suffered a severe head injury and was in a coma for 2 months after the accident. As a result, he is only able to use his left upper and lower extremities. He was right-hand dominant prior to the accident. He is also expressively aphasic, only able to nod yes/no. He has difficulty maintaining attention to tasks for longer than 5 minutes. He uses a wheelchair and has difficulty maintaining an upright position when leaning forward or reaching to his sides. He is cognitively impaired, only able to follow simple directions. He often gets frustrated with people, especially when there is too much noise, and he will hit or push people away from him. Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Case Example: Ryan, cont. Prior to the injury, Ryan was a high school student who enjoyed talking with his friends (and girlfriends) on the phone. He loved classic cars and worked on his own 1967 Cadillac with his dad in the garage. He loves rock and roll music (he will often do better during therapy when music is played). He likes to snowboard and skateboard. His parents describe him as a typical teenager that would sleep in all morning and be up all night. He and his family are very involved in their church. His parents live an hour away but come to visit every weekend. They live in a 2-story cabin in Big Bear, where Ryan’s bathroom is upstairs with a walk-in shower. He has 4 younger siblings. His parents verbalize that they want him to be as independent as possible and want him to return to “normal.” However, Ryan’s mom hates to see him struggle, and thus rushes to help him any time he has trouble. Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Case Example: Ryan, cont. What contexts inhibit Ryan’s ability to engage in his daily occupations? Which contexts support Ryan’s ability to engage in his daily occupations? What performance patterns does Ryan exhibit? Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.  Conclusion Conducting an occupation-based activity analysis involves understanding how the client defines the occupation. The multiple environments and contexts that surround the client must be considered. We must understand the client’s meaning and purpose for engaging in the occupation. Performance patterns also influence engagement. Environment and contexts can support or hinder participation. This information can be gathered through the occupational profile interview. Thomas H. Occupation-Based Activity Analysis, Second Edition. © 2015 SLACK Incorporated.