Abstracts Thur 4pm - 5pm
Responsiveness to Māori / Professional Scope
Exploring the Sensory Experiences of Tangata Whaiora Engaging in Kapa Haka
Author / Presenter: Tania Hollands, Auckland University of Technology
Theme: Responsiveness to Māori
Presentation Type: Presentation – Research 15min + 5min Q&A
Other authors:Dr Daniel Sutton, & Assoc. Prof Valerie Wright-St Clair, Auckland University of Technology
Raymond Hall, Mason Clinic Regional Forensic Psychiatry Services
Introduction
Sensory modulation research has not specifically explored the use of meaningful cultural activity to assist with optimal arousal and self-regulation for occupational engagement.
Aim
To understand the sensory experiences of tangata whaiora engaging in kapa haka within a kaupapa Māori mental health unit.
Methods
The qualitative descriptive methodology, informed by interpretive phenomenology, was conducted in partnership with Māori advisors. Three Māori adult participants, two men and one woman, were purposively recruited. Data was gathered through semi structured in-depth interviews. Conversations were audio taped and transcribed verbatim. Stories of sensory experiences were identified, and interpreted through writing, rewriting and reflecting, guided by van Manens (1997) approach. Research integrity was promoted through cultural collaboration, peer debriefing and member checking. The Northern Regional X Ethics Committee and Auckland University of Technology Ethics Committee granted ethics approval.
Results
Findings revealed that within the culturally meaningful space of kapa haka, the physical environment and interpersonal interactions contribute to a sense of acceptance, safety and choice for participants, affording alert states and self-expression. Three main themes arose: gaining a sense of social connection and identity, gaining a sense of physicality and gaining a sense of embodied emotion.
Conclusion
In addition to its use as a cultural intervention, these findings support the use of kapa haka as a form of sensory intervention, within a sensory modulation approach, to enhance responsiveness to Māori.
Reference
van Manen, M. (1997). Researching lived experience: Human science for an action sensitive pedagogy (2nd ed.). London, Ont: Alt House Press.
Biography
Tania Hollands is a new graduate occupational therapist passionate about mental health care and culturally responsive interventions. This study was completed as part of a Bachelor of Health Science (Honours) qualification from Auckland University of Technology in 2011.
Professional Scope
Double Session
ACC's Direction for Health Service Purchasing: Working with occupational therapists to improve outcomes for clients
Presenter: Jane Kelley, ACC
Theme:Professional Scope
Presentation Type: Presentation – 30min + 10min Q&A
Introduction
In order to ensure optimal levels of rehabilitation services are available for ACC clients, improve client participation outcomes, and deliver a sustainable rate of growth in liabilities, a diverse range of health professionals, services, external agencies and internal staff are required to work together despite having separate funding, administration, reporting structure and sometimes different goals.
Objective
To share the new direction of ACC health procurement purchasing and hear from occupational therapists what role they think they can play in the future of ACC services.
Approach Used
Two key approaches will be presented. Firstly, developing more collaborative relationships with suppliers, achieved through consolidation of suppliers and a local engagement model. Secondly, establishing incentivised quality improvement through the introduction of key performance indicators (KPIs), performance benchmarking, reporting and incentives.
Outcomes
Occupational therapists will be informed of ACC's strategic approach to purchasing health services for clients and collaborative partnerships with allied health, and how that is expected to support integrated community rehabilitation, and be enabled to provide feedback.
Conclusion
Working relationships between ACC and health professionals, services and external agencies will be facilitated by up-to-date knowledge of ACC directions in health procurement purchasing and knowledge of the roles the health professions can play.
Biography
Jane Kelley is the Category Manager for Social Rehabilitation at ACC. This includes Home and Community Support Services, Residential Support Services, In -Patient Rehabilitation and Assessment Services. Jane has held a number of senior roles in the health sector spanning the last 20 years more recently at the Ministry of Health promoting health and wellbeing in the workforce.
Occupation
Exploring Connectedness: The meaning of transition experiences for those within a forensic psychiatric service
Presenter: Penelope Kinney, Otago Polytechnic
Theme: Occupation
Presentation Type: Presentation – Research 15min + 5min Q&A
Other authors: Dr Linda H Wilson, Otago Polytechnic
Dr Sue Galvin, Canterbury District Health Board
Introduction
Transitions are significant and occur throughout a person's life. Blair (2000) suggests that occupation, and its personal meaning, is central during life transitions. People in forensic psychiatric services undergo many transitions, which are often forced upon them. Little research exists which examines the impact of transitions within a forensic psychiatric population and what meaning it has for the individual.
Aims
This research aimed to explore the experience of transition for people moving from a forensic psychiatric unit into a rehabilitation unit, to understand how occupational therapists might facilitate these transitions.
Methods
After approval by the Upper South A regional ethics committee, six interviews were conducted with five men at varying stages of transition (before, during and after) relocation from a secure unit into an open rehabilitation ward. Data was analysed using phenomenological analysis.
Results
Findings show that success of transition is related to the person's connectedness to the process. Connectedness to the process is generated when those transitioning are able to form connections to occupations, place and people. Connectedness to these three key areas is interrelated and may be assisted through occupational therapy.
Conclusions
Occupational therapists can assist people in transition by attending to occupation, place and people and linking them through careful engagement in meaningful activities. If these three elements can have quality connections established then the likelihood is increased of connectedness to the transition process and therefore successful transitions
Reference
Blair, S. (2000). The centrality of occupation during life transitions. The British Journal of Occupational Therapy, 63(5), 231-237.
Biographies
Penelope Kinney is an experienced occupational therapist who lectures at the School of Occupational Therapy at Otago Polytechnic. . She teaches in both the undergraduate and postgraduate programmes and holds coordination roles within both programmes as well. Penelope has recently successfully completed her Masters by Thesis. Her research project focused on a forensic psychiatric population.
Linda H Wilson is an experienced occupational therapist who currently lectures in the School of Occupational Therapy at Otago Polytechnic in postgraduate courses, and supervises honours and masters students.
Sue Galvin is a clinical psychologist who works within the forensic psychiatric service. She works extensively with patients over the broad forensic psychiatric service, including the courts, prison, secure units, open rehabilitation ward and the community. She previously held a lecturing position at the Psychology Department, University of Otago.
Engaging Hard to Reach Populations: Lessons learned by sharing knowledge with policy makers and social care services
Presenter: Jenni Mace, Auckland University of Technology
Yvonne Thomas, James Cook University
Theme: Occupation
Presentation Type: Presentation – Research 15min + 5min Q&A
Introduction
As a profession we have a growing body of knowledge about the importance of meaningful occupations to health and well-being. However as other professions and policy makers recognise occupation as a fundamental determinant of health, their demand for evidence has resulted in this body of knowledge growing and developing in other sectors' Meaningful occupation is now a key term used in a number of United Kingdom (UK) policies requiring health and social care services to demonstrate how it is being used and its effectiveness. The aim of this literature review was to investigate how services required to use meaningful occupation in the UK homelessness sector understand the term and its value in engaging this hard to reach population group.
Methods
A scoping review of UK government policies and non government organizations reports and research was undertaken.
Results
Four themes emerged from a thematic analysis of the literature: 1) Defining meaningful occupation; 2) Benefits of engaging in meaningful occupation; 3) Facilitating engagement in meaningful occupation; 4) Welcoming spaces. This body of knowledge shows how occupation as key concept in promoting health and well-being can be promoted through its inclusion in policy and strategy documents. It also demonstrates that our knowledge can be reinforced and extended by others that deliver meaningful occupation as a service.
Conclusion
Knowledge about occupation can be enriched when occupational therapists promote its use by consulting with policy makers and health and social care services.
Biographies
Jenni is a senior occupational lecturer whose clinical experience has been in housing, homelessness and community services in both the United Kingdom and New Zealand. She is a PhD candidate looking at what enables families in temporary accommodation to participate in daily occupations.
Having trained in the United Kingdom, Yvonne Thomas has lived and worked in Masterton, Christchurch, Dunedin and Auckland and left New Zealand in 2000 to live by the beach in tropical Queensland. Since then she has worked at James Cook University and completed a Masters in Education and a PhD on the occupation and wellbeing of people experiencing homelessness. She hopes to return to New Zealand one day if she gets the right job offer.
The Meaning of Home and Homelessness: Exploring the importance of place to occupational wellbeing
Presenters: Yvonne Thomas, James Cook University
Jenni Mace, Auckland University of Technology
Theme: Occupation
Presentation Type: Presentation – practice development 15min + 5min Q&A
Introduction
In occupational therapy, primary importance is afforded to meaningful occupations that contribute to well-being. The locations of these occupations are considered as contexts for living, but limited research explores the importance of place to the experience of wellbeing. This paper explores the meaning of home and homelessness as the basis for wellbeing and the locus for our occupational transactions (Dickie, Cutchin & Humphry, 2006).
Aim
To identify cultural meanings of home and homelessness in relation to occupational engagement and the experience of wellbeing.
Methods
A scoping review was undertaken using search terms: meaning, home, place and homelessness. Forty-two relevant articles were selected encompassing Pākehā, Māori and Pacifika literature.
Results
Thematic analysis revealed five themes; meaning of home revealed in the language, colonisation and urbanisation, housing tenure, housing design and home and its relevance to meaningful occupation. People occupy places to create a sense of home and home becomes the heart of occupation. People create a sense of home according to personal, structural and cultural factors with important implications for identity and belonging.
Conclusion
By exploring the meaning of home and homelessness across different cultures we begin a dialogue within the profession about the importance of home to occupation. Knowledge of home as a place of identity and belonging establishes evidence for new dimensions of occupation and wellbeing.
Reference
Dickie,V., Cutchin, M., & Humphry, R. (2006). Occupation as transactional experience: A critique of individualism in occupational science. Journal of Occupational Science, 13(1), 94-96.
Biographies
Yvonne Thomas and Jenni Mace share a common interest in occupational therapy education, occupational justice, community occupations and homelessness. Despite living on different sides of the Tasman and in different Universities they collaborate in education, research and publications. Yvonne is senior lecturer and program coordinator at James Cook University and Jenni Mace is a senior lecturer at Auckland University of Technology.
Community & Society Involvement
Something Fishy's Going On: Exploring how the aquaponics garden at the Basin View Masonic Village is promoting resident participation through occupation and community and social involvement
Presenter: Alison Wicks, University of Canberra
Theme: Community and Society Involvement
Presentation Type: Presentation – Research 15min + 5min Q&A
Other author: Dr Helen Hasan, University of Wollongong
Introduction
Innovative collaborations have created the aquaponics garden at the Basin View Masonic Village. It is being developed as an eco-friendly way to build communion within the village, provide meaningful occupations through growing nutritious food, and increase community engagement of the village. Stakeholders include village staff and residents, local schools and businesses, aquaponics experts and academics. Considering the potential of community gardens to reconnect people with nature, promote integration with the community and provide volunteer and educational opportunities (Quayle, 2007), final occupational and social outcomes are highly anticipated.
Aim
The aim of this ongoing field study is to evaluate over time from multi-disciplinary perspectives, the garden's impact on: the village culture; occupational participation of self-care residents, residents with dementia, staff and carers; and the local community's involvement.
Method
Investigators are using qualitative research methods (interviews, focus groups, and storytelling), observation of selected stakeholders and digital technology to record the garden story and analyse processes and outcomes along many dimensions. The University of Wollongong has granted ethics approval.
Results
Resident interest and participation, staff enthusiasm and engagement, healthy plants and fish, in-kind support from local businesses and contributions from volunteer school children have already contributed to significant culture change within the village.
Conclusion
Valuable general insights from various perspectives about sustainable community-based, occupation-focused programs and specific practice strategies for engaging people with dementia in occupations will be gained.
Reference
Quayle, H. (2007).The true value of community farms and gardens; social, environmental, health and economic. Bristol, UK: Federation of City Farms and Community Gardens.
Biography
Alison Wicks is associate professor in occupational therapy at the University of Canberra. She is also chair of the International for Occupational Science. Her research focuses on community-based occupation-focused programs.
Keeping it Fresh... Knowing the People Planning: Keeping mental health services responsive
Presenter: Kim Henneker, Hawkes Bay District Health Board
Theme: Community and Society Involvement
Presentation Type: Presentation – Research 15min + 5min Q&A
Co-author: Dr Kirk Reed, Auckland University of Technology
Introduction
Knowing the People Planning (KPP) is an approach to provide evidence for change in service delivery. Data has been collected and analysed for ten years in Hawkes Bay Mental Health Services. In the absence of any other tool, KPP provides real data to assist with planning services to meet the needs of consumers.
Aim
This paper reports the implementation of KPP in the Hawkes Bay. It describes the tool, how it has been implemented, and how new perspectives have refined services which have influenced occupational outcomes and health and well being.
Method:
KPP is a simple and effective tool that enables quantitative data to be collected and analysed. Practitioners contribute to data collection which can then be used to directly impact service design and investment. The KPP process allows practitioners to know the people they are working with; to identify and address consumer needs which in turn lead to an improved service creating a more satisfying working environment; KPP also develops a means to measure the effectiveness of clinical practice.
Results
The data analysis verifies clear positive trends with many of the KPP key features. Evidence describes increasing numbers of consumers participating within the recovery centres with a quarter of the consumer population now engaged within paid employment.
Conclusion
The KPP tool has demonstrated that gaining quantitative data to show trends, to map change and track the impact of service re design has led to improved service delivery.
Biographies
Kim Henneker is an occupational therapist and associate clinical manager with the Hawkes Bay District Health Board, Mental Health Services. Knowing the People Planning (KPP) has measured the impact of service re-design on consumer driven outcomes for ten years. KPP was a finalist in the Health Innovations Awards in 2007, winner of the medical staffing award NZAOT 2008 and silver award winner at ThemHS 2011.
Dr Kirk Reed DHSc, NZROT, head of department, Occupational Science and Therapy | Auckland University of Technology
A Mental Health response to the Canterbury Earthquakes
Presenter: Lilian Margetts, Canterbury District Health Board
Theme: Community and Society Involvement
Presentation Type: Presentation – practice development 15min + 5min Q&A
Introduction
Natural disaster of this nature was unexpected in Canterbury; a population severely affected by loss and trauma. Christchurch has been the first major urban centre in New Zealand to suffer a disaster of this scale. There are many learnings that health professionals can disseminate to others.
Aim
To pass on knowledge, and to assist others in their preparation for such an event.
Method
Occupational therapists worked collaboratively with government departments and local body agencies to provide a mental health presence in a range of community based settings and forums where the local population assembled.
These settings ranged from working in emergency relief centres to assisting at public forums and mobile units, responding to society's changed needs. Additionally, participation in group work focusing on anxiety and stress management with affected individuals and families has provided a method of response in a time limited approach.
Outcomes
By applying well developed skills and knowledge of mental health in community based settings, occupational therapists have assisted a society in need by recognising the potential for occupational therapy in ongoing trauma.
Occupational therapists recognise the signs of distress, and know when to offer the link with secondary services for providing ongoing mental health clinical input.
Conclusion
Knowledge of this level and nature of response will assist occupational therapists working in mental health settings to recognise they have the clinical and professional skill set on which to base competent decision making and actions following a major natural disaster.
Biography
Lilian Margetts provides a dual role within the specialist mental health service, Canterbury District Health Board, as occupational therapy professional advisor and as clinician in the acute inpatient service.
Professional Scope
Recovery and Rehabilitation: What happens when the health professionals stop coming
Presenter: Pauline Boland, University of Otago
Theme: The Profession's Scope
Presentation Type: Presentation – Research 15min + 5min Q&A
Other authors: Dr William Levack, Associate Professor Will Taylor & Professor Mark Weatherall, University of Otago
Professor Kath McPherson, Jo Fadyl & Nicola Kayes, Auckland University of Technology
Richard Siegart, Cavit ABI
Aim
The aim of the overall study was to enhance understanding on how traumatic brain injury (TBI) affects people's sense of self. However, early exploration of the data suggested a secondary aim about how the passage of time impacted on people's experience of recovery, which formed this current analysis.
Methods
Forty-nine people with TBI (from 6 months to 26 years ago) were recruited in eight focus groups in 2011 throughout New Zealand. Two groups involved solely Māori. Meetings were recorded and transcribed verbatim. Grounded theory was used to develop emerging themes. Two researchers independently coded the transcripts; a third Māori researcher gave support. This study was approved by the Northern Y Regional Ethics Committee.
Results
Analysis developed three themes: 1) The extended duration of recovery period from the perspective of the person with TBI (years to decades); 2) The significance of depression post-TBI; and 3) The important role of social support groups in long term recovery.
Conclusion
These findings suggested that an individual's readiness for aspects of rehabilitation may not occur until long after health professionals have stopped working with them. Recommendations include greater opportunities for people with TBI to re-engage in rehabilitation years after injury and on-going, if not increased, investment in community-based advocacy groups for people with TBI.
Biography
Pauline Boland is an occupational therapist who has worked as a researcher and studied for the last three years with the Rehabilitation Teaching and Research Unit. She has a clinical interest in neurological rehabilitation and the lived experience of people with disability as well as how to optimise working environments to empower clinicians to practice in an evidence based way.
Our Profession's Scope: Developing sustainable outcomes for disabled students in a resource-constrained practice environment
Presenter: Gerard Chow, Massey University
Theme: The Profession's Scope
Presentation Type: Presentation – practice development 15min + 5min Q&A
Introduction
Disability services offered by different tertiary education institutions can vary, even though there is a Code of Practice for an inclusive tertiary education environment for students with impairments (Achieve, 2004). Current service delivery tends to apply a support-based rather than enabling philosophy, which may not facilitate students' independence and effective organisational resource utilisation.
Objective
Incorporate an occupational perspective to enable sustainable outcomes for students and institution.
Approach
Multiple sources of evidence were accessed, including analysis of local and international inclusive practices for disabled students, and interviews with students and key staff. An occupational perspective was used to develop and implement strategies such as collaborative problem solving, strategic network building, and the development of inclusive teaching and learning resources.
Outcomes
Initial findings reflect that students appreciate the focus on strategies to enable their study and work goals. Staff welcomed the opportunities to collaborate on the development of more sustainable systemic processes. Such practices are likely to benefit other students and promote staff satisfaction in their capabilities to engage students.
Conclusion
Occupational therapists can contribute towards establishing inclusive and sustainable practices for students in the tertiary education environment, in addition to the translation professional role (Townsend & Polatajko, 2007).
References
Achieve. (2004). Kia Orite: Achieving equity: New Zealand Code of Practice for an Inclusive Tertiary Education Environment for Students with Impairments. Retrieved from http://www.achieve.org.nz/KiaOrite-codeofpractice.pdf
Townsend, E. A., & Polatajko, H. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being & justice through occupation. Ottawa, Canada: CAOT Publications.
Biography
Gerard Chow is the student adviser: disability at Massey University. He has been a teacher and a disability policy officer before training as an occupational therapist at Auckland University of Technology. His interest is in enabling individuals, organisations and communities to develop sustainable and wellbeing-promoting practices.