Journal of Community Medicine & Public Health Care Category: Medical Type: Review Article
Occupational Therapy: From A to Z
- Hassan Izzeddin Sarsak1*
- 1 Occupational Therapy Program, Batterjee Medical College, Jeddah, Saudi Arabia
*Corresponding Author:Hassan Izzeddin Sarsak
Occupational Therapy Program, Batterjee Medical College, Jeddah, Saudi Arabia
Received Date: Oct 30, 2019 Accepted Date: Nov 25, 2019 Published Date: Dec 02, 2019
The purpose of this study was to promote learning and knowledge development in the field of Occupational Therapy (OT) and to enhance awareness of this important healthcare profession. To promote the profession, we will be sharing a series called “OT: from A to Z”. In our attempts to further educate the public about what Occupational Therapists (OTs) do, we will be highlighting twenty-six different ways OTs can help and provide services and solutions for living.
Occupational Therapy (OT) is recognized by the World Health Organization (WHO) as a health profession which is represented by the World Federation of Occupational Therapy (WFOT) that supports and promotes occupational therapy profession [1,2]. As members of health teams, Occupational Therapists (OTs) work with other health professionals and share the occupational therapy’s unique body of knowledge on occupation. Occupations are those purposeful and meaningful functional Activities of Daily Living (ADLs). The primary goal of OT is to enhance individuals’ ability to participate in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement . OT has been used along with other medical treatments in treating patients with different diagnoses and age groups and proven to be useful and effective in managing symptoms and enhancing and/or maintaining functional performance . Despite this vital role of OT, recent studies reported that OT is still not well-known or understood and people lack knowledge and awareness of the OT profession . A study indicated that few members of the public, including even patients who receive OT services, know how to describe the occupational therapist’s role. Unfortunately, overall, little mention is made on the important role of OT in helping persons with disabilities improve their quality of life . Additionally, OT services are not widespread and not well-represented or integrated into many rehabilitation services. As a result, OT is not available at many clinical and rehabilitation institutions, which has led to both poor access and reduced, benefit from OT in many countries worldwide . This may be due to lack of governmental and private sector support, weak promotion, and limited public educational campaigns that would enhance awareness of the OT profession [8,9].
In order for OT profession to be successful and well-integrated, promotion and education of people about its services and long-term positive effects are crucial. Therefore, the main objective of this study was to contribute to the ability to promote learning and knowledge development in the field of OT and to enhance awareness of this important healthcare profession services in a simple, informative, and concise way.
THE A TO Z OF OT
Guided by the Occupational Therapy Practice Framework, Occupational Therapists (OTs) have the skills and knowledge to evaluate, support, and facilitate the occupational performance and participation of older adults by positively influencing key factors that affect productive aging. The ability of older adults to engage in meaningful occupations, manage/maintain their health, and performs ADLsis vital to their ability to productively age. Therefore, when it comes to helping older adults make the decision to age in place or move, OTs can help .
It is well known that brain injury is one of the leading causes of death and disability worldwide. A brain injury can cause many physical, emotional and cognitive problems. Recovery from a brain injury can often be a long and bumpy road. OTs helps individuals with brain injury with all aspects of living including, physical symptoms, their living environment, cognition and memory and more .
Caregivers do not really “Elect” the role. Most are not trained to be a caregiver, and really just try to do their best with the skills and resources they have. Maintaining their own health and well-being while dedicating their physical and emotional time to another person can be a challenge. OTs recognizes the risk of caregiver burnout and work to encourage caregivers to take time to care for themselves .
Learning Disabilities (LD) are problems that affect the brain’s ability to receive process, analyze, or store information (i.e., inability to read “dyslexia”, inability to write “dysgraphia”). These problems can make it difficult for a student to learn as quickly as someone who isn’t affected by learning disabilities. OTs enhance the student’s ability to function within the educational environment and use techniques that correct, facilitate or adapt the student’s functional performance. OTs help people with LD in many ways including reading hand writing, and visual perceptual skills improvements and more .
Ergonomics is the study of people’s efficiency in their work environment and the process of ensuring the body is in an appropriate position when completing daily tasks. Sitting, standing, bending, and lifting; all these movements require the proper ergonomic position of the legs, spine, and arms to promote comfort and productivity, and to reduce the risk of physical injury. Proper ergonomics is often most important at work, as this is where you spend the majority of your time. Everyone deserves to be comfortable at work. When people are comfortable they are happier, more productive, feel valued and supported, and are less likely to leave work due to physical injury from poor office ergonomics. OTs offers a rich history and unique expertise as one profession in the field of ergonomics and work rehabilitation .
One of the main therapeutic goals and focus of OT is to enhance functional performance of individuals in terms of independence, safety, and quality through therapeutic activities of daily living (occupations) that are functional, purposeful, meaningful, and meet the individual goals, interests, and priorities .
OTs should refer patients with specific gait issues to physical therapy. However, fall risk assessments are common components of evaluations and are suitable to be used by both professions. OTs help in falls prevention among seniors through home modifications and help patients with neuro-physical dysfunctions with ambulation as they pertain to patients’ balance and function in daily activities .
One of the main reasons that parents seek OT services for their children arises from problems with printing and handwriting. While many children quickly take to writing and printing, many have difficulties. When difficulties arise, an OT can help and recommend many solutions and useful assistive technology devices Freeman .
OT believes that prevention is really the best medicine. OTs has a significant contribution in the areas of health promotion and prevention and is actively involved in the development and provision of related educational and awareness programs and services .
A physical and cognitive demands analysis goes beyond the standard job description, as these typically only define the job to be performed in terms of duties and roles. In contrast, a physical and cognitive demands analysis digs deeper into the job and clearly outlines all the different demands that will be placed on that worker in that position. Physical components such as lifting, carrying, walking, and fine motor skills, along with cognitive demands like visual and perceptual skills, attention, and memory are important to understand and document. Then, when hiring workers, these reports serve as a reference point for ensuring the right hire, and are also essential in making solid decisions about someone’s ability to return to a job after injury or illness. OTs use job analysis as a basis for evaluating injured workers, planning rehabilitative programs, structuring pre-employment screening protocols, developing transitional work plans, and conducting environmental modifications and risk management programs .
OTs work with people of any age, including children. If a child needs support to develop optimally, OT can help. For children with developmental delays or a known physical or mental condition associated with a high probability of delays, OT can help improve their motor, cognitive, sensory processing, communication, and play skills. OT is a treatment that works to improve fine and gross motor skills and motor planning. It can also help kids who struggle with self-regulation and sensory processing. The therapy is tailored to a child's specific needs .
The primary focus of OT is enabling individuals to participate actively and meaningfully in their day to day lives. Occupation is defined as any meaningful activity a person may do throughout the course of a day, including taking care of one’s self (self-care), contributing to society through paid and unpaid work (productivity), and simply enjoying life (leisure). Leisure activities integrate all aspects of OT, including the development of interactive, social and personal skills, as well as cognitive functioning and motor ability .
The foundation of the profession of OT is creating Person-Environment-Occupation fit. We call this our PEO model. What it means is that optimal function arises from the best interaction of the person, their environment, and those “occupations” that are the daily tasks they need to complete. So, if someone is struggling to complete daily activities, feeling that they need more support to manage at home, or are worried they might get injured falling in or around their house, perhaps they need to consider OT home modifications .
Just as we need to exercise the muscles in our body, we also need to exercise our brain. Our brains are made of billions of neurons, which interact with each other to complete specific tasks. Signals are sent from one neuron to another along neural pathways, and these determine our thoughts, emotions, insights, and so much more. Each task relies on a different neural pathway, so the pathway for reading a book is different than the pathway for putting on our shirt. The more we use a pathway, the stronger the connection becomes. These neurons have the ability to physically change themselves when faced with new and difficult experiences. This ability is called neuroplasticity. Neurological disorders (i.e., stroke, sensory-processing disorders) may affect neuroplasticity, thus therapy is needed. OT implications can promote neuroplasticity and recovery .
We all have different levels of energy, tolerance and mental attention. If suffering from chronic pain, brain injury, or emotional disturbances, daily activities will take more time and more energy. The focus of OT becomes helping people to organize their activities, their stuff or their time through developing organizational skills, attention span, and self- control. Even small steps to help people to be more organized can have a huge impact .
Pain is a common occurrence following an injury, illness, or traumatic event like a motor vehicle accident. While pain does play an important role in alerting us to potential dangers, injury, or an impending problem, it can also become a significant barrier to function as it can often continue long after the dangerous situation resolves. Whether this pain is primarily physical or emotional, visible or invisible, it is important to remember that the pain experience is real and can be debilitating. OTs is qualified to identify the psychological, cognitive and physical needs of the individual and to provide treatment to improve function in daily activities. With appropriate treatment, pain and daily function can improve, helping the individuals participate in meaningful activities and regain or maintain their sense of self .
One of my favorite quotes about OT is, “Medicine adds days to life… OT adds life to days!” OTs provides solutions for living and therefore, helps individuals achieve optimal function and maximum quality of life based on each person’s unique interests and goals. Community OT can improve patient’s and caregiver’s quality of life, mood, and health status .
The process of returning an injured worker to their previous job or a modified position needs to be handled properly to reduce re-absenteeism and employer risk. Getting the employee back to their previous job duties and regular hours is the goal, which is tackled carefully to reduce re-injury. Much like getting an injured athlete back in the game, return to work coordination involves an individual approach and is a thorough process to ensure the future success of the employee and company. OT positively influences return to work assessments and interventions and is a key element of work rehabilitation .
Stress can negatively affect many aspects of your physical and emotional health. OTs can help people manage their stress through the application of a variety of behavioral self-management strategies such as the cognitive behavioral approach which has proved to be effective when the person is ready for change. OTs can also provide counseling, relaxation and stress management in programs (i.e. relaxation, imagery, stress management, cognitive coping skills, biofeedback and psychotherapeutic interventions, both group and individual) which significantly reduce anxiety on both the short and long term .
While travel is a fun and rewarding leisure activity, it can also be extremely stressful. Traveling with a disability can be even more difficult, but with thorough planning, it can be a wonderful experience. Universal design is defined as, “the design of buildings, products or environments to make them accessible to all people, regardless of age, disability or other factors.” One major factor in achieving universal design is to create buildings and environments that are “barrier-free” and physically accessible for all. OTs work with businesses and individuals to CREATE accessibility solutions and help design spaces, both public and private, that allow access for the greatest majority of people .
Pressure Ulcer (PU) is a localized area of tissue injury caused by unrelieved pressure usually located over bony prominences resulting in damage of underlying tissue. OTs is involved in the prevention and management of PUs. OT intervention designed to reduce the incidence of medically serious PUs in adults with spinal cord injury and in older adults at risk of developing PUs with proper seats and positioning and the use of support surfaces (i.e., skin protection and positioning cushions) being the most common interventions . Research has shown that the use of appropriate pressure-relief cushions for wheelchair users who are at high risk for developing PUs leads to a lower incidence rate of pressure ulcers. In addition, research has reported that the appropriate use of power wheelchairs with multiple seating functions, such as tilt-in-space, backrest recline, and seat elevator has proven to play an important role in PU prevention. OT can conduct a comprehensive wheelchair evaluation to ensure that individuals who are at high risk of developing PU receive properly fitted wheelchairs that meet their needs .
Low vision can significantly decrease a person's functional ability and independence. Restoring and maintaining ability to function independently through the use of specific interventions calls for the collaboration of various health care professionals. OTs is essential members of the multidisciplinary rehabilitation team providing such interventions. OTs in low vision rehabilitation enhances performance for specific ADLs by training skills that are dependent on residual vision, such as reading and writing. OTs also conducts environmental assessments in the home and in the workplace or school to improve and promote a safe environment for patients with low vision. OTs may also assist in developing rehabilitation programs for orientation and mobility, driving, and vision rehabilitation therapy .
One of occupational therapy’s core assumptions is that active engagement in meaningful and purposeful daily occupations positively influences overall health and well-being . There are many ways that OTs promotes wellness and wellbeing for different populations and diagnoses. From ergonomics to accessibility, injury prevention to return to work programs, psychosocial programs, OTs can help in many ways. For example, OTs can help individuals with cognitive problems and psychiatric disorders improve their mental health .
Ataxia is characterized by a loss of muscle control and coordination, and can affect the whole body or only specific parts. Ataxia has a significant impact on ADLs. Without adequate muscle control and coordination, tasks like getting dressed, walking, and preparing a meal become more challenging. OT interventions proved to be effective and focus on improving the ADLs functional performance in terms of independence, safety, and quality .
After experiencing physical trauma, there is a severe body and mind separation that impacts the abilities of the nervous system and alters the pattern of the body, breath, and mind structure. This is where the practice of yoga and mindfulness meditation can assist the recovery. Yoga is a complete system of occupational regulation. Yoga therapy is a type of therapy that uses yoga postures, breathing exercises, meditation, and guided imagery to improve mental and physical health. Modern yoga therapy covers a broad range of therapeutic modalities, incorporating elements from OTs, physical therapy, and psychotherapy. Combined yoga and OT interventions help manage neuro-physical and psychological symptoms of a variety of disorders such as stroke, stress, schizophrenia, and many others [35,36].
Sleep plays an essential role in physical, cognitive and emotional functioning, occupational performance and participation, and is an important part of healthy daily routine and lifestyle. OT practitioners are important members of the health care team addressing sleep disorders that place clients at risk for health problems or performance deficits during daily life tasks. They often work with individuals following diagnosis to create behavioral or environmental changes that can facilitate effective sleep habits and routines, providing a foundation for effectively participating in valued activities. So, if you or someone you love has trouble falling or staying asleep, an OT can help .
Promotion of effective health-related professions in the community enhances health and quality of life for all people. Occupational Therapy (OT) is an important health profession that has proven to be effective and has been applied in a variety of rehabilitative fields, such as psychiatric, geriatrics, pediatrics, and stroke and spinal cord injuries rehabilitation. The Occupational Therapists (OTs) knowledge and practice embrace a client-centered, holistic, and dynamic perspective of the person, the occupation, and the environment. This integrated practice approach makes occupational therapy’s contribution to rehabilitation, recovery and health so effective . OT complements other rehabilitative and medical interventions and has proven to be useful in managing symptoms of a variety of disorders and enhancing and/or maintaining functional performance for individuals with diverse health-related problems . OT services contribute significantly in improving and empowering individual’s functional performance and everyday living skills in terms of independence, safety, and quality of life. The inclusion of OT professionals to the existing interdisciplinary medical and rehabilitation team fosters collaboration and integrated intervention planning . Although OT is now over 100-years old but it is still not well-known by the general public indicating a gap in their level of knowledge and how they understand the diverse aspects of the OT profession . It is our responsibility to promote our profession by raising awareness on what our areas of practice are. Launching educational outreach campaigns to raise awareness and enhance community perception and knowledge of the OT profession is crucial. OT services and benefits can be highlighted through different activities such as community-service, volunteer work, social media, brochures circulation, educative interactive sessions, videos, and workshops. Spreading the word about OT on the OT international ceremonies (i.e., World OT Day on October 27, World OT Month in April) helps promote the profession and lets people know what a positive impact OT can make on people’s lives .
Occupational Therapists (OTs) help people of all ages from newborns to older adults improve health and quality of life. It is an absolute essential to helping people regain their independence and ability to do what they love and enjoy in life. Occupational Therapy (OT) is equally as important as other health professions. Supporting the OT profession by promoting the unique value and role of OT and heightening community awareness is essential and should be shed light on.
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Citation:Sarsak HI (2019) Occupational Therapy: From A to Z. J Community Med Public Health Care 6: 059.
Copyright: © 2019 Hassan Izzeddin Sarsak, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.