English Professional Association of Occupational Therapists
APETO
Task Force April 1999
INTRODUCTION Man is by nature an active being that occupies your time on activities that meet their needs and desires.
health and occupation are linked because the loss of health reduces the capacity to engage in the activity.
These are the pillars which underpin the philosophy and theory of occupational therapy. The history of occupational therapy is interwoven with the history of man, but it is worth noting the growth and development that is in the early twentieth century, by a single point. Movements like humanism and humanitarianism, development of arts and crafts in the previous century, technological advances, successes in physics and astronomy, political, industrial development ... are setting up a tissue that, in general, puts at risk the health of society, the environment, the environment ... causing profound changes
Health systems also evolve with the progress of society and as they grow, are heading towards a mechanistic approach, specially designed with the purpose to isolate, identify and try to approach the problem in isolation, this approach is effective since it has made progress and develop new technologies, but perhaps you miss the person, to see it in its entirety.
Occupational Therapy uses problem solving to improve quality of life of the person and does so from a holistic approach considers all the tasks related to the situation where the person develops. Occupational Therapy is based on the philosophical assumptions have to do with the nature of the person and their relationship to the human and physical environment. These assumptions have several functions:
- facilitate communication with the society of which they are responsible and professional (OT argues that people are entitled to a meaningful life, the medical sciences: it has the right to life)
- are the starting point for their ethical code
- give a sense of identity in the development and evolution of the profession.
In Spain, the first steps of the profession are beginning to happen in the Sixties. Begin working in the fields of psychiatry and physical rehabilitation, the next field boom is taking geriatrics. But society is evolving very rapidly, technology, industrial development ... provides other dysfunctions that alter the overall health of our society: accidents, traffic, environmental ... get medical sciences eradicate diseases and therefore life expectancy is increased considerably, generating other needs that society demands.
needs that go beyond what purely medical, involving social and environmental aspects.
political and social changes in Spain, allow these needs can begin to be covered. Enter the era of joining forces: political, economic and social, we joined the European project and get to the level that requires marking the European Community.
the early 90's, the training of occupational therapists who had been offered in the only school that was, is recognized by the establishment concerned: Ministry of Education and Science, following European directives and plans to unify the different formations academic. The training and practice was already recognized in the European and international forums. Arise early colleges, so the company has a growing number of occupational therapists to meet their demands, giving the service it required to keep optimal levels of health and wellness.
DEFINITIONS
We started the previous paragraph by saying that "man is by nature an active being that occupies your time on activities that meet their needs and desires." The man is an active being whose development is influenced by the use of the intended activity, with purpose. Using his ability to intrinsic motivation, man is able to vary their physical and mental and physical and social environments through the order activity, with purpose.
Life is a continuous process of adaptation. Factors biological, psychological and environmental, can disrupt the adaptation process at any time of life. Purposeful activity facilitates this process of adaptation.
But what is purposeful activity?. The tasks or experiences in which the person is actively participating, is coordinating aspects of motor, cognitive and emotional, as it is, the activity, are also interacting intra-and interpersonal aspects. When we do an activity, also are dealing with time and space, we are interacting with the environment.
The set of activities we call occupation, the occupation is considered the medium through which humans make sense of the meaning of life and maintains the organization structure of the time ... Occupational Therapy uses the occupation as a means and an end:
* as a means: a selection and analysis and its application evaluates, facilitates, restores and maintains the function according to the needs of the person as an end
*: acts as an inter-relationship and possible social cohesion of the individual, therefore, improves self-concept (when the person does occupations according to their age, their motivations, their needs .., he is efficient, effective in their midst, as someone who can control the actions and situations.)
The common core of occupational therapy is the "activity with the intention", it is used as a key tool to prevent and mediate dysfunction and produce the maximum adaptation.
For the activity could be construed as therapeutic, it must meet a number of features, namely:
- be goal-directed
- have meaning for the patient / user
- requires the participation of the patient / user
some level - be an instrument for the prevention of dysfunction, maintain or improve function and quality of life
- reflect participation patient / user
vital tasks - be adaptable and adjustable
- to be determined by the professional opinion of the TO and based on their knowledge (knowledge about human development, medical conditions, interpersonal relationships and the value of the activity.)
After verifying that the activity meets these characteristics, we must analyze it carefully evaluated its therapeutic potential, for this we must measure skills that potentially can be developed. These are:
-
motor - sensory
-
cognitive - perceptual
-
emotional - social
- cultural
-
common
After making these considerations can Occupational Therapy defined as:
"socio-discipline that evaluates the ability of the person to perform activities of daily life and intervenes when that capacity is at risk or harmed by any cause. The Occupational Therapist uses purposeful activity and the environment to help people acquire the knowledge, skills and attitudes necessary for everyday tasks required to develop and achieve maximum independence and integration. "
The definition of Occupational Therapy, its philosophical basis and the claim that the occupation is the essence of occupational therapy, provide the basis on which the discipline is based science, thereby establishing a framework in which, taking into account the changes occurring in society, falls training, practice and research.
Occupational Therapy as part of the geriatric care system as a determinant of health in its broadest sense, has a critical role in health promotion and disease prevention, given that it is considered the dynamic concept of health, which is defined as "achieving the highest level of physical, mental, social and operational capacity to enable social factors in which the person is immersed and society. "Thus, occupational therapy, as a discipline that adapts and meets the requirements arising from this definition, from a biopsychosocial perspective, is an essential element in health and health agent acting on human biology, lifestyle and environment.
INTERVENTION
OCCUPATIONAL THERAPY Occupational Therapy is the role and uses procedures and activities aim to:
- promote health and wellness
- minimize or prevent deterioration
- develop, maintain, improve and / or restore the performance of the functions necessary
- offset dysfunctions in place.
function categories are: areas of occupational performance and occupational performance components.
occupational performance areas include activities of daily living, work activities and leisure activities. Occupational performance components relate to functional skills required in occupational performance, including sensory components, motor, cognitive and psychosocial.
there other factors that influence the intervention from Occupational Therapy and must be taken into account, is what we call "living space influences." That is, the environment, culture and family.
The environment can be defined as the aggregate of phenomena that surround a person and influence the development and existence of it (Mosey, 1986), this consists of human factors: individuals and groups, and non-human factors: physical conditions, things and ideas.
culture will influence the way in which social interactions take place: religion, ethnicity, ethical values \u200b\u200b...
The family relationships, the strategy designed to address the dysfunction ... is also a factor.
OCCUPATIONAL PERFORMANCE AREAS
1 .- Activities of Daily Living:
1.1 .- BASIC:
1.1.1 .- Personal Care:
1.1.1.1 .- (bathing)
1.1.1.2 .- 1.1.1.3 .-
dress
1.1.1.4 .- grooming supply (food - food)
continence
1.1 1.1.1.5 .- .1.6 use of the toilet .- 1.1.2 .-
functional mobility:
1.1.2.1 .- transfers (wheelchair, bath, bed ...)
1.1.2.2 .- locomotion:
1.1.2.2. 1 .-
up stairs
1.1.2.2.3 1.1.2.2.2 .- .- advice and use wheelchairs
1.1.2.2.4 .- aids progress
1.2 .- INSTRUMENTAL:
1.2.1 .- 1.2.1.1
functional communication .- 1.2.1.2 .-
understanding
expression
Food Preparation 1.2.2 .- 1.2.3 .-
routine medications Money Management 1.2.4 .- 1.2.5 .-
Garment Care Management
phone 1.2.6 .- 1.2.7
.- Transport Management
2 .- Work Activity:
2.1 .- Management of the household cleaning
2.1.1 .- 2.1.2 .-
job scheduling 2.1.3 .-
purchases 2.1.4 .- 2.1.5
dinners organized security procedures .- 2.2 .-
third parties Care
Educational Activities
2.3 .- 2.4 .-
Work Activities: 2.4.1 .-
career exploration
Acquisition 2.4.2 .- 2.4.3 .-
job performance 2.4.4 .-
employment retirement planning
3 .- Leisure activity: Exploration
3.1 .- 3.1 .- Performance
4 .- Relations with the environment:
4.1. - Management of the environment / resources
4.2 .- 4.3 .- Interpersonal Socialization
sexual expression
4.4 .-
COMPONENTS OF FUNCTIONAL PERFORMANCE
sensorimotor
1 .- Component:
1.1 .- Sensory Integration:
Sensory Awareness
1.1.1 .- 1.1.2 .- 1.1.3 .- Sensory Processing Skills perceptual
1.2 .- Neuromuscular:
1.2.1 .- 1.2.2 .- Arc Reflection
motion muscle tone
1.2.3 .- 1.2.4 .- 1.2.5 .- Resistance Force
postural control
1.2.6 .- 1.2.7. - Integrity of the soft tissues
1.3 .- Motor:
Tolerance 1.3.1 .- 1.3.2 .-
activity gross motor coordination
1.3.3 .- Crossing the midline
1.3.4. - Laterality
bilateral Integration 1.3.5 .- 1.3.6 .- 1.3.7 .- Praxias
coordination / fine motor skills
1.3.8 .-
visual-motor integration 1.3.9 .- oral motor control
2 .- Integration
cognitive and cognitive components
2.1 .- alert level to stimuli
2.2 .- Orientation Recognition
2.3 .- 2.4 .-
call time 2.5 .- 2.6 .- Sequencing
Memory
2.7 .- 2.8 .- Training Categorization of concepts
2.9 .- intellectual operations in space
2.10. Troubleshooting
2.11. Generalization of learning
2.12. Integration of learning
2.13. Summary of learning
3 .- psychosocial skills and psychological components
3.1 .- Psychological:
3.1.1 .- 3.1.2 .- Securities
Roles
3.1.3 .- 3.1.4 .-
Interests Initiation
activity 3.1.5 .- Completion
activity 3.1.6 .- Self-Concept
same
3.2 .- Social: 3.2.1 .-
Social behavior
3.2.2 .- 3.2.3 .- Expression Conversation
3.3 .- Handling of himself: 3.3.1 .-
Skills to manage and resolve the difficulties
Time Management 3.3.2 .- 3.3.3 .- Self
Occupational Therapist determined by evaluating what limitations of the components of occupational performance are affecting areas occupational performance.
In the process of planning the intervention or treatment is selected activities, methods and techniques of occupational therapy to treat components of occupational performance and occupational performance areas.
STANDARDS OF PERFORMANCE IN PRACTICE
intervention process
1 .- Evaluation Process:
1.1 .- Collection of information: 1.1.1 .-
history and / or reports from professionals
personal interview
1.1.2 .- 1.1.3 .- 1.1.4 .- family interview
user observation test and batteries 1.1.5 .- 1.1.6 .- other
1.2 .- Analysis of information:
1.2.1 .- 1.2.2 .-
assessment of needs definition 1.2.3 .-
contrast
needs and interests
2 .- 3 .- Determine objectives and treatment planning
4 .- Evaluation of the process
5 .- High: 5.1 .-
temporary / permanent monitoring
5.2 .- 5.3 .- derivation
OBJECTIVES The overall goal of occupational therapy is to improve the quality of life by getting the highest level of autonomy and integration of the individual. To break it down better understanding of:
- promote health and wellness
- minimize or prevent deterioration
- develop, maintain, improve and / or restore the performance of the functions necessary
- to compensate for malfunctions in place.
OCCUPATIONAL THERAPIST FUNCTIONS
Assessment Identification of areas of dysfunction treatment and intervention
Council, advisory and consultancy
Prevention and Health Promotion Research and teaching
Education and Supervision Directorate administration and management. SERVICES
Assessment and Evaluation and Intervention Planning
Enabling / rehabilitation in the skills / abilities sensorimotor
Enabling / rehabilitation in the skills / motor skills
Enabling / rehabilitation skills / cognitive skills
Enabling / rehabilitation in the skills / abilities
Training psychosocial activities of daily living (basic and instrumental)
Training for employment integration
Exploration
prevocational
Adaptation housing / school / work training
upper limb prosthesis
Identification, design, implementation and adaptation of splints, braces and Assisted
Education and training in ergonomics:
-
functional joint economy - simplification of the
-
energy conservation -
postural hygiene education and training in the use of technical aids and home adaptations
Education and Training
prosthetic training / education of families and / or educators
leisure Education Training
different habitats
Promoting full accessibility improvements
Occupational Risk Prevention Integration
early sensory stimulation
Rehabilitation / rehabilitation psychomotor
ACTION LOCATION
Scope health education:
health promotion TO
TO preventive health behavior
TO
determining health care:
TO
specialized care - care in acute
- Attention
hospital units - average stay
Care - Day Care Hospital
-
Outpatient Care - Care
detoxification units in primary care
TO
socio
Scope:
TO
centers
day in home care
TO TO long-stay units in palliative care
TO
social Scope:
TO TO
residential community (including among others):
TO devices alternative to institutionalization:
- Flats protected
- halfway houses
- miniresidencias ...
OT in home support service (DSS)
TO psychosocial rehabilitation centers (CRPS) TO
care centers to the drug (CAD)
TO
TO occupational centers in vocational rehabilitation centers (CRL)
TO in care. Prison
TO
Educational
:
special education
TO TO TO
in computers integration of early attention in formal education
TO
Field of expertise:
AATT TO centers and orthopedic
OT in prevention teams TO
occupational hazard in urban planning commissions in courts TO
disability surveys and Scope
teacher: Schools
university courses
training of trainers courses related to their specialty
Research
These areas will be constant review, depending of the needs expressed by society and established the distribution of health policy at all times. CAMPOS
Pediatrics Geriatric Psychiatry
Physical disabilities:
-
neurology - oncology
- Rheumatology
-
trauma - burns
- cardio-respiratory
- amputees ...
learning disorders (psychomotor delay, dyspraxia, dysgraphia ...) Units
sensory deficiencies Marginalization and poverty
mental deficiency
Other Palliative Care
PATHOLOGY
Developmental defects:
- Arthrogryposis multiplex congenita
- Disturbance in attention
- Cerebral Palsy:
- dystonic
- spastic
- dyskinetic
-
Abuse and Neglect - Infants at high risk
- Mental Retardation:
-
adult - children
- S. Down
- Premature
- S. Rett
- Spina bifida
- Dysfunctions of sensory impairment:
- dyspraxia and developmental apraxia
-
gravitational insecurity - tactile defensiveness, hypersensitivity
-
bilateral vestibular disorder - learning disorders
- Other
Sensory disturbances:
- visual impairment or blindness in children
- Blindness
- Chronic Pain
- Deafblind
- Loss of hearing in children
- Low Vision
- Sensory deprivation
- Other
Disorders
nervous system - Parkinson's disease
-
extrapyramidal diseases - Diseases spinocerebellar
- motor neuron disease
- myelopathies
- Reflex Sympathetic Dystrophy
- Multiple Sclerosis
-
stroke -
Quadriplegia - Paraplegia
- Epilepsy
- Syndrome carpal tunnel
- Other median nerve lesions
-
ulnar nerve injuries - Injury radial nerve
- Neuropathies
- Other
cardio-pulmonary disorders
-
Heart disease - chronic obstructive pulmonary disease
- Other
Trauma:
- upper limb amputation in adults
- upper limb amputation in children
-
Back Injuries - Fractures of upper limbs (shoulder, arm, elbow, forearm, wrist, hand and fingers):
- wounds, fractures, bruises ...
-
tendon transpositions - reimplantation
- Dishabilidades
- Hip Fractures and fitting
- legs
Injuries - Spinal Trauma:
-
paraplegia - quadriplegia
- Other
Musculoskeletal:
- Arthritis or polyarthritis:
- rheumatic
- atrophic
- juvenile rheumatoid
- Osteoarthritis
- Tendinitis
- Synovitis
- Myositis
- Dupuytren's Contracture
- Osteoporosis
- polymyositis-dermatomyositis
- Other
systemic disorders:
- Diabetes mellitus II
- Impaired kidney dialysis
- Scleroderma, systemic sclerosis
- Other
immune disorders:
- AIDS
- Neoplasms
- Other
Skin changes:
- Burned adults
- Burned Children
- Other
Alterations the psychomotor and cognitive
- E. Alzheimer
- Other dementias
- Apraxias
- disorders of cognition:
- disorders of swallowing, dysphagia
- disturbances of vision and perception: adults and children
- Other
mental health disorders
- Autism
- Psycho
- Neurotic disorders and personality:
- Dependencies -
substance abuse - self-injury
- Mental retardation
- Changes in eating behavior
- Forensic Psychiatry
- Other
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