Occupational therapy is increasingly becoming clearer concerning the core of professional activities, and the importance of meaningful tasks and actions for a healthy and purposeful life for our clients. Research is increasingly being reported that focuses on interventions to enable persons to take responsibility for all parts of their lives. Whether the limitations in a person's life are due to an illness, a disease, an accident or some other more or less clarified obstacle, the occupational therapist is the guide in how to meet the obstacles and work together with the person to overcome those obstacles for a fruitful and fulfilling life.
This issue of the Scandinavian Journal of Occupational therapy includes two interesting studies that discuss the core of occupational therapy, or how occupation is described by occupational therapists in academe. They are referring to the occupational therapy core assumption that there is a strong relationship between occupation and health or well-being. Their work contributes to the theory within occupational therapy and their conclusion is similar to what professor Kielhofner mentioned in his key-note at the world congress in Stockholm in 2002: that studies in occupational therapy praxis need to be performed in order to confirm or validate the occupational therapy theory.
The use of the concept of well-being in occupational therapy is common and yet it is not a universally acknowledged or recognized concept. This has been reviewed and critiqued in the second study on the core of occupational therapy in this issue. The concept of well-being in the occupational therapy literature is used both as a term that is not referenced and as a term being discussed from different perspectives. The authors conclude that we need to be clear about the uncertainties when using the concept and, as we publish, we need to make more considered and nuanced use of the concept of well-being.
Another interesting study describes the consultative role of the occupational therapist working in community health care. The consultations comprise not only advice and assessments, but also supervision, information and support to both patients and relatives, and to assistant staff. Furthermore, in another study in this issue we learn about the experience of working with patients from other cultures. The authors have found that the occupational therapy models used in Sweden might be insufficient when working with immigrants, and they illuminate the need for more culturally sensitive techniques and strategies while working with individuals from other cultures.
The adaptation process is the focused of another study, where professional support is suggested after the rehabilitation period for persons with traumatic brain injury. Such support would enable individuals with traumatic brain injury to practise their abilities at home, using their own and new strategies that are efficient and satisfying. This support would help these persons to build a new identity that helps them to resume an active and meaningful life. Persons with mild cognitive impairment and dementia often have a limited awareness of their disabilities, which is the focus of one article. The study reveals that these persons do have an awareness of their limitations in everyday occupations, although there are individual variations, leading the authors to conclude that it is important to evaluate each person for his/her awareness of disabilities irrespective of that person's diagnosis.
In order for occupational therapy to continue to build our competence in research, we need to make sound judgements on our assessments. One of the articles in this issue of our journal describes the process of creating a test, from generating items to testing of the validity and reliability of a test of joint protection self-efficacy in persons with rheumatoid arthritis (RA). Modern test theory and Rasch analysis have been used to evaluate the psychometric properties of the test for use in research and clinical practice. The test was found to be valid and reliable and can be used in clinical practice to stimulate efficacy-enhancing methods in education on joint protection.
How health professionals can stimulate older adults to adhere to group exercise in the community is explored in another study. The aim of the group exercise was to prevent falls. The authors describe the motivational factors and the barriers for participants in adhering to group exercise, and they conclude and suggest greater involvement from all the health professions in motivating older adults to engage in such groups.
As we go to print with this issue of the Scandinavian Journal of Occupational Therapy we all are eagerly awaiting our journal's first impact factor to be announced later this year. In the world of science, the impact of a journal article can influence the scientific value of an author as well as the area in which the article has been published. We know that in occupational therapy we have several high-ranking journals within our field, and an impact factor will not change that. But in the bigger scheme, a sizeable impact factor may contribute to a realization that occupational therapy is also an important area of research within health care.