Emerita professor, McMaster University, Canada. Areas of focus: cultural influences in health care, professional preparation and continuing professional development
Canadian Journal of Occupational Therapy, Oct 1, 1989
This paper describes the interview process, the assessments, report writing and potential giving ... more This paper describes the interview process, the assessments, report writing and potential giving of testimony involved in an occupational therapy medico-legal service for chronic pain patients which is provided for lawyers, insurance companies and other community agencies. The programme is available through the occupational therapy department at McMaster University Medical Centre of Chedoke-McMaster Hospitals, Hamilton, Ontario. The assessment process is delineated, including descriptions of the initial interview and functional assessment using both standardized and non-standardized tests, a self-monitoring diary, a home visit, a job site visit, and a work placement. Potential treatment recommendations are outlined. The content of the medico-legal report is examined utilizing personal experience and current literature and recommendations for testimony are explored.
Work-a Journal of Prevention Assessment & Rehabilitation, 2004
This paper addresses the particular experience of negotiating, creating and operationalizing stre... more This paper addresses the particular experience of negotiating, creating and operationalizing streamlined processes for a specialized consultation team, within a multi-site academic health science complex, for determining the rehabilitation needs and appropriate program for patients who had experienced surgery for a fractured hip. Background information concerning the main study is provided with the focus of analysis and discussion being upon the processes and outcomes of changing the way work had been undertaken over many years. It also addresses the complexity of attempting to encourage ongoing reflection related to roles and functions within a multi-disciplinary health care team.
Canadian Journal of Occupational Therapy, Apr 1, 2000
ABSTRACT The "Vancouver experience" engendered great interest, generating palpa... more ABSTRACT The "Vancouver experience" engendered great interest, generating palpable energy and enthusiasm. There were clear messages concerning what we need to know, what we need to learn and how we need to make this awareness a reality. This was a powerful opportunity to share ideas and to build on natural passion and beliefs. Now the task is to ensure that actions are coupled with these insights, resulting in a rich and vibrant future for Canadian occupational therapists.
Canadian Journal of Occupational Therapy, Apr 1, 1994
Doubling enrolment in the undergraduate occupational therapy programme at McMaster University was... more Doubling enrolment in the undergraduate occupational therapy programme at McMaster University was introduced in a climate of fiscal crisis. This paper will discuss the creative implementation of a Quality Circle Model in the Occupational Therapy Department at Chedoke-McMaster Hospitals, Hamilton, Ontario, which promoted concerted staff participation and self management development in light of increased student learning needs. An alternate model of Clinical Supervision was examined. The impact of this proactive, problem solving approach will be addressed and may encourage application in other occupational therapy settings.
This paper describes a group program which is part of the therapeutic management of outpatients w... more This paper describes a group program which is part of the therapeutic management of outpatients with chronic pain at the multidisciplinary Pain Clinic in Hamilton, Ontario (McMaster Division, Chedoke-McMaster Hospi-t~). The programme seeks to assist chronic pain sufferers in developing more adaptive coping styles. Groups of 12-14 patients meet for 9 weeks, 3 h/week, under the coleadership of a physiotherapist and an occupational therapist with backgrounds in psychology and psychiatry. Seventy-five patients with diverse aetiologies of chronic pain have completed these "pain control classes". Outcome was assessed on the basis of several parameters. Results indicate a considerable reduction in depression, pain perception and analgesic intake. Conversely, employment figures increased from 20 to 48% after completion of the program. 21% were considered failures. Significant variables differentiating successes from failures were sex, marital status, work incentive, employment and absence of litigation or Workmen's Compensation claims.
Problem Based Learning for Learners: A Primer is an interesting and unique new text written with ... more Problem Based Learning for Learners: A Primer is an interesting and unique new text written with the occupational therapist in mind. Following the PBL process, the scenario for exploration is established by using "problem-based learning". Developed from the perspective of a learner resource, over 30 years of experience within a problem-based learning environment is brought to the pages of this comprehensive text, from the author. While it is necessary to understand the process of problem-based learning, "doing" is the main focus of teaching in this text. Inside the different steps taken in the PBL process are covered, such as articuiating the problem, deciding what is already known, brainstorming ideas, defining a learning plan, researching, synthesizing the knowledge learned, and re-defining further learning needs.
World Federation of Occupational Therapists Bulletin, Nov 1, 2013
To successfully advance the profession of occupational therapy and improve access to our services... more To successfully advance the profession of occupational therapy and improve access to our services, we need leadership as well as mentorship strategies and initiatives. Leaders help push boundaries and champion advancements in practice, policy, research and education to develop and promote client-centred, occupation-based enablement. To further develop leadership capacity, we need to put in place multiple, innovative mentorship strategies. This article illustrates some concrete strategies and initiatives undertaken by the Canadian Association of Occupational Therapists (CAOT) to foster mentorship and leadership such as the creation of a new Fellowship program. Our goal in sharing this information is to inspire and encourage occupational therapists worldwide to develop personalized and creative initiatives to foster the role of leaders and mentors.
Primary Health Care Research & Development, Jun 22, 2010
Aim: The primary objective of this study was to determine whether adults with a chronic illness w... more Aim: The primary objective of this study was to determine whether adults with a chronic illness within a primary care setting who received a rehabilitation intervention in this setting showed greater improvement in health status and had fewer hospital admissions and emergency room visits compared with adults who do not receive the intervention. Background: More than half of Canadians (16 million people) live with chronic illness. Persons with chronic illness in primary care, especially older persons who are most at risk for functional decline, are currently not receiving effective management. Methods: A randomized controlled trial was used. A rehabilitation multi-component intervention was delivered by a physiotherapist (PT) and occupational therapist in a primary care setting and included collaborative goal setting for rehabilitation needs, a six-week chronic disease self-management (SM) workshop, referral to community programs and a web-based education programme. Findings: Three hundred and three patients participated, n 5 152 intervention group and n 5 151 in the control group. There was a significant difference between the groups for planned hospital days (F 5 6.3, P 5 0.00) with an adjusted difference 0.60 day per person, and increased satisfaction with rehabilitation services however no difference on health status or emergency room visits. This rehabilitation intervention which had a strong SM component prevented planned hospitalizations that resulted in a conservative estimated cost saving from reduced hospitalizations of $65 000. Future research needs to examine which patient groups with chronic illness show positive responses to rehabilitation and self-management.
E-Learn: World Conference on E-Learning in Corporate, Government, Healthcare, and Higher Education, Oct 15, 2007
... The construction of learning ecologies will enable collaborative learning to emerge from with... more ... The construction of learning ecologies will enable collaborative learning to emerge from within online communities of practice (Looi, 2001; Barajas & Owen, 2000). ... Cambridge, UK; New York, NY: Cambridge University Press. Looi, C.-K. (2001). ...
World Federation of Occupational Therapists Bulletin, May 1, 2008
Abstract The World Federation of Occupational Therapists (WFOT) and McMaster University collabora... more Abstract The World Federation of Occupational Therapists (WFOT) and McMaster University collaborated on a study to gain an understanding of the current profile of inclusive education that is in place presently in WFOT accredited occupational therapy (OT) educational programs. This study utilized survey methodology to gather data on admission to and learning in OT education programs for students with disabilities at the international level. The survey instrument used was a self-administered on-line questionnaire. The target sample was the total pool of 568 WFOT accredited post-secondary educational institutions that offer OT education programs at the pre-licensure level. The results indicate that physical, attitudinal and social issues were most frequently raised as barriers to inclusive education. However, occupational therapy programs have made considerable efforts to address issues of access and inclusion, including making changes to campus environments and developing student support services. The information from this study will contribute to the existing literature on inclusive education and will also serve to inform WFOT on the development of a position statement on inclusive OT education which is critical to promoting increased awareness and dialogue on issues of accessaffecting OT education and how the OT community can best work together to address them.
Background: The International Classification of Functioning, Disability and Health (ICF) and subs... more Background: The International Classification of Functioning, Disability and Health (ICF) and subsequent ICF-CY (child and youth version) recognize the importance of personal and environmental factors in facilitating holistic transition planning and service delivery for youth with chronic health conditions (YCHC). Aims: The objective of this scoping review is to investigate the degree to which the ICF and ICF-CY have been used in transition research and practice since its initial publication. Methods: Arksey and O'Malley's five-stage methodological framework guided the scoping review using the following databases: AMED, CINAHL, EMBASE, HealthSTAR, MEDLINE, and PsycINFO. Keywords included: 'ICF', 'ICF-CY', and 'transition', which were adapted to each database. Results: 25 articles met final inclusion. Two key themes emerged regarding use of the ICF: 1) the ICF enhances transdisciplinary processes to inform transition planning and interventions; and 2) the ICF facilitates comprehensive and developmentally appropriate transition services over a youth's lifecourse. The strengths and limitations of the ICF in guiding the planning and delivery of transition services are discussed. Some limitations include the large number of items inherent within the ICF and a lack of clarity between the components of activity and participation. Conclusion: Key recommendations include: i) further explanation and development of items for quality of life and well-being, personal factors, and psychological issues; and ii) additional research to advance knowledge towards developing empirically-based evidence for the application of the ICF in clinical practice to facilitate transition. What this paper adds The findings of this scoping review advances knowledge about how the ICF framework can be implemented in the planning and delivery of transition services to address some of the current knowledge gaps, including: i) provision of a common language and an internationally recognized transdisciplinary framework to guide interventions, goal-setting, evaluation procedures, assessing and monitoring progress and healthcare outcomes; ii) shift the focus from diagnosis and treatment of somatic issues (illness, injury, or
Canadian Journal of Occupational Therapy, Oct 1, 2018
Linking occupational therapy models and assessments to the ICF to enable standardized documentati... more Linking occupational therapy models and assessments to the ICF to enable standardized documentation of functioning Relier les modè les et é valuations en ergothé rapie à la CIF en vue de favoriser la cré ation d'un systè me de documentation normatif du fonctionnement
Canadian Journal of Occupational Therapy, Oct 1, 1989
This paper describes the interview process, the assessments, report writing and potential giving ... more This paper describes the interview process, the assessments, report writing and potential giving of testimony involved in an occupational therapy medico-legal service for chronic pain patients which is provided for lawyers, insurance companies and other community agencies. The programme is available through the occupational therapy department at McMaster University Medical Centre of Chedoke-McMaster Hospitals, Hamilton, Ontario. The assessment process is delineated, including descriptions of the initial interview and functional assessment using both standardized and non-standardized tests, a self-monitoring diary, a home visit, a job site visit, and a work placement. Potential treatment recommendations are outlined. The content of the medico-legal report is examined utilizing personal experience and current literature and recommendations for testimony are explored.
Work-a Journal of Prevention Assessment & Rehabilitation, 2004
This paper addresses the particular experience of negotiating, creating and operationalizing stre... more This paper addresses the particular experience of negotiating, creating and operationalizing streamlined processes for a specialized consultation team, within a multi-site academic health science complex, for determining the rehabilitation needs and appropriate program for patients who had experienced surgery for a fractured hip. Background information concerning the main study is provided with the focus of analysis and discussion being upon the processes and outcomes of changing the way work had been undertaken over many years. It also addresses the complexity of attempting to encourage ongoing reflection related to roles and functions within a multi-disciplinary health care team.
Canadian Journal of Occupational Therapy, Apr 1, 2000
ABSTRACT The "Vancouver experience" engendered great interest, generating palpa... more ABSTRACT The "Vancouver experience" engendered great interest, generating palpable energy and enthusiasm. There were clear messages concerning what we need to know, what we need to learn and how we need to make this awareness a reality. This was a powerful opportunity to share ideas and to build on natural passion and beliefs. Now the task is to ensure that actions are coupled with these insights, resulting in a rich and vibrant future for Canadian occupational therapists.
Canadian Journal of Occupational Therapy, Apr 1, 1994
Doubling enrolment in the undergraduate occupational therapy programme at McMaster University was... more Doubling enrolment in the undergraduate occupational therapy programme at McMaster University was introduced in a climate of fiscal crisis. This paper will discuss the creative implementation of a Quality Circle Model in the Occupational Therapy Department at Chedoke-McMaster Hospitals, Hamilton, Ontario, which promoted concerted staff participation and self management development in light of increased student learning needs. An alternate model of Clinical Supervision was examined. The impact of this proactive, problem solving approach will be addressed and may encourage application in other occupational therapy settings.
This paper describes a group program which is part of the therapeutic management of outpatients w... more This paper describes a group program which is part of the therapeutic management of outpatients with chronic pain at the multidisciplinary Pain Clinic in Hamilton, Ontario (McMaster Division, Chedoke-McMaster Hospi-t~). The programme seeks to assist chronic pain sufferers in developing more adaptive coping styles. Groups of 12-14 patients meet for 9 weeks, 3 h/week, under the coleadership of a physiotherapist and an occupational therapist with backgrounds in psychology and psychiatry. Seventy-five patients with diverse aetiologies of chronic pain have completed these "pain control classes". Outcome was assessed on the basis of several parameters. Results indicate a considerable reduction in depression, pain perception and analgesic intake. Conversely, employment figures increased from 20 to 48% after completion of the program. 21% were considered failures. Significant variables differentiating successes from failures were sex, marital status, work incentive, employment and absence of litigation or Workmen's Compensation claims.
Problem Based Learning for Learners: A Primer is an interesting and unique new text written with ... more Problem Based Learning for Learners: A Primer is an interesting and unique new text written with the occupational therapist in mind. Following the PBL process, the scenario for exploration is established by using "problem-based learning". Developed from the perspective of a learner resource, over 30 years of experience within a problem-based learning environment is brought to the pages of this comprehensive text, from the author. While it is necessary to understand the process of problem-based learning, "doing" is the main focus of teaching in this text. Inside the different steps taken in the PBL process are covered, such as articuiating the problem, deciding what is already known, brainstorming ideas, defining a learning plan, researching, synthesizing the knowledge learned, and re-defining further learning needs.
World Federation of Occupational Therapists Bulletin, Nov 1, 2013
To successfully advance the profession of occupational therapy and improve access to our services... more To successfully advance the profession of occupational therapy and improve access to our services, we need leadership as well as mentorship strategies and initiatives. Leaders help push boundaries and champion advancements in practice, policy, research and education to develop and promote client-centred, occupation-based enablement. To further develop leadership capacity, we need to put in place multiple, innovative mentorship strategies. This article illustrates some concrete strategies and initiatives undertaken by the Canadian Association of Occupational Therapists (CAOT) to foster mentorship and leadership such as the creation of a new Fellowship program. Our goal in sharing this information is to inspire and encourage occupational therapists worldwide to develop personalized and creative initiatives to foster the role of leaders and mentors.
Primary Health Care Research & Development, Jun 22, 2010
Aim: The primary objective of this study was to determine whether adults with a chronic illness w... more Aim: The primary objective of this study was to determine whether adults with a chronic illness within a primary care setting who received a rehabilitation intervention in this setting showed greater improvement in health status and had fewer hospital admissions and emergency room visits compared with adults who do not receive the intervention. Background: More than half of Canadians (16 million people) live with chronic illness. Persons with chronic illness in primary care, especially older persons who are most at risk for functional decline, are currently not receiving effective management. Methods: A randomized controlled trial was used. A rehabilitation multi-component intervention was delivered by a physiotherapist (PT) and occupational therapist in a primary care setting and included collaborative goal setting for rehabilitation needs, a six-week chronic disease self-management (SM) workshop, referral to community programs and a web-based education programme. Findings: Three hundred and three patients participated, n 5 152 intervention group and n 5 151 in the control group. There was a significant difference between the groups for planned hospital days (F 5 6.3, P 5 0.00) with an adjusted difference 0.60 day per person, and increased satisfaction with rehabilitation services however no difference on health status or emergency room visits. This rehabilitation intervention which had a strong SM component prevented planned hospitalizations that resulted in a conservative estimated cost saving from reduced hospitalizations of $65 000. Future research needs to examine which patient groups with chronic illness show positive responses to rehabilitation and self-management.
E-Learn: World Conference on E-Learning in Corporate, Government, Healthcare, and Higher Education, Oct 15, 2007
... The construction of learning ecologies will enable collaborative learning to emerge from with... more ... The construction of learning ecologies will enable collaborative learning to emerge from within online communities of practice (Looi, 2001; Barajas & Owen, 2000). ... Cambridge, UK; New York, NY: Cambridge University Press. Looi, C.-K. (2001). ...
World Federation of Occupational Therapists Bulletin, May 1, 2008
Abstract The World Federation of Occupational Therapists (WFOT) and McMaster University collabora... more Abstract The World Federation of Occupational Therapists (WFOT) and McMaster University collaborated on a study to gain an understanding of the current profile of inclusive education that is in place presently in WFOT accredited occupational therapy (OT) educational programs. This study utilized survey methodology to gather data on admission to and learning in OT education programs for students with disabilities at the international level. The survey instrument used was a self-administered on-line questionnaire. The target sample was the total pool of 568 WFOT accredited post-secondary educational institutions that offer OT education programs at the pre-licensure level. The results indicate that physical, attitudinal and social issues were most frequently raised as barriers to inclusive education. However, occupational therapy programs have made considerable efforts to address issues of access and inclusion, including making changes to campus environments and developing student support services. The information from this study will contribute to the existing literature on inclusive education and will also serve to inform WFOT on the development of a position statement on inclusive OT education which is critical to promoting increased awareness and dialogue on issues of accessaffecting OT education and how the OT community can best work together to address them.
Background: The International Classification of Functioning, Disability and Health (ICF) and subs... more Background: The International Classification of Functioning, Disability and Health (ICF) and subsequent ICF-CY (child and youth version) recognize the importance of personal and environmental factors in facilitating holistic transition planning and service delivery for youth with chronic health conditions (YCHC). Aims: The objective of this scoping review is to investigate the degree to which the ICF and ICF-CY have been used in transition research and practice since its initial publication. Methods: Arksey and O'Malley's five-stage methodological framework guided the scoping review using the following databases: AMED, CINAHL, EMBASE, HealthSTAR, MEDLINE, and PsycINFO. Keywords included: 'ICF', 'ICF-CY', and 'transition', which were adapted to each database. Results: 25 articles met final inclusion. Two key themes emerged regarding use of the ICF: 1) the ICF enhances transdisciplinary processes to inform transition planning and interventions; and 2) the ICF facilitates comprehensive and developmentally appropriate transition services over a youth's lifecourse. The strengths and limitations of the ICF in guiding the planning and delivery of transition services are discussed. Some limitations include the large number of items inherent within the ICF and a lack of clarity between the components of activity and participation. Conclusion: Key recommendations include: i) further explanation and development of items for quality of life and well-being, personal factors, and psychological issues; and ii) additional research to advance knowledge towards developing empirically-based evidence for the application of the ICF in clinical practice to facilitate transition. What this paper adds The findings of this scoping review advances knowledge about how the ICF framework can be implemented in the planning and delivery of transition services to address some of the current knowledge gaps, including: i) provision of a common language and an internationally recognized transdisciplinary framework to guide interventions, goal-setting, evaluation procedures, assessing and monitoring progress and healthcare outcomes; ii) shift the focus from diagnosis and treatment of somatic issues (illness, injury, or
Canadian Journal of Occupational Therapy, Oct 1, 2018
Linking occupational therapy models and assessments to the ICF to enable standardized documentati... more Linking occupational therapy models and assessments to the ICF to enable standardized documentation of functioning Relier les modè les et é valuations en ergothé rapie à la CIF en vue de favoriser la cré ation d'un systè me de documentation normatif du fonctionnement
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