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Person Environment Occupational Performance model [keywords]
- Cross-border contributions to obesity research and interventions: a review of canadian and american occupational therapy contributions. [Journal Article]
- Occup Ther Health Care 2013 Apr; 27(2):129-41.
This paper identifies the contributions of Canadian and American occupational therapists to the empirical discourse on obesity. This scoping study includes an independent review of the published literature followed by a series of meetings during which key themes and contributions were categorized. The Person, Environment, Occupation, and Performance Model (Baum & Christiansen, 2005) was used to organize the themes reported in the literature. Although occupational therapists contribute to knowledge about body systems and functions as well as activity limitations and participation restrictions for persons with obesity, the majority of work has a focus on the environment and the person, with limited attention to occupation. Occupational therapy practitioners and researchers are contributing in areas valued in obesity research and practice but can do more to promote consideration of the interaction of personal, environmental, and occupational factors which may cause obesity or contribute to the participation in everyday living for persons with obesity.
- A conceptual-practice model for occupational therapy to facilitate return to work in breast cancer patients. [Journal Article]
- J Occup Rehabil 2013 Dec; 23(4):516-26.
Improved therapies and early detection have significantly increased the number of breast cancers survivors, leading to increasing needs regarding return to work (RTW). Occupational therapy (OT) interventions provide successful RTW assistance for other conditions, but are not validated in breast cancer. This paper aims to identify a theoretical framework for OT intervention by questioning how OT models can be used in OT interventions in RTW of breast cancer patients; criteria to be used to select these models and adaptations that would be necessary to match the OT model(s) to breast cancer patients' needs?Using research specific criteria derived from OT literature (conceptual OT-model, multidisciplinary, referring to the International Classification of functioning (ICF), RTW in breast cancer) a search in 9 electronic databases was conducted to select articles that describe conceptual OT models. A content analysis of those models complying to at least two of the selection criteria was realised. Checking for breast cancer specific issues, results were matched with literature of care-models regarding RTW in breast cancer.From the nine models initially identified, three [Canadian Model of Occupational Performance, Model of Human Occupation (MOHO), Person-Environment-Occupation-Performance model] were selected based on the selection criteria. The MOHO had the highest compliance rate with the criteria. To enhance usability in breast cancer, some adaptations are needed.No OT model to facilitate RTW in breast cancer could be identified, indicating a need to fill this gap. Individual and societal needs of breast cancer patients can be answered by using a MOHO-based OT model, extended with indications for better treatment, work-outcomes and longitudinal process factors.
- Innovative system for real-time ergonomic feedback in industrial manufacturing. [Journal Article, Research Support, Non-U.S. Gov't]
- Appl Ergon 2013 Jul; 44(4):566-74.
This work presents a system that permits a real-time ergonomic assessment of manual tasks in an industrial environment. First, a biomechanical model of the upper body has been developed by using inertial sensors placed at different locations on the upper body. Based on this model, a computerized RULA ergonomic assessment was implemented to permit a global risk assessment of musculoskeletal disorders in real-time. Furthermore, local scores were calculated per segment, e.g. the neck region, and gave information on the local risks for musculoskeletal disorders. Visual information was fed back to the user by using a see-through head mounted display. Additional visual highlighting and auditory warnings were provided when some predefined thresholds were exceeded. In a user study (N = 12 participants) a group with the RULA feedback was compared to a control group. Results demonstrate that the real-time ergonomic feedback significantly decreased the outcome of both globally as well as locally hazardous RULA values that are associated with increased risk for musculoskeletal disorders. Task execution time did not differ between groups. The real-time ergonomic tool introduced in this study has the potential to considerably reduce the risk of musculoskeletal disorders in industrial settings. Implications for ergonomics in manufacturing and user feedback modalities are further discussed.
- Work capacity assessment and return to work: a scoping review. [Journal Article, Review]
- Work 2013 Jan 1; 44(1):37-55.
This review sought to synthesize existing evidence on work capacity assessments and to identify the knowledge supporting their use in return to work practice and future research.A scoping review was conducted identifying studies examining assessments used in return to work. Studies published before 1986 and studies not written in English were excluded. A five point relevancy criteria was used to establish the fit of articles with the research question. Articles were thematically analyzed into components of the PEO Model, proposed future research, and areas of vested interest.Forty four articles met the criteria for inclusion. For over twenty five years, work capacity assessment literature has remained focused on the individual's physical work performance capacities. Gaps were identified in the lack of qualitative research and incorporation of person, occupation, and environmental dimensions in evaluation of work capacity. Future research recommendations emphasize the need for knowledge generation on work modification and investigation of psychosocial factors that impact work capacity and return to work yet only minimal progression is evident in these areas in the literature reviewed.The limited consideration of the occupation and environmental dimensions in returning to work and the global interest in work capacity assessment highlight the need for the development of contextually based assessment tools. Assessment needs to move toward the incorporation of environmental and occupational aspects in addition to the person dimension in a culturally transcendent manner.
- Support and process in individual placement and support: a multiple case study. [Journal Article, Research Support, Non-U.S. Gov't]
- Work 2013; 44(4):435-48.
This multiple case study investigated support and process in the Individual Placement and Support (IPS) approach from individual client, longitudinal, and Person-Environment-Occupation (PEO) model perspectives.Five IPS-participants, or cases, with severe mental illness (SMI) who worked a minimum of 4 hours a week entered the study.A multiple data collection method was used over a period of 12 months and included IPS-vocational profiles and plans as well as various instruments and questionnaires concerning socio-demographics, work performance, limitations, and accommodations. Both within- and across-case analyses were performed.The IPS-process concerned job search support, job-matches (PEO-match), and adjustment of the PEO-match by providing accommodations by on- and off-worksite support. All participants had limitations concerning social interactions and handling symptoms/tolerating stress. Several accommodations were made for the same limitations, mostly directed towards the social environment. Prior work experience, disclosure, and not being in an acute phase of illness seemed important to the support provided.This study has visualised the support and process in IPS and provided a theoretical framework, the PEO-model, to detect limitations and provide IPS-support. The organization of IPS-support and methods of providing it to individuals may be important for job tenure and employment success.
- Real-time fit of a respirator during simulated health care tasks. [Evaluation Studies, Journal Article, Research Support, Non-U.S. Gov't]
- J Occup Environ Hyg 2012; 9(10):563-71.
Fit is an important but difficult-to-predict feature of respirator performance. This study examined a new approach to measuring respirator performance using two continuous direct-reading particle-counting instruments in a simulated health care workplace. A pilot test was conducted with eight experienced health care professionals who passed a traditional quantitative fit test before performing three randomized 10-min health care scenarios (patient assessment [PA], IV treatment [IV], and wound care [WC]). Two TSI Portacount Plus (Model 8020) with N95 Companion (Model 8095) instruments were used to continuously measure 1-sec ambient particle concentrations inside and outside the respirator facepiece. A simulated workplace protection factor (SWPF) was calculated by dividing outside by inside concentrations. Data were log transformed and examined using analysis of variance (ANOVA) between subjects, scenario types, and scenario order. The GM SWPF for the eight subjects, three scenarios per subject, ranged from 172 to 1073 (GSD 1.7 to 3.5) and was significantly different for each subject. A multi-way analysis of variance showed no difference between the three scenario types (PA, IV, WC). There were differences by the order in which scenarios were performed: the third scenario SWPF was significantly different and higher than that of the first and second scenarios. All subjects passed the initial quantitative fit test with a fit factor of at least 100. Five subjects had fit factors greater than 200 and GM scenario SWPFs greater than 400. Three participants with initial fit factors less than 200 had GM scenario SWPFs ranging from 132 to 326. This pilot test demonstrates that it is possible to evaluate instantaneous respirator fit using two quantitative fit test instruments in a simulated health care environment. Results suggest that an initial fit test may be predictive of fit during simulated tasks and that one scenario may be adequate for measuring a simulated workplace protection factor. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a video for subject D activities overlaid with simulated workplace protection factor data.].
- Health factors in the everyday life and work of public sector employees in Sweden. [Journal Article]
- Work 2012; 42(3):321-30.
The aim was to explore aspects of everyday life in addition to established risk factors and their relationship to subjective health and well-being among public sector employees in Sweden. Gainful employment impact on employees' health and well-being, but work is only one part of everyday life and a broader perspective is essential in order to identify health-related factors.Data were obtained from employees at six Social Insurance Offices in Sweden, 250 women and 50 men.A questionnaire based on established instruments and questions specifically designed for this study was used. Relationships between five factors of everyday life, subjective health and well-being were investigated by means of multivariate logistic regression analysis.The final model revealed a limited importance of certain work-related factors. A general satisfaction with everyday activities, a stress-free environment and general control in addition to not having monotonous movements at work were found to be factors explaining 46.3% of subjective good health and well-being.A person's entire activity pattern, including work, is important, and strategies for promoting health should take into account the person's situation as a whole. The interplay between risk and health factors is not clear and further research is warranted.
- Partnering for change: an innovative school-based occupational therapy service delivery model for children with developmental coordination disorder. [Journal Article]
- Can J Occup Ther 2012 Feb; 79(1):41-50.
Developmental coordination disorder (DCD) is a common, chronic health condition that is poorly recognized and understood in school settings. Without appropriate support, children with DCD are at increased risk of depression, decreased fitness, and obesity. Evidence shows that occupational therapy intervention needs to shift from remediation of impairment to chronic disease management.This paper describes Partnering for Change (P4C), an innovative, empirically derived school health service delivery model for children with DCD.The model emphasizes the partnership of the occupational therapist with educators and parents to change the life and daily environment of a child. The P4C partnership focuses on capacity building through collaboration and coaching in context. The model uses a tiered approach which includes whole class instruction, dynamic performance analysis, and monitoring response to intervention.P4C is a model that responds to the needs of this population, addresses issues identified in research, and provides a continuum of services designed to build capacity.
- Comparison of occupational exposure methods relevant to musculoskeletal disorders: Worker-workstation interaction in an office environment. [Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.]
- J Electromyogr Kinesiol 2012 Apr; 22(2):176-85.
Work related musculoskeletal disorders have been associated with office work yet exposure quantification is challenging and not measured consistently. Our objective was to examine associations within and across exposure measurements guided by a conceptual model of three measurement locations: external to the body, at the interface, and internal to the body. Forty-one office workers (71% female), mean age 41 years (SD=9.6), mean height 168cm (SD=10.3), and mean weight 74kg (SD=19), were recruited from a large urban newspaper. Four methods of quantifying mechanical exposure were used linked to locations: equipment dimensions (external), relative fit and postures (interface), and EMG (internal). We explored: (1) a within-location analysis of relationships among methods; and (2) a cross-location analysis of relationships among methods. Exposure method comparisons showed mostly weak correlations among equipment variables, moderate correlations among posture variables, and strong or moderate correlations among EMG variables. For the majority of pair-wise comparisons between exposure measures across locations, the correlations were weak or moderate. Comparisons of relative fit revealed some differences in dimensions, postures, and EMG measures. Few strong associations between various exposure measures were found, although worker-reported relative fit holds promise. Future work might link exposure methods (specific measures) with locations for particular purposes.
- Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints. [Journal Article, Research Support, U.S. Gov't, P.H.S.]
- Appl Ergon 2012 May; 43(3):554-63.
It is well established that psychosocial work stressors relate to employees' work-related musculoskeletal disorder (WRMSD) symptoms. Using a model investigating psychological strain as a mediator between work stressors and WRMSD complaints, this study demonstrated that high levels role conflict, low job control, and low safety-specific leadership are associated with increased employee strain. Strain, in turn, was related to higher levels of WRMSD symptoms of the wrist/hand, shoulders, and lower back. Partial mediation of some relationships was also found, suggesting that additional meditational mechanisms for the relationships between stressors and musculoskeletal symptoms are plausible. This work supports the notion that psychosocial stressors in the work environment have important links to employee health, especially WRMSDs.