Australian Occupational Therapy Journal, Mar 10, 2023
IntroductionCulturally safe and meaningful cognitive assessment methods for use with Aboriginal a... more IntroductionCulturally safe and meaningful cognitive assessment methods for use with Aboriginal and Torres Strait Islander peoples are scarce. Concerns are raised regarding the efficacy of existing methods in cross‐cultural contexts. The Perceive, Recall, Plan and Perform (PRPP) Assessment offers a person‐centred alternative whereby cognitive strategy application is examined during performance of culturally relevant everyday tasks. This paper explores its use with Aboriginal and Torres Strait Islander peoples in Australia.MethodsA critical case study design was applied to examine the effectiveness and relevance of the PRPP Assessment with two Aboriginal Australian people in the Northern Territory of Australia. ‘Ivan’ and ‘Jean’ were each receiving occupational therapy through a rehabilitation service over a 6‐month period following acquired brain injuries. Ivan and Jean were assessed performing everyday tasks of interest and importance to them as part of routine care. A partnership approach was adopted throughout the process, and both consented to their stories being told.ResultsThe PRPP Assessment was able to measure changes in Ivan's and Jean's cognitive strategy use and its impact on performance of meaningful tasks. Ivan demonstrated a 46% increase in performance mastery and a 29% increase in cognitive strategy use with most improvements identified in his ability to sense information, initiate action, and continue performance. Jean demonstrated a 71% increase in performance mastery and a 32% increase in cognitive strategy use. Her greatest improvements were in the ability to recall schemes, self‐evaluate, and initiate action.ConclusionThe two critical case stories shared in this study suggest that the PRPP Assessment has emerging evidence of clinical utility when used with Aboriginal people with acquired brain impairment. The information gained revealed strengths in performance; it was effective in measuring change in cognitive strategy use, was able to inform the goal setting process, and guided intervention to support cognitive strategy use during task performance.
A common and clinically important complication of late stage human immunodeficiency virus Type 1 ... more A common and clinically important complication of late stage human immunodeficiency virus Type 1 (HIV-1) infection is HIV-associated neurocognitive disorder (HAND). HAND encompasses three syndromes, HIVassociated asymptomatic neurocognitive impairment (ANI), HIV-1-associated mild neurocognitive disorder (MND), and HIV-1-associated dementia (HAD). It is estimated that 30-60% of all HIV-1 infected individuals will have at least mild neurocognitive impairment (MND), and 10-15% of those will develop HAD. Research conducted outside medicine has focused on identifying the type and pattern of neuropsychological impairments present in people with HAND, and to correlate impairments identified from neuropsychological testing with scores on laboratory-based tests of everyday task performance. Typically, the performance of tasks and routines in daily life occurs in naturalistic contexts, and is orchestrated around the achievement of personally meaningful, needed and/or desired performance goals. It requires that one uses cognitive strategies to attend, perceive, remember, decide, plan and act on intentions within real-world contexts. Little is known about the impact of cognitive information processing strategy application impairments on the performance of meaningful tasks and routines carried out by people with HAND in contexts where performance would naturally occur. vii
British Journal of Occupational Therapy, Apr 13, 2016
Introduction Few ecologically valid assessment tools are available for occupational therapists to... more Introduction Few ecologically valid assessment tools are available for occupational therapists to evaluate the cognitive demands and performance of women with breast cancer in the workplace. This study aims to identify difficulties in work-related cognitive strategy use experienced by women with breast cancer using the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. Method Deductive content analysis was used to code secondary data from 10 interview transcripts involving women who had breast cancer and experienced difficulties in everyday cognitive functioning after treatment. Thirty-four PRPP cognitive strategy items were used as pre-determined codes in a secondary analysis to identify and quantify specific cognitive difficulties described by the women. Results The 10 women experienced problems with work tasks that required the cognitive strategies related to the ‘programming’, ‘continuing’, and ‘attending’ processing categories of the PRPP system. In addition, the women demonstrated strengths in their capacity to evaluate their own thinking and performance. Conclusion This pilot study indicated the need for further research to determine how cognitive impairments which may occur after breast cancer treatment impact on occupational performance in a complex work environment. The PRPP System of Task Analysis was identified as a potentially useful measurement and interview tool for this purpose.
This study explores how spirituality is integrated into practice across the different Australian ... more This study explores how spirituality is integrated into practice across the different Australian health professions. Utilising the Joanna Briggs Institute's (JBI) protocol, six databases were searched, and sixty-seven articles were finally included. To present the findings, a qualitative synthesis was used. 'Meaning' and 'purpose in life' were found to be key to many spirituality definitions. The most frequently reported approach for Australian health professionals (HPs) in asking about client spirituality was using one or two questions within a comprehensive assessment. Major facilitators included a holistic care approach and prior training, whereas a key barrier was a lack of time.
Australian Occupational Therapy Journal, May 8, 2014
Research into the paid employment of people with spinal cord injury or traumatic brain injury is ... more Research into the paid employment of people with spinal cord injury or traumatic brain injury is prevalent; however, little research has examined the factors that may support employment for adults with a concomitant spinal cord injury and traumatic brain injury (dual diagnosis). This study aimed to determine the level of paid employment reported by people with dual diagnosis and to explore contextual factors that supported paid employment. This cross-sectional cohort study recruited 30 participants with dual diagnosis from a specialist spinal rehabilitation unit. Interviews were conducted during the first five years post-rehabilitation discharge to determine level of paid employment and contextual factors that supported employment. At interview, 47% of participants were in paid employment. Employment type at interview indicated a shift away from more physically intensive jobs. Employed and unemployed participants reported a high level of social support and reported experiencing few physical or attitudinal barriers in their day to day lives. These environmental factors did not differentiate between employed and unemployed participants (z range = -0.98 to -0.17; P value range = 0.33-0.86). The most common facilitator of employment identified by participants was the personal factor - motivation (93% of employed participants). When considering the impact of contextual factors on paid employment for people with a dual diagnosis of spinal cord injury/traumatic brain injury, personal factors may be of greater influence than environmental factors. Study participants experienced few physical or attitudinal barriers and reported highly supportive interpersonal relationships.
This study explores how spirituality is integrated into practice across the different Australian ... more This study explores how spirituality is integrated into practice across the different Australian health professions. Utilising the Joanna Briggs Institute’s (JBI) protocol, six databases were searched, and sixty-seven articles were finally included. To present the findings, a qualitative synthesis was used. ‘Meaning’ and ‘purpose in life’ were found to be key to many spirituality definitions. The most frequently reported approach for Australian health professionals (HPs) in asking about client spirituality was using one or two questions within a comprehensive assessment. Major facilitators included a holistic care approach and prior training, whereas a key barrier was a lack of time.
TOG : Revista de Terapia Ocupacional de la APGTO, 2007
RESUMENLas ideas actuales de desempeño ocupacional están siendo desarrolladas en todo el mundo al... more RESUMENLas ideas actuales de desempeño ocupacional están siendo desarrolladas en todo el mundo al mismo tiempo como directrices para la práctica (Asociación canadiense de Terapia, 1991) y con un sentido de desarrollo de una lengua profesional (Asociación americana de Terapia Ocupacional, Inc. 1989). Este artículo describe la aportación Australiana a este esfuerzo que extiende la existencia de conceptualizaciones a través del desarrollo de un modelo de desempeño ocupacional que explica la estructura del desempeño de las ocupaciones humanas. El Modelo de Desempeño (Australia) (Apéndice1) está estructurado alrededor de ocho construcciones, desempeño ocupacional, roles de desempeño ocupacional, áreas de desempeño ocupacional, componentes de desempeño ocupacional, elementos principales del desempeño ocupacional, entorno, espacio y tiempo.Este artículo describe la etapa de origen de la teorización sobre el desempeño ocupacional a través de la definición de la terminología constructiva y sugiriendo como están relacionadas esas estructuras. Las modificaciones de las construcciones y la terminología se sucederán tanto en el modelo susceptible de una investigación y un desarrollo adicional adicional, como también el resultado de la prueba de campo en las situaciones prácticas.
Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy ... more Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors. Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL). Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]): Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 -10.18, p = 0.000; WMFT (Functional Ability): z = -4.63, p = 0.000). Seven out of the eight participants exceeded the minimal detectable change on both subscales of the MAL. This study offers positive preliminary data regarding the feasibility of a home-based CI Therapy protocol. This requires further study through an appropriately powered control trial.
Australian Occupational Therapy Journal, May 8, 2014
Research into the paid employment of people with spinal cord injury or traumatic brain injury is ... more Research into the paid employment of people with spinal cord injury or traumatic brain injury is prevalent; however, little research has examined the factors that may support employment for adults with a concomitant spinal cord injury and traumatic brain injury (dual diagnosis). This study aimed to determine the level of paid employment reported by people with dual diagnosis and to explore contextual factors that supported paid employment. This cross-sectional cohort study recruited 30 participants with dual diagnosis from a specialist spinal rehabilitation unit. Interviews were conducted during the first five years post-rehabilitation discharge to determine level of paid employment and contextual factors that supported employment. At interview, 47% of participants were in paid employment. Employment type at interview indicated a shift away from more physically intensive jobs. Employed and unemployed participants reported a high level of social support and reported experiencing few physical or attitudinal barriers in their day to day lives. These environmental factors did not differentiate between employed and unemployed participants (z range = -0.98 to -0.17; P value range = 0.33-0.86). The most common facilitator of employment identified by participants was the personal factor - motivation (93% of employed participants). When considering the impact of contextual factors on paid employment for people with a dual diagnosis of spinal cord injury/traumatic brain injury, personal factors may be of greater influence than environmental factors. Study participants experienced few physical or attitudinal barriers and reported highly supportive interpersonal relationships.
NOTE: Some aspects of the constructs and assumptions presented in this model of occupational perf... more NOTE: Some aspects of the constructs and assumptions presented in this model of occupational performance are not new, but reflect a synthesis of ideas about the nature of human occupations found in the literature (CAOT, 1991; Christiansen, 1991; Meyer, 1922; Reed, 1984). Other aspects of the model extend these constructs and assumptions to form a new configuration of occupational performance that differs from notions currently in existence.
Introduction Few ecologically valid assessment tools are available for occupational therapists to... more Introduction Few ecologically valid assessment tools are available for occupational therapists to evaluate the cognitive demands and performance of women with breast cancer in the workplace. This study aims to identify difficulties in work-related cognitive strategy use experienced by women with breast cancer using the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. Method Deductive content analysis was used to code secondary data from 10 interview transcripts involving women who had breast cancer and experienced difficulties in everyday cognitive functioning after treatment. Thirty-four PRPP cognitive strategy items were used as pre-determined codes in a secondary analysis to identify and quantify specific cognitive difficulties described by the women. Results The 10 women experienced problems with work tasks that required the cognitive strategies related to the ‘programming’, ‘continuing’, and ‘attending’ processing categories of the PRPP system. In addition, t...
Conceptual models have become a major focus of occupational therapy practice and education in the... more Conceptual models have become a major focus of occupational therapy practice and education in the last two decades (American Occupational Therapy Association, Inc., 1973; Hagedorn, 1992; Dutton, Levy & Simon, 1993, Christiansen, 1991a; Reed, 1984; Reed & Sanderson, 1983). These conceptualisations are interpretations of the construct, 'occupation'. Some conceptual models interpret occupation from the perspective of human function and describe the nature of human occupations (Gilfoyle, Grady & Moore, 1981; Kiehlhofner 1985; Reed, 1984, p. 491). The majority, however, interpret occupation from the perspective of occupational therapy, thereby forming the basis of practice models for intervention (Allen, 1985; Ayres, 1979). Despite the evolution of numerous conceptual models describing both human occupations and occupational therapy no single model has adequately met the range of theoretical, practice, and explanatory demands of the profession (Hubbard, 1991).
Australian Occupational Therapy Journal, Mar 10, 2023
IntroductionCulturally safe and meaningful cognitive assessment methods for use with Aboriginal a... more IntroductionCulturally safe and meaningful cognitive assessment methods for use with Aboriginal and Torres Strait Islander peoples are scarce. Concerns are raised regarding the efficacy of existing methods in cross‐cultural contexts. The Perceive, Recall, Plan and Perform (PRPP) Assessment offers a person‐centred alternative whereby cognitive strategy application is examined during performance of culturally relevant everyday tasks. This paper explores its use with Aboriginal and Torres Strait Islander peoples in Australia.MethodsA critical case study design was applied to examine the effectiveness and relevance of the PRPP Assessment with two Aboriginal Australian people in the Northern Territory of Australia. ‘Ivan’ and ‘Jean’ were each receiving occupational therapy through a rehabilitation service over a 6‐month period following acquired brain injuries. Ivan and Jean were assessed performing everyday tasks of interest and importance to them as part of routine care. A partnership approach was adopted throughout the process, and both consented to their stories being told.ResultsThe PRPP Assessment was able to measure changes in Ivan's and Jean's cognitive strategy use and its impact on performance of meaningful tasks. Ivan demonstrated a 46% increase in performance mastery and a 29% increase in cognitive strategy use with most improvements identified in his ability to sense information, initiate action, and continue performance. Jean demonstrated a 71% increase in performance mastery and a 32% increase in cognitive strategy use. Her greatest improvements were in the ability to recall schemes, self‐evaluate, and initiate action.ConclusionThe two critical case stories shared in this study suggest that the PRPP Assessment has emerging evidence of clinical utility when used with Aboriginal people with acquired brain impairment. The information gained revealed strengths in performance; it was effective in measuring change in cognitive strategy use, was able to inform the goal setting process, and guided intervention to support cognitive strategy use during task performance.
A common and clinically important complication of late stage human immunodeficiency virus Type 1 ... more A common and clinically important complication of late stage human immunodeficiency virus Type 1 (HIV-1) infection is HIV-associated neurocognitive disorder (HAND). HAND encompasses three syndromes, HIVassociated asymptomatic neurocognitive impairment (ANI), HIV-1-associated mild neurocognitive disorder (MND), and HIV-1-associated dementia (HAD). It is estimated that 30-60% of all HIV-1 infected individuals will have at least mild neurocognitive impairment (MND), and 10-15% of those will develop HAD. Research conducted outside medicine has focused on identifying the type and pattern of neuropsychological impairments present in people with HAND, and to correlate impairments identified from neuropsychological testing with scores on laboratory-based tests of everyday task performance. Typically, the performance of tasks and routines in daily life occurs in naturalistic contexts, and is orchestrated around the achievement of personally meaningful, needed and/or desired performance goals. It requires that one uses cognitive strategies to attend, perceive, remember, decide, plan and act on intentions within real-world contexts. Little is known about the impact of cognitive information processing strategy application impairments on the performance of meaningful tasks and routines carried out by people with HAND in contexts where performance would naturally occur. vii
British Journal of Occupational Therapy, Apr 13, 2016
Introduction Few ecologically valid assessment tools are available for occupational therapists to... more Introduction Few ecologically valid assessment tools are available for occupational therapists to evaluate the cognitive demands and performance of women with breast cancer in the workplace. This study aims to identify difficulties in work-related cognitive strategy use experienced by women with breast cancer using the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. Method Deductive content analysis was used to code secondary data from 10 interview transcripts involving women who had breast cancer and experienced difficulties in everyday cognitive functioning after treatment. Thirty-four PRPP cognitive strategy items were used as pre-determined codes in a secondary analysis to identify and quantify specific cognitive difficulties described by the women. Results The 10 women experienced problems with work tasks that required the cognitive strategies related to the ‘programming’, ‘continuing’, and ‘attending’ processing categories of the PRPP system. In addition, the women demonstrated strengths in their capacity to evaluate their own thinking and performance. Conclusion This pilot study indicated the need for further research to determine how cognitive impairments which may occur after breast cancer treatment impact on occupational performance in a complex work environment. The PRPP System of Task Analysis was identified as a potentially useful measurement and interview tool for this purpose.
This study explores how spirituality is integrated into practice across the different Australian ... more This study explores how spirituality is integrated into practice across the different Australian health professions. Utilising the Joanna Briggs Institute's (JBI) protocol, six databases were searched, and sixty-seven articles were finally included. To present the findings, a qualitative synthesis was used. 'Meaning' and 'purpose in life' were found to be key to many spirituality definitions. The most frequently reported approach for Australian health professionals (HPs) in asking about client spirituality was using one or two questions within a comprehensive assessment. Major facilitators included a holistic care approach and prior training, whereas a key barrier was a lack of time.
Australian Occupational Therapy Journal, May 8, 2014
Research into the paid employment of people with spinal cord injury or traumatic brain injury is ... more Research into the paid employment of people with spinal cord injury or traumatic brain injury is prevalent; however, little research has examined the factors that may support employment for adults with a concomitant spinal cord injury and traumatic brain injury (dual diagnosis). This study aimed to determine the level of paid employment reported by people with dual diagnosis and to explore contextual factors that supported paid employment. This cross-sectional cohort study recruited 30 participants with dual diagnosis from a specialist spinal rehabilitation unit. Interviews were conducted during the first five years post-rehabilitation discharge to determine level of paid employment and contextual factors that supported employment. At interview, 47% of participants were in paid employment. Employment type at interview indicated a shift away from more physically intensive jobs. Employed and unemployed participants reported a high level of social support and reported experiencing few physical or attitudinal barriers in their day to day lives. These environmental factors did not differentiate between employed and unemployed participants (z range = -0.98 to -0.17; P value range = 0.33-0.86). The most common facilitator of employment identified by participants was the personal factor - motivation (93% of employed participants). When considering the impact of contextual factors on paid employment for people with a dual diagnosis of spinal cord injury/traumatic brain injury, personal factors may be of greater influence than environmental factors. Study participants experienced few physical or attitudinal barriers and reported highly supportive interpersonal relationships.
This study explores how spirituality is integrated into practice across the different Australian ... more This study explores how spirituality is integrated into practice across the different Australian health professions. Utilising the Joanna Briggs Institute’s (JBI) protocol, six databases were searched, and sixty-seven articles were finally included. To present the findings, a qualitative synthesis was used. ‘Meaning’ and ‘purpose in life’ were found to be key to many spirituality definitions. The most frequently reported approach for Australian health professionals (HPs) in asking about client spirituality was using one or two questions within a comprehensive assessment. Major facilitators included a holistic care approach and prior training, whereas a key barrier was a lack of time.
TOG : Revista de Terapia Ocupacional de la APGTO, 2007
RESUMENLas ideas actuales de desempeño ocupacional están siendo desarrolladas en todo el mundo al... more RESUMENLas ideas actuales de desempeño ocupacional están siendo desarrolladas en todo el mundo al mismo tiempo como directrices para la práctica (Asociación canadiense de Terapia, 1991) y con un sentido de desarrollo de una lengua profesional (Asociación americana de Terapia Ocupacional, Inc. 1989). Este artículo describe la aportación Australiana a este esfuerzo que extiende la existencia de conceptualizaciones a través del desarrollo de un modelo de desempeño ocupacional que explica la estructura del desempeño de las ocupaciones humanas. El Modelo de Desempeño (Australia) (Apéndice1) está estructurado alrededor de ocho construcciones, desempeño ocupacional, roles de desempeño ocupacional, áreas de desempeño ocupacional, componentes de desempeño ocupacional, elementos principales del desempeño ocupacional, entorno, espacio y tiempo.Este artículo describe la etapa de origen de la teorización sobre el desempeño ocupacional a través de la definición de la terminología constructiva y sugiriendo como están relacionadas esas estructuras. Las modificaciones de las construcciones y la terminología se sucederán tanto en el modelo susceptible de una investigación y un desarrollo adicional adicional, como también el resultado de la prueba de campo en las situaciones prácticas.
Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy ... more Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors. Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL). Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]): Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 -10.18, p = 0.000; WMFT (Functional Ability): z = -4.63, p = 0.000). Seven out of the eight participants exceeded the minimal detectable change on both subscales of the MAL. This study offers positive preliminary data regarding the feasibility of a home-based CI Therapy protocol. This requires further study through an appropriately powered control trial.
Australian Occupational Therapy Journal, May 8, 2014
Research into the paid employment of people with spinal cord injury or traumatic brain injury is ... more Research into the paid employment of people with spinal cord injury or traumatic brain injury is prevalent; however, little research has examined the factors that may support employment for adults with a concomitant spinal cord injury and traumatic brain injury (dual diagnosis). This study aimed to determine the level of paid employment reported by people with dual diagnosis and to explore contextual factors that supported paid employment. This cross-sectional cohort study recruited 30 participants with dual diagnosis from a specialist spinal rehabilitation unit. Interviews were conducted during the first five years post-rehabilitation discharge to determine level of paid employment and contextual factors that supported employment. At interview, 47% of participants were in paid employment. Employment type at interview indicated a shift away from more physically intensive jobs. Employed and unemployed participants reported a high level of social support and reported experiencing few physical or attitudinal barriers in their day to day lives. These environmental factors did not differentiate between employed and unemployed participants (z range = -0.98 to -0.17; P value range = 0.33-0.86). The most common facilitator of employment identified by participants was the personal factor - motivation (93% of employed participants). When considering the impact of contextual factors on paid employment for people with a dual diagnosis of spinal cord injury/traumatic brain injury, personal factors may be of greater influence than environmental factors. Study participants experienced few physical or attitudinal barriers and reported highly supportive interpersonal relationships.
NOTE: Some aspects of the constructs and assumptions presented in this model of occupational perf... more NOTE: Some aspects of the constructs and assumptions presented in this model of occupational performance are not new, but reflect a synthesis of ideas about the nature of human occupations found in the literature (CAOT, 1991; Christiansen, 1991; Meyer, 1922; Reed, 1984). Other aspects of the model extend these constructs and assumptions to form a new configuration of occupational performance that differs from notions currently in existence.
Introduction Few ecologically valid assessment tools are available for occupational therapists to... more Introduction Few ecologically valid assessment tools are available for occupational therapists to evaluate the cognitive demands and performance of women with breast cancer in the workplace. This study aims to identify difficulties in work-related cognitive strategy use experienced by women with breast cancer using the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. Method Deductive content analysis was used to code secondary data from 10 interview transcripts involving women who had breast cancer and experienced difficulties in everyday cognitive functioning after treatment. Thirty-four PRPP cognitive strategy items were used as pre-determined codes in a secondary analysis to identify and quantify specific cognitive difficulties described by the women. Results The 10 women experienced problems with work tasks that required the cognitive strategies related to the ‘programming’, ‘continuing’, and ‘attending’ processing categories of the PRPP system. In addition, t...
Conceptual models have become a major focus of occupational therapy practice and education in the... more Conceptual models have become a major focus of occupational therapy practice and education in the last two decades (American Occupational Therapy Association, Inc., 1973; Hagedorn, 1992; Dutton, Levy & Simon, 1993, Christiansen, 1991a; Reed, 1984; Reed & Sanderson, 1983). These conceptualisations are interpretations of the construct, 'occupation'. Some conceptual models interpret occupation from the perspective of human function and describe the nature of human occupations (Gilfoyle, Grady & Moore, 1981; Kiehlhofner 1985; Reed, 1984, p. 491). The majority, however, interpret occupation from the perspective of occupational therapy, thereby forming the basis of practice models for intervention (Allen, 1985; Ayres, 1979). Despite the evolution of numerous conceptual models describing both human occupations and occupational therapy no single model has adequately met the range of theoretical, practice, and explanatory demands of the profession (Hubbard, 1991).
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Papers by Judy Ranka