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Therapeutic use of self as defined by Swedish occupational therapists working with clients with cognitive impairment following acquired brain injury: a Delphi study
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0001-5418-3154
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2013 (English)In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 60, no 1, p. 48-55Article in journal (Refereed) Published
Abstract [en]

BACKGROUND/AIM: The concept therapeutic use of self has mainly been described theoretically. Empirical descriptions are few and empirical validation is needed to make the concept more useful for informing practice and explaining what occupational therapists do in the interaction with their clients to facilitate successful outcomes. The aim of this study was to empirically define the aspects that occupational therapists working with clients with cognitive impairments following acquired brain injury find are consistent with the concept of therapeutic use of self.

METHOD: Thirteen expert occupational therapists participated. Reactive Delphi technique in three rounds was used where each round built on the results of the previous one. A questionnaire based on current literature was developed for the first round.

RESULTS: Twenty of 33 statements reached a consensus level of 75% or more. These statements reflected the therapists' consciousness, self-awareness and use of personal characteristics. The statements also concerned the intentions of therapeutic use of self, including client group-specific intentions such as enhancing self-awareness. The results indicate that the content of the concept may be defined differently depending on the client group.

CONCLUSIONS: The empirical descriptions generated from this study may help occupational therapists working with clients with cognitive impairments following acquired brain injury to describe how and with what intention they use themselves therapeutically in the rehabilitation process. In occupational therapy education, the results may be used to highlight how the concept may be understood in practice and to discuss it in relation to different client groups.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013. Vol. 60, no 1, p. 48-55
Keywords [en]
Concept, development, occupational therapy
National Category
Medical and Health Sciences
Research subject
Occupational therapy
Identifiers
URN: urn:nbn:se:oru:diva-26098DOI: 10.1111/1440-1630.12001ISI: 000315101000006PubMedID: 23414189Scopus ID: 2-s2.0-84874017526OAI: oai:DiVA.org:oru-26098DiVA, id: diva2:558658
Available from: 2012-10-04 Created: 2012-10-04 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Occupational therapy practice for clients with cognitive impairments following aquired brain injury: occupational therapists' perspective
Open this publication in new window or tab >>Occupational therapy practice for clients with cognitive impairments following aquired brain injury: occupational therapists' perspective
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe occupational therapy practice for clients with cognitive impairment following acquired brain injury (CIABI) from the perspective of practicing occupational therapists (OTs).

To fulfill this aim, qualitative and quantitative approaches were used including interviews (Study I) and questionnaires (Studies II -IV). Based on the qualitative descriptions generated in Study I, a questionnaire was developed and evaluated for content validity and test-rest validity (Study II). The questionnaire was then used in a survey (Study III). The reactive Delphi technique was used to empirically define the aspects that OTs found to be consistent with the concept of therapeutic use of self (Study IV).

The results showed that a predominant practice pattern was the use of ADL activities for intervention regardless of whether limitations in occupational performance or cognitive function were assessed, or whether the approach to therapy was remedial or compensatory. General ADL-instruments were used more than instruments focused on impairment level. Therapies covering a wide range of cognitive impairments, and abilities important to organizing and executing occupational performance were commonly targeted. Therapies targeting clients’ activity limitations were prioritized before remediating impairment. Therapeutic use of self was regarded as being important and the results identified clientspecific aims not earlier described in relation to therapeutic use of self. Another prominent practice pattern was the collaborative approach toward clients, relatives, and other staff. Theories used to support practice were primarily general. Occupational therapy practice for clients with CIABI was found to be complex, and the practice patterns were affected by circumstances such as the ‘hidden’ nature of the cognitive impairments, perceived lack of knowledge, and organizational issues. The results of this thesis can be used as a foundation for further research on practice patterns or the specific therapies used. It can facilitate discussions on strengths and weaknesses witcurrent practice, the need for development, and research utilization.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 89
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 41
Keywords
occupational therapy, cognition, rehabilitation, practice, acquired brain injury, stroke, TBI, assessment, intervention
National Category
Occupational Therapy Other Health Sciences
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-26007 (URN)978-91-7668-903-5 (ISBN)
Public defence
2012-12-07, Örebro universitet, Prismahuset, hörsal HSP2, Fakultetsgatan 1, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-09-25 Created: 2012-09-25 Last updated: 2017-10-17Bibliographically approved

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Lidström Holmqvist, KajsaHolmefur, MarieIvarsson, Ann-Britt

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