CONTENTS Editorial 3 Monitoring the progress of young people’s occupational performance in an inpatient mental health setting. Glenda Schnell 4 The nature of occupational therapy practice in acute physical care settings. Luciana Blaga & Linda Robertson 11 Occupational participation at 85 plus: A review of the literature. Laura Haslam 19 Occupational therapy student’s fieldwork placement: Institutional and community based rehabilitation models in the Solomon Islands. Ana Burggraaf & Helen Bourke-Taylor 25 Tools of practice: A view of changes in occupational therapy in Aotearoa New Zealand. Linda H Wilson & Kaye Cheetham 32 Cover photograph courtesy of photographer, John Nelson: Ponga Tree - tree fern. Ferns are an unofficial symbol of New Zealand’s national identity. Their dominance in native bush, and their importance as food and medicine, led to their common use as design elements in traditional Ma-ori carving. The ponga has been commemorated in the Christmas song by Kingi Ihaka (1981) which includes the lines: ... On the twelfth day of Christmas My true love gave to me Twelve piupius swinging Eleven haka lessons Ten juicy fish heads Nine sacks of pipis Eight plants of puha Seven eels a swimming Six pois a twirling Five - big - fat - pigs ! Four huhu grubs Three flax kits Two kumera And a pukeko in a ponga tree! Volume 55 No 2 New Zealand Journal of Occupational Therapy New Zealand Journal of Occupational Therapy Advertising enquiries is an official publication of the New Zealand Association of All matters relating to advertisement bookings should be Occupational Therapists Inc. You may visit our web site at addressed to: www.nzaot.com Pam Chin Aims and scope Tasman Image Ltd The New Zealand Journal of Occupational Therapy is dedicated to PO Box 51014 the publication of high quality national and international articles Tawa that are grounded in practice. We invite practitioners, researchers, Wellington 5249 teachers, students and users of services to submit manuscripts Phone: +64 4 232 3128 that provide a forum to discuss or debate issues relevant to Fax: +64 4 232 3129 occupational therapy. These will be reviewed promptly by the Email: [email protected] Editorial Review Board, and, if accepted, will be published in a timely manner. Disclaimer The Association or the Editor cannot be held responsible for Editorial correspondence errors or any consequences arising from the use of information Papers and other material for publication should be sent to the published in this Journal. Opinions expressed in articles and letters do not necessarily represent those of the Association or of Editor: Grace O’Sullivan the Editor. Publication of advertisements does not constitute any New Zealand Journal of Occupational Therapy endorsement by the Association or the Editor. PO Box 12506 Thorndon Editorial committee Wellington 6144 New Zealand Editor Phone: +64 9 410 9541 Grace O’Sullivan Private Practice, Auckland Email: [email protected] Assistant editors For details related to the submission of manuscripts please re- Nancy Wright fer to the Guidelines for Authors, available in this publication or Rowena Scaletti Child & Family Counselling Ltd from the Association web site. Retired, Auckland Abstracting and indexing Editorial review board The Journal is now indexed in the CINAHL, the OT SEARCH Ann Christie Community Child, Adolescent, and database and the OTDBASE. Family Service, Auckland Subscription enquiries Gretchen Thomas Counties Manukau DHB, Auckland The Journal is published twice a year and the prices for 2008 are Lyn Dancer Community Health Services, as follows: (nee Leadley) Retired, Al Khobar, Saudi Arabia ■ For NZAOT members - NZ$40 in New Zealand, NZ$47 in Mary Butler Otago Polytechnic, Dunedin Australia and the Pacific, and NZ$52 for the rest of the world. Merrolee Penman Otago Polytechnic, Dunedin ■ For non NZAOT members and institutions - NZ$70 in New Zealand, NZ$80 in Australia and the Pacific, and NZ$88 for Robert Bull Funding & Planning, Hawkes Bay DHB the rest of the world. Trisha Egan Private Practice, Christchurch & Dunedin Subscription enquiries should be directed to: Executive Director New Zealand Association of Occupational Therapy PO Box 12506 Thorndon Wellington 6144 New Zealand Phone: +64 473 6510 Fax: +64 473 6513 Email: [email protected] New Zealand Journal of Occupational Therapy Volume 55 No 2 EDITORIAL Editorial elcome to the September 2008 issue of The New Zealand Haslam’s review of literature pertaining to the occupations of WJournal of Occupational Therapy. Many topics relevant people aged 85 plus, found links to theories of aging. Wilson and to the advancement of occupational therapy have been covered Cheetham’s article looked at the history of occupational therapy in NZJOT in recent editions, including Occupational Therapy’s in New Zealand. This review of literature revealed how the tools place and purpose in aging New Zealand, Embracing diversity: of occupational therapy practice outlined by Anne Mosey, over 25 Explaining the cultural dimensions of our occupational therapeutic years ago, are basically the same even though practice has grown selves, and Autonomy, accountability, and professional practice: and diversified in that time. On a different track, Anna Burggraaf Contemporary issues and challenges, to name a few. However, and Helen Burke-Taylor write about a student’s experience of perhaps the greatest stride forward has been the increase in the helping to develop occupational therapy services within existing number of research articles ‘grounded in practice’ that have been institutional and community based rehabilitation models while submitted for publication. on student placement in the Solomon Islands. Enjoy! Developing evidence which underscores the role of occupation Acknowledgement to health and well-being, and thereby the profession’s place in the In this the second, and final, edition of the Journal for the year provision of health services, has helped to promote our unique I would like to acknowledge and thank colleagues who have knowledge while at the same time focusing on advances in clinical given their time, and made the effort to review one or more practice. The importance of providing evidence which enhances manuscripts submitted for publication to the New Zealand taken-for-granted knowledge cannot be overstated. Ultimately it Journal of Occupational Therapy during 2007-8. In many may be used to improve quality of life for the many people we instances, these are people I have never met so I want them to strive to serve. Keeping readers informed and up to date with know that I appreciate their support, especially since the number new knowledge is the purpose of the Journal. If you have made a of articles being submitted for review has increased. difference in your practice, via innovative practice, or if you have a story to tell, please share your knowledge and let others know. Once again I thank Clare Hocking who is always willing to share her knowledge and experience as an editor. Next, to Ann Paddy, This issue of the Journal is supported by an interesting selection Beth Gordon, Clare Miller, Dale Rook, Daniel Sutton, Diane of articles. The topics look back, forward, and broad side, at the Henare, Gale Cull, Gretchen Thomas, Heleen Blijlevens, Helen diversity of occupational therapy in New Zealand. Glenda Schnell Byrne, Jean Dominy, Jo-Anne Gilsenan, Kaye Buchanan, Mary leads the way with a retrospective analysis of data. This research Butler, Mathijs Lucassen, Nancy Wright, Rowena Scaletti, Sarah article looked at the effectiveness of occupational therapy services Haskell, Tamzin Brott, and Valerie Wright-St Clair – many thanks, for young people in an inpatient mental health setting. Similarly, without your support... Luciana Blaga and Linda Robertson’s research explored the challenges faced by occupational therapists working in acute care Grace O’Sullivan settings. Other articles focus on literature. For instance, Laura Editor Volume 55 No 2 New Zealand Journal of Occupational Therapy RESEARCH ARTICLE Glenda Schnell Monitoring the progress of young people’s occupational performance in an inpatient mental health setting Glenda Schnell Abstract Objective: This retrospective analysis of existing data was undertaken to determine the extent to which young people in an inpatient mental health setting improve in the area of occupational and social functioning. Method: Components of occupational performance were observed, and tracked over time. The revised version of the Occupational Therapy Task Observation Scale (OTTOS) was used to gather data during group work within the unit. The data was analysed retrospectively. Results: A strong positive linear relationship with recovery was indicated, although individual variance was evident. Clusters of OTTOS subscores were also analysed, and results indicated the rate of change in cognition was quicker than conation (motivation), affect or behaviour. Conclusion: The use of the OTTOS provided a means to effective communication and useful clinical application within the team. Further prospective research is recommended. Key words Retrospective analysis; adolescent; inpatient mental health; occupational performance. Reference Schnell, G. (2008). Monitoring the progress of young people’s occupational performance in an inpatient mental health setting. New Zealand Journal of Occupational Therapy, 55(2), 4-10. hen adolescents face serious mental health issues, their families who experience serious mental health disorders which Wperformance