Evolving Health Environments and Occupational Therapy: Definitions, Descriptions and Opportunities

1997 ◽  
Vol 60 (10) ◽  
pp. 456-460 ◽  
Author(s):  
Marcia Finlayson ◽  
Jeanette Edwards

Over the past 20 years, the world has seen a slow but steady shift in thinking about illness and wellness and about what constitutes health and health care. Concepts such as primary health care, disease and injury prevention, disability postponement, health promotion and population health are the focal points of this shift. In order to contribute in this evolving health environment, occupational therapists need to understand this terminology and make the link between these concepts and their philosophy and skills in enabling health through occupation. To contribute to this understanding, the objectives of this paper are to review the history of occupational therapy as it relates to recent shifts in thinking about health and health care, to define and describe briefly the relevant health and health care terms and concepts, and to illustrate the existing and potential links between the practice of occupational therapy and these health and health care concepts.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A P N Fornereto ◽  
P G Furlan ◽  
S H Ferigato ◽  
A S Moura ◽  
C B Faria ◽  
...  

Abstract This study regards the experience of implementing a professional internship intended to students of Occupational Therapy in Primary Health Care in a Federal University located in São Paulo State, Brazil. Occupational therapist profession in Brazil was inserted in this level of care to offer specialised support to teams, mainly concerning qualification of care to vulnerable and invisible populations (community, family and cultural aspects), health promotion, encouragement of team work, humanisation in health. Such curricular internship occurs since 2017 to students of the 4th and 5th years of undergraduate course, completing 240 hours. How is the practice programme in Primary Health Care organised in the pedagogic project? Which are the strengths and fragilities of this field, as far as education is concerned? Among the practice scenarios, there are Basic Health Unit, Family Health Strategy teams, Family Health Support Centre, Street Clinic and University Basic Health Unit, with tutors who establish the collaboration. The interns follow individual and group cases, take part in team meetings and actions for team qualification and are also supervised weekly by a professor. Among their strengths, we can list a diversified education, based on the most recent public policies for the level of care that represents the stepping stone to the health system. As well as the access to the occupational therapy professional in this first contact, if the team identifies such necessity. Regarding challenges, there is unawareness about professional practice, difficulty to access work instruments and resources, as well as physical space. We hope this experience can help other educational institutions to implement their practice programmes in and for the health system. Egresses report that enables learning to work in a team in different scenarios. Such strategy aims to form a generalist professional, with criticality regarding challenges and potentialities of Brazilian public health. Key messages This study reports the experience of a professional internship of Occupational Therapy in Primary Health Care, understanding the health system as a scenario for practice, teaching and learning. Educating occupational therapists to this level of care is necessary, in agreement with the attributes of Primary Care.


2015 ◽  
Vol 5 (2) ◽  
pp. 45-50
Author(s):  
Juan E Mezzich ◽  
James Appleyard ◽  
Michel Botbol ◽  
Tesfa Ghebrehiwet ◽  
Joanna Groves ◽  
...  

The popular usual meaning of primary care is health care at a basic rather than specialized level for people making an initial approach to a doctor or nurse for treatment. The concept of primary health care has evolved dramatically over the past four decades, particularly under the aegis of the World Health Organization with the additional participation of other institutional actors around the world. It is increasingly recognized as a fundamental concept and strategy for the advancement of health care and the promotion of health at national and international levels.Separately, as the programmatic global initiative on person centered medicine has been unfolding over the past decade, primary care, not surprisingly, is emerging as a prominent topic and concern for advancing person-centered medicine and health care. There are certainly conceptual and strategic reasons for such emergence. There have been as well institutional reasons for this. At the same time, person-centeredness is an open road for the optimization of primary care.Further understanding of the prominent position, special role, and particular challenges of primary care in person centered medicine is contributed by several of the papers published in the present issue of the International Journal of Person Centered Medicine.


Author(s):  
Rodrigo Alves dos Santos Silva ◽  
Fátima Correa Oliver

É relevante conhecer a diversidade de práticas de terapeutas ocupacionais na Atenção Primária à Saúde (APS) no contexto brasileiro, devido esse nível assistencial apoiar o rearranjo da atenção à saúde à população. O estudo identificou ações e atividades realizadas por terapeutas ocupacionais na APS. Trata-se de pesquisa do tipo Survey, efetuada entre novembro de 2017 e fevereiro de 2018, através de Questionário On line autoaplicável com terapeutas ocupacionais da APS. Participaram 105 profissionais, a maioria do gênero feminino, com até 39 anos de idade e tempo de atuação na APS variando entre um e cinco anos, inseridos, sobretudo, em Núcleos de Apoio à Saúde da Família das regiões sudeste e nordeste. Os profissionais informaram realizar atendimento individual (97,1%) e grupal (93,3%); atenção domiciliar (84,8%); apoio matricial (88,6%); educação em saúde (86,7%); promoção da saúde (95,2%); prevenção de doenças (89,5%); educação permanente e/ou continuada (84,8%); participação em reuniões de planejamento dos serviços (89,5%) e de articulação com redes saúde (81,9%). Também utilizam atividades, tecnologia assistiva e recursos terapêuticos em ações junto a pessoas com dificuldades na realização das atividades cotidianas. As práticas referidas indicam a integração dos profissionais às equipes e aos serviços de saúde e do território. A identificação das ações e atividades representa etapa inicial de construção de dados aprofundados sobre a atuação da terapia ocupacional na APS. Abstract It is relevant to know the diversity of practices of occupational therapists in Primary Health Care (PHC) in the Brazilian context, due to this level of support to the rearrangement of health care to the population. The study identified actions and activities performed by occupational therapists in PHC. This is a Survey-type, conducted between November 2017 and February 2018, through a self -administered On-line Questionnaire with PHC occupational therapists. A total of 105 professionals, most of them female, with up to 39 years of age and working time in PHC ranging from one to five years, were included, mainly in Expanded Core Family Health and Basic Care in the Southeast and Northeast Regions. The professionals reported individual care (97.1%) and group (93.3%); home care (84.8%); matrix support (88.6%); health education (86.7%); health promotion (95.2%); disease prevention (89.5%); continuing and/or continuing education (84.8%); participation in service planning meetings (89.5%) and articulation with health networks (81.9%). They also use activities, assistive technology and therapeutic resources in actions with people with limitations in daily activities. The practices referred to indicate the integration of the professionals to the teams and the health services and the territory. The identification of actions and activities represents an initial stage of construction of in-depth data on the performance of occupational therapy in PHC.Keywords: Primary Health Care; Occupational Therapy; Unified Health System.


2021 ◽  
Vol 6 (2) ◽  
Author(s):  
David Gaus

COVID-19 has negatively impacted primary health care (PHC) activities globally. Some argue that now is the time, more than ever, to strengthen PHC in a post-COVID world. It could be argued that COVID-19 revealed the failures of PHC. Global aid agencies, starting with the World Bank, are already calling for the same technical solutions that, by themselves, have not addressed PHC failures in the past. A deeper understanding of the complexity of PHC failures might provide greater clarity to forge a path forward for PHC. Bourdieu’s theory of fields might be a useful framework for that understanding.


Author(s):  
Ilka Veras Falcão ◽  
Adriana Lobo Jucá ◽  
Sémares Genuino Vieira ◽  
Cinthia Kalyne De Almeida Alves

Uma desconhecida e letal infecção respiratória se disseminou mundialmente levando a Organização Mundial de Saúde a decretar uma pandemia pelo COVID-19. O Sistema Único de Saúde (SUS) brasileiro adotou recomendações de distanciamento social, uso de equipamentos de proteção e outras, para prevenção a novas infecções. A demanda hospitalar é crescente, requerendo participação dos demais serviços, incluindo a rede de Atenção Primária à Saúde (APS), tanto para enfrentamento a epidemia como continuidade do cuidado a outros problemas de saúde. O objetivo é apresentar às experiências da Terapia Ocupacional no contexto da APS na epidemia pelo COVID-19. As experiências estão apresentadas como remotas e presenciais. O trabalho remoto usa a comunicação telefônica e/ou redes sociais para teleatendimento, telemonitoramento e reuniões de equipes. Atividades desenvolvidas pelas famílias são adaptadas, para que ocorram de forma segura. As terapeutas ocupacionais realizam grupos de promoção á saúde, informativos sobre a rede de saúde, orientações para isolamento domiciliar, atividades de autocuidado e funcionalidade para pessoas com deficiência, transtorno mental e outras com tratamentos interrompidos. Presencialmente, as terapeutas ocupacionais organizam ambientes e processo de trabalho, acolhimento, triagem e prioridade de atendimento, incluindo urgências por adoecimento mental, pânico e vivência do luto. A Terapia Ocupacional vem apoiando a equipe com escuta qualificada e uso de práticas integrativas. A epidemia escancarou dificuldades do SUS e as injustiças ocupacionais, as quais o terapeuta ocupacional e a equipe da APS já enfrentavam. A epidemia vai passar, mas as desigualdades e injustiças permanecerão e combatê-las com afinco e consciência crítica será fundamental. AbstractAn unknown and lethal respiratory infection has spread worldwide leading the World Health Organization to decree a pandemic by COVID-19. The Brazilian Unified Health System (SUS) has adopted recommendations for social distance, the use of protective equipment and other measures to prevent new infections. Hospital demand is growing, requiring the participation of other services, including the Primary Health Care (PHC) network, both to face the epidemic and to continue care for other health problems. The objective is to present the experiences of Occupational Therapy in the context of PHC in the epidemic by COVID-19. The experiences are presented as remote and in person. Remote work uses telephone communication and / or social networks for teleconsultation, telemonitoring and team meetings. Activities developed by families are adapted, so that they occur safely. Occupational therapists hold health promotion groups, information about the health network, guidelines for home isolation, self-care activities and functionality for people with disabilities, mental disorders and others with interrupted treatments. In person, occupational therapists organize environments and the work process, reception, screening and priority care, including emergencies due to mental illness, panic and bereavement. Occupational Therapy has been supporting the team with qualified listening and use of integrative practices. The epidemic opened up difficulties for SUS and occupational injustices, which the occupational therapist and the PHC team already faced. The epidemic will pass, but inequalities and injustices will remain and tackling them with diligence and critical awareness will be critical.Key words: Occupational therapy; Primary Health Care; Basic Attention; COVID-19; NASF. ResumenUna infección respiratoria desconocida y letal se ha extendido en todo el mundo, lo que llevó a la Organización Mundial de la Salud a decretar una pandemia por COVID-19. El Sistema Único de Salud de Brasil (SUS) ha adoptado recomendaciones para la distancia social, el uso de equipos de protección y otras medidas para prevenir nuevas infecciones. La demanda hospitalaria está creciendo y requiere la participación de otros servicios, incluida la red de Atención Primaria de Salud (APS), tanto para enfrentar la epidemia como para continuar atendiendo otros problemas de salud. El objetivo es presentar las experiencias de la terapia ocupacional en el contexto de la APS en la epidemia por COVID-19. Las experiencias se presentan como remotas y en persona. El trabajo remoto utiliza la comunicación telefónica y / o las redes sociales para teleconsulta, telemonitorización y reuniones de equipo. Las actividades desarrolladas por las familias se adaptan para que ocurran de manera segura. Los terapeutas ocupacionales organizan grupos de promoción de la salud, información sobre la red de salud, pautas para el aislamiento en el hogar, actividades de autocuidado y funcionalidad para personas con discapacidades, trastornos mentales y otras personas con tratamientos interrumpidos. En persona, los terapeutas ocupacionales organizan los entornos y el proceso de trabajo, la recepción, la detección y la atención prioritaria, incluidas las emergencias debido a enfermedades mentales, pánico y duelo. La terapia ocupacional ha estado apoyando al equipo con la escucha calificada y el uso de prácticas integradoras. La epidemia abrió dificultades para el SUS y las injusticias ocupacionales, que el terapeuta ocupacional y el equipo de APS ya enfrentaron. La epidemia pasará, pero las desigualdades e injusticias permanecerán y abordarlas con diligencia y conciencia crítica será fundamental.Palabras clave: Terapia ocupacional; Atención primaria de salud; Atención básica; COVID-19; NASF. 


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.


2010 ◽  
Vol 16 (3) ◽  
pp. 211 ◽  
Author(s):  
Helen Keleher ◽  
Rhian Parker ◽  
Karen Francis

Health reform is increasingly targeted towards strengthening and expansion of primary health systems as care is shifted from hospitals to communities. The renewed emphasis on prevention and health promotion is intended to curb the tide of chronic disease and sustain effective chronic disease management, as well as address health inequities and increase affordable access to services. Given the scope of nurses’ practice, the success of Australia’s health system reforms are dependent on a nursing workforce that is appropriately educated and prepared for practice in community settings. This article reports on the results of an Australian national audit of all undergraduate nursing curricula to examine the extent of professional socialisation and educational preparation of nurses for primary health care. The results of the audit are compared with Australian nursing standards associated with competency in primary health care. The findings indicate that Australian nursing competencies are general in their approach to skills and knowledge, not specifying any particular competencies for primary health care, while undergraduate student preparation for practice in primary health and community settings is patchy and not keeping pace with reform agendas that promote expanded roles for nurses in primary health care, prevention and health promotion. The implication for nursing curriculum reform is that attention to achieving nursing graduate capacity for primary health care and health promotion is a priority.


Author(s):  
Hashim Mohamed

AbstractIntroductionPostnatal Depression (PND) is a major health problem affecting mother, her child and family.  Its prevalence and associated risk factors among South Asian mothers (SAM) living  in Qatar remain unknown. The objectives of this study were to estimate the prevalence of PND among (SEAM) in Qatar and to correlate risk factors contributing to the development of PND.Materials and methodsA total of (285 ) (SAM)females who were six months  postpartum were interviewed as  part of a prospective study conducted in primary health care centers in Qatar.  PND symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Descriptive statistics were used for summarizing the study and outcome variables. The χ2 test and ORs with 95% confidence intervals (CIs) were used for observation and quantifying the association between different variables. Multivariate binary logistic regression was used to identify the independent associated factors of PPD. P≤0.05 was considered significant. Variables included were age , occupation, education level ,previous psychiatric history ,comorbidities , ,history of depression during current  pregnancy, history of anxiety during current pregnancy, number of previous pregnancies, strong social support, husband support, marital problem before pregnancy and ongoing marital problems during current pregnancy.Results The prevalence of postnatal depression among 285 respondents was 33.2% .several psychosocial risk factors were significantly associated with postnatal depression and, after multiple regression analysis, a history of depressive illness ,anxiety ,marital problems before delivery ,a history of diabetes and asthma ,history of congenital malformations ,and lack of mother support.Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95), but marginally indicative of the risk of depressive symptoms.ConclusionThis study showed a high rate of depressive symptoms among(SAM) six months Postpartum . Future screening protocols  must be employed at primary care level and hospital based clinics in Qatar to detect and treat post natal depression.Keywords: postnatal  depression,  South Asians, primary health care ,Doha, EPDS  


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