Occupational form and occupational performance 2005
1. Occupational Form and
Occupational Performance
Or
How to think about occupations!
October 2005 J.Taylor 1
2. Occupations
• Occupations are fundamental to health,
well-being and identity.
• Occupations are the therapeutic media
employed by the occupational therapist.
• And so …….
• We need to have a sophisticated
understanding of occupations (Creek 1996)
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3. Two ways we can use
occupations
• As the end • As the
point that we means to
are aiming for improve
in our someone’s
intervention impaired
abilities
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4. Occupation as end point
• These occupations are part of the person’s
normal roles
– They organise the person’s time
– They help the person to participate in life
/society
– They have purpose and meaning for the person
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5. Occupation as end point
• The O.T. can help the person learn / relearn
these occupations, and / or can make
adaptations if necessary
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6. Occupation as a means to an end
• We can introduce occupation as
intervention to help improve someone after
illness or when disabled
• Enables eventual occupational functioning
• We choose occupations which interest the
client and which have therapeutic value
• They should be challenging but enable
success
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7. Two ways we can analyse
occupation
• Occupational • Occupational
form performance
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8. Nelson’s question about baseball
• What is an occupation?
• Is the format of the game (the structure) the
occupation?
• Or is the playing of the game (the doing)
the occupation?
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9. His answer ….
• Occupation is the relationship between
occupational form and occupational
performance
• Occupation is the relationship between the
‘something to be done’ and the ‘doing’ of it
– Playing a game of Monopoly
– Cooking a meal for a special occasion
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10. Occupational Form
• ‘an objective set of circumstances,
independent and external to a person’
(p633)
• a ‘pre-existing structure that elicits, guides,
or structures subsequent human
performance’ (p634) (Nelson 1988)
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11. Occupational form has two
dimensions
The physical dimension
and
The sociocultural dimension
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12. The physical dimension
can be observed and measured
• The objects and their properties
• The environment
• The temporal aspects
• The human aspects
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13. The sociocultural dimension –
the social and cultural aspects
• Symbols, norms, sanctions,
roles
• These operate at different levels
of society
• Language
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15. Occupational Performance
• ‘to go through or carry out the
occupational form’
• ’the doing, the action, the active behaviour,
or the active responses exhibited within the
context of an occupational form.’
Nelson (1988, p634)
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17. Overt occupational performance
can be observed
• Gross and fine movement
• Speech and related vocalisations
• Facial expressions
• All movements and postures under
voluntary motor control
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18. Covert occupational performance
may not be observed directly
• Cognitive processes
• Emotional reactions
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19. Chains of occupational
performance
Occupational Performance Aspects of form
Walks to the refrigerator
Opens The fridge door
Looks for Milk
Picks up Milk
Pushes shut Fridge door
Walks to Table
Pours Milk into glass
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20. Opening a fridge door is a
complex activity!!!
• Reach out to handle
• Grasp handle
• Firmly pull the handle (to break the hold of
the rubber seal)
• Gently pull the handle
• Stop pulling
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21. What might go wrong?
• What if some of the muscles are weak?
• What if you cannot initiate muscle action?
• What if you cannot control muscle action?
• What if you have no movement in one or
more of your joints?
• What if you cannot recognise the handle?
• What if you cannot see it?
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22. The developmental structure of
the human
• The human has
– Sensorimotor }
– Cognitive } abilities
– Psychosocial }
• These have developed over time
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23. Occupational performance
depends on …..
• The occupational form which is
encountered PLUS
• The unique developmental structure of the
individual
• The specific features of that one-off
occasion
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24. Occupation
Occupational The Occupational
meaning purpose
form person performance
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25. References
• Creek, J (1996) Making a cup of tea as an honours
degree subject British Journal of Occupational
Therapy 59 (3) 128-130
• Nelson, D.L. (1988) Occupation: Form and
Performance The American Journal of
Occupational Therapy 42 (10) 633-641
• Trombly, C.A., Radomski, M.V.(eds) (2002)
Occupational Therapy for Physical Dysfunction 5th
edition Philadelphia:Lippincott Williams &
Wilkins
October 2005 J.Taylor 25
Notas del editor
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford These occupations are part of the person’s normal roles WE WANT TO GET OUR CLIENT BACK TO THEIR NORMAL LIVES, IF POSSIBLE They have purpose and meaning for the person - purposeful means they help people to achieve their goals - meaning is very individual e.g. what does walking in the countryside mean to you? They organise the person’s time They help the person to participate in life /society
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford The O.T. can help the person learn / relearn these occupations, and can make adaptations if necessary - e.g. ramps, small pieces of equipment – a large handled trowel for someone with stiff joints to return to gardening
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Occupational Therapy for Physical Dysfunction by Trombly and Radomski is excellent around this. We can introduce occupation as intervention to help improve someone after illness or when disabled e.g. improve muscle strength, standing tolerance, improve insight, social skills Enables eventual occupational functioning e.g. being able to cook a meal, return to work, make and keep a social network We choose occupations which interest the client and which have therapeutic value They should be challenging but enable success
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Main reference here is Nelson 1988 – don’t worry about getting hold of it – it is summarised in several OT text books. This lecture introduces some simple concepts – you’ll be eager to know more – but they will be elaborated on later in the course.
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Write down a celebration or special occasion when you have a special meal
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford ‘ an objective set of circumstances, independent and external to a person’ (Nelson 1988 p633) Occupational form is a ‘pre-existing structure that elicits, guides, or structures subsequent human performance’ - what other people are aware of – they can see it, hear it or know about it. We, most of us in this room, know what a game of Monopoly looks like, many of know what the pieces and board look like, some of know what the rules are.
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Think about how you got to university this morning Did you catch a bus? Drive a car? Get a lift? Walk? Think of an occupation you carried out yesterday evening Did you cook a meal? Go for a drink with friends? Write an essay? Watch the TV?
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Can be measure and described The objects and their properties e.g. a bus, a car, what type – size, shape, colour, tickets? Bus passes? Bus stops? The temporal aspects e.g. the sequence of events, the time it took, the movement of objects over time, the changes in objects over time The human aspects the presence of other people, where they are, characteristics? E.g. other passengers, the driver
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Symbols, norms, sanctions, roles symbol – when something stands for something, and we all understand, e.g. red traffic light norms – what is normally done, and therefore expected of us (by law, or social expectation) e.g. stopping at traffic lights, letting people get off the bus before we get on. (E.G. OF CROSSING THE ROAD IN Antwerp or using a sauna in Finland)) sanctions – typical social rewards and punishments associated with norms roles – set of expectations involving others, e.g. student, worker, mother SOMETIMES WHEN WE ENCOUNTER A NEW OCCUPATIONAL FORM, WE DO NOT KNOW WHAT IS EXPECTED Levels of society Some sociocultural aspects are universal – we all, everywhere, understand them – eg water is for drinking Some only work at a national level (symbols, norms, laws, sanctions, roles etc), or at a religion level, or ethnic group, professional group, region, community, family smaller groups Language Speech is part of most occupational forms – it is part of sociocultural life – again their may be symbols, norms, there are rules of grammar etc – and these are all dependent on the various levels we operate at. E.g. families may have their own jokes and short cuts to communicating. Writing is included here.
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford OCCUPATIONAL FORM IS ‘ an objective set of circumstances, independent and external to a person’ (p633) a ‘ pre-existing structure that elicits, guides, or structures subsequent human performance’
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Cognitive processes e.g. problem solving, thinking, recalling Emotional reactions e.g. anxiety, enjoyment, sorrow, fear
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Think about what could go wrong! What if someone tells you to get the milk from the fridge, but you have never seen one before in your life! What if you have forgotten what a fridge is? What if you can’t walk? What if the milk carton is coloured orange and all the writing is in Chinese? BUT THESE STEPS IN THE CHAIN CAN BE BROKEN DOWN FURTHER
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford What might go wrong? Which parts of the arm do you use when reaching for the handle? Which mental processes do you use?
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford No two people are alike in the way they approach an occupational form, and the way they perform. The occupational form, on the face of it, looks as though it demands certain responses and behaviours and attitudes, but not so!….
07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Have you discovered the journals in the library yet?