Occupational therapy within the Western world is right in the middle of a paradigm shift. For decades the practice arena has mostly been institutional to its character and aimed at serving principally occidentals grateful for the treatment they were offered by professionals. Occupational therapy educational programmes and text books have followed the same pattern. But the societal panorama has changed over the years, becoming more and more multicultural with citizens coming from all over the world. The Internet has opened up unlimited possibilities to search for knowledge ending up in clients often better informed of their diagnosis than the practitioner him/herself.
This now means that practitioners have to think of different approaches as do educators and researchers, since even the meaning and interpretation of central concepts of the profession have to be revaluated for best practice. The first article in this issue of Scandinavian Journal of Occupational is from Spain and illustrates this phenomenon by arguing different world views which take into account the developments of occupational therapy culture that are used globally and host diverse meanings and occupation-focused practices. The next article illustrates how educators in an American School of Health Professions have met this challenge by designing an entry-level educational model of culturally responsive care in occupational therapy embedded in service learning that is perceived as clear, relevant and evidence-based. The model is intended to respond to the dynamic, multicultural and diverse environments in which occupational therapists practice but also to the future needs of a global community where people’s living conditions and occupational needs are affected dramatically.
Via Google, clients are able to search for best practices according to their diagnosis. Consequently, the profession and research have to keep up with this development if occupational therapists should be able to propose interventions that are proven to be effective and evidence based, and preferably easy to apply also in non-institutional arenas. From Norway we have two articles heading in this direction, the first one introduces an evidence-based exercise programme for people with hand osteoarthritis that recently has been evaluated in a randomized controlled trial. The second article presents the results of a pilot study aiming to develop a group-based self-management program for individuals with chronic fatigue syndrome by using the participants’ experiences with the initial version of the programme, which intends to promote coping with the illness in primary health care settings.
In a Swedish article, we can read about health care professionals’ experience-based understanding of capacity to work in individuals with depression and/or anxiety disorders. The findings provide a deeper understanding of the reduced capacity to work, ie difficulties in managing time, daily work demands and emotions, resulting in a work performance that was no longer recognizable as familiar. ADL task performance problems among adult disabled hospitalized cancer patient are investigated by the Activities of Daily Living Questionnaire and the Canadian Measure of Occupational Performance in a study from Denmark. A paper from Australia reports the validation and reliability testing of a video risk assessment tool for use with drivers, the Occupational Therapy Risk Propensity Test. Finally in this issue there is a study from England comparing the effect of two colored-filter systems on the symptoms of visual stress in children with reading delay. The reduction in symptoms eased the children’s visual discomfort when reading which could facilitate their occupational engagement.
By this parti-colored collection of articles I wish you good reading!
Anita Björklund
Editor in Chief SJOT