Occupation Analysis in Practice

Lynette Mackenzie, Gjyn O'Toole, Lynette Mackenzie, Gjyn O'Toole

• Publisher: Wiley-Blackwell
• Year: 2011
• Print ISBN: 9781405177382
• eBook ISBN: 9781444339970
• Edition: 1
• Topic: Medicina
• Subtopic: Terapia ocupacional

Occupation Analysis in Practice is the essential book for all future and current occupational therapists. It offers a practical approach to the analysis of occupations in real world practice.

The book frames occupation as the key component for analysis and builds upon previous work limited to analysis at the activity level. It examines the interests, goals, abilities and contexts of individuals, groups, institutions and communities, along with the demands of the occupation. It presents examples of occupation analysis in different practice context including working with children, health promotion, indigenous health, medico-legal practice; mental health and occupational rehabilitation.

The book has four sections. Section 1 introduces theoretical perspectives of the concept of occupation analysis and how such analysis relates to particular models of Occupational Therapy practice and the generic World Health Organisation International Classification of Functioning, Disability and Health. Section 2 discusses analysis of particular components of occupation that support practice. These include culture, spirituality, home and community environments as well as self-care and leisure. Section 3 applies analysis of occupations to particular specialties encountered in practice. Section 4 considers the application of Occupation Analysis within professional reasoning and goal setting.

FEATURES

• International team of contributors
• Examples of occupation analysis proforma
• Application to a wide range of practice areas.
• Glossary of key terms
• Incudes the International Classification of Functioning, Disability and Health.

PART I

Theoretical Perspectives on Occupation Analysis

Chapter 1

What is occupation analysis?

Gjyn O’Toole

Chapter outline

An occupation analysis requires an understanding of the centrality of the concept of occupation from an occupational therapy (OT) and occupational science perspective. This chapter considers that engagement in occupations occurs because individuals, groups and communities possess skills or values that facilitate choice and performance of specific occupations within particular contexts. The chapter proposes six innate intrinsic elements and seven environmental contexts that influence performance of occupations. Occupation analysis explores the transactional relationship between three components of occupational performance: the occupation itself; the participating individual, group or community and the contexts surrounding the occupational participation.

Chapter objectives

The reader should be able to:

• Define occupation from an OT perspective.
• Recognize differences between occupation, activity, task and action.
• Identify and explain the ‘areas of occupation’ defined by the American Occupational Therapy Association (AOTA) in the Occupational Therapy Practice Framework, 2008.
• Explain the need for an occupation analysis.
• State and connect the components of an occupation analysis.
• Outline the occupation analysis process.

Concepts implicit within occupational therapy

Occupational therapists are concerned about the needs, desires, experiences and expectations of individuals and/or groups and the role of occupation in meeting those needs and achieving those expectations. Until the late twentieth century a major focus of OT practice was the therapeutic use of occupations to improve skills and occupational performance. The late twentieth century saw a growing understanding of the purpose and power of occupation in influencing health, wellbeing and participation in life (Wilcock, 2006). This understanding supports the use of occupation as an intervention and facilitates the unique synthesis of knowledge from various fields into a scholarly discipline known as occupational science. Occupational science is dedicated to examining the form, function and meaning of occupations (Zemke & Clark, (1996). Occupation became more than using objects for therapeutic benefit or successful performance of an activity. It became a force that potentially empowers engagement and performance, thereby contributing to and maintaining health, participation and a sense of wellbeing. Thus, occupational therapists believe that appropriate engagement in relevant occupations has the potential to structure, shape and transform the lives of individuals, groups and communities. In order to analyse occupation in the lives of people with occupational needs, it is necessary to explore this concept.

Occupation: an occupational therapy perspective

There are various definitions for the word ‘occupation’. Reflection upon definitions found in OT literature contributes to understanding the concept of occupation from this perspective.

Learning Point

Stage One: Consider the definitions below, or other definitions of occupation found in OT literature. Choose or create a favourite definition and provide a rationale for this definition.

Stage Two: Share this definition and rationale with others (either a small group or the entire class).

Stage Three: Evaluate and discuss chosen definitions. Record points of difference and relevant comments that challenge your choice.

Stage Four: Compose your own definition and be prepared to explain that definition to another health professional, a relative, a member of the public and a physiotherapist.

• ‘Occupations are defined in the science as chunks of daily life that can be named in the lexicon of the culture’ (Zemke & Clark, (1996), p. vii).
• ‘Activities that people engage in throughout their daily lives to fulfil their time and give life meaning. Occupation involves mental abilities and skills, and may or may not have an observable physical dimension’ (Hinojosa & Kramer, (1997), p. 865).
• ‘Daily activities that reflect cultural values, provide structure to living, and meaning to individuals; these activities meet human needs for self-care, enjoyment, and participation in society’ (Crepeau et al., (2003), p. 1031).
• ‘Goal-directed pursuits that typically extend over time, have meaning to the performance, and involve multiple tasks’ (Christiansen et al., (2005), p. 548).

The above definitions indicate that occupations are part of daily life. They are all the things people do and they give life meaning (Fisher, (2006). Occupations exist within a dynamic relationship between the unique person and their ability to perform occupations in particular contexts (Nelson & Jepson-Thomas, (2003). They require abilities and skills; they are affected by many factors, including culture; and they can contribute to the needs of individuals, groups or societies (Law et al., (1997). They have a purpose or are goal directed and provide a structure for living. As such, occupations are essential for sustaining human life (Wilcock, (1993), influencing the quality of life experiences and determining the health and wellbeing of individuals, groups or communities (Wilcock & Townsend, (2008). Occupations are central to the identity and competence of people, as individuals, groups or communities assign priority and meaning to occupations according to their values and beliefs. Occupation is more than paid employment or occupying time; rather, occupation encompasses what Wilcock ((2006) defines as being, doing and becoming.

These definitions indicate the centrality of occupation to OT practice (Polatajko et al., (2004). Facilitating optimal engagement in occupations requires analysis of the occupations to support health and participation in life (DeLany, (2007). It considers the vibrant relationship between the occupation, the individual (group/community) and the contexts that support and facilitate successful occupational participation (Christiansen & Baum, (2005); Law et al., (1996), 2005).

Reviewing terms: occupation, activity and task

The word occupation is often used interchangeably with either activity or task and sometimes even action. Alternatively, some scholars view the terms occupation and activity as having different meanings (Christiansen & Townsend, (2004); Pierce, (2001); Reed, (2005). The following discussion also proposes a different meaning for these terms. In this chapter, consistent with the ‘taxonomic code for understanding occupation’ (Polatajko et al., (2004), the term ‘occupation’ is not synonymous with the terms ‘activity’ or ‘task’, it is an overarching term, which includes and builds upon both activities and tasks. For instance, voluntary movement, movement patterns and cognitive/perceptual skills initiate the action of positioning and moving specific body parts to use a keyboard to complete an assignment. This positioning and movement fulfils tasks, which might include making a plan, choosing references, completing an introduction and so forth. The completion of such tasks contributes to the performance of the overall activity of writing an assignment. The completion of the assignment is an activity within the overall occupation of communicating through writing and can be classified as a productive occupation associated with the role of a student. The occupation of communicating through writing is a meaningful occupation for many occupational roles (student, teacher, health professional, scientist, engineer and so on). Certainly, many cultures consider communicating with writing skills an essential occupation. Another significant occupation is caring for self through maintenance of personal hygiene, an occupation commonly classified as an essential self-care occupation, which belongs with activities of daily living (ADL). This significant occupation – personal hygiene and grooming – includes activities such as caring for nails, hair, skin, ears, eyes, nose, teeth, and each activity encompasses a variety of tasks. Occupational therapists commonly classify occupations according to their purpose or theme (Polatajko et al., (2004), which tends to create three broad occupational groupings: self-care, productivity and leisure.

Learning Point

Using the taxonomic code for understanding occupation (Polatajko et al., (2004), name the occupation and the purpose or theme of each occupation. The first one is completed as an example.

Minute taking

Action	=	Position notepad and pick it up.
Tasks	=	Listen and record important points and decisions.
Activity	=	Taking minutes at a meeting.
Occupation	=	Performance of defined work role (paid or unpaid).
Purpose/theme	=	Productivity.
Actions	=	Pushing up, maintaining balance, e.g. positioning feet.
Tasks	=	Choose an appropriate wave, stand and steer the board.
Activity	=	Riding a wave. (One activity in this occupation.)
Occupation	=
Purpose/theme	=
Actions	=	1. pick up brush with non-dominant hand and 2. container of toothpaste (lid already off or open) with dominant hand.
Tasks	=	With toothpaste already on brush, use brush to clean all teeth surfaces, wash mouth and repeat cleaning if necessary. Return brush to usual place and restore lid to paste container.
Activity	=	Brushing teeth.
Occupation	=
Purpose/theme	=

Areas of occupation

The following is a brief summary of how the Occupational Therapy Practice Framework; Domain & Process 2nd edition (AOTA, 2008) classifies occupations into eight areas.

1. Activities of Daily Living (ADL). ADL are self-care or self-maintenance activities that facilitate basic survival and life satisfaction in an interactive world (Christiansen & Hammecker, (2001). Examples include eating, bathing, dressing, sexual activity, toileting.

2. Instrumental Activities of Daily Living (IADL). IADL are those activities that support daily life in the home and community. These include care of pets and others; communicating with others; managing finances, health and home; moving around the community; preparing meals; shopping; participating in religious practices; maintaining safety and responding to emergencies.

3. Sleep. Sleep includes all activities that occur because of the occupation of sleeping, specifically, preparing self and children (if necessary) and the environment to ensure restful and safe sleep. These might include covering the children, completing usual rituals or habits (e.g. saying goodnight, reading, relaxation, saying prayers), interacting with others who share the sleeping space. The occupation of sleeping also includes dreaming, night toileting and as necessary negotiating the sleeping space and covers with others.

4. Education. Education involves learning and includes all activities supporting learning. Formal education can include academic (e.g. science, reading, undergradua...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Notes on contributors
• Preface
• PART I: Theoretical Perspectives on Occupation Analysis
• PART II: Analysing Relevant Components of Occupation that Underpin Practice
• PART III: Application of Occupation Analysis to Specific Practice Contexts
• PART IV: The Interface Between Aspects of Practice and Occupation Analysis
• Appendices: Analysing occupations: useful resources
• Appendix A: Chapter 1: A proforma for occupational therapists when conducting an occupation analysis
• Appendix B
• Appendix C: Chapter 4: Spirituality
• Appendix D: Chapter 4: Culture
• Appendix E: Chapter 6: Environment
• Appendix F: Chapter 7: Self-care
• Appendix G: Chapter 8: Leisure
• Appendix H: Chapter 12: Falls
• Appendix I: Chapter 17
• Appendix J: A proforma for analysing occupations in practice
• Glossary
• Index