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66 Cards in this Set
- Front
- Back
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Ethics
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Philosophy which deals with systematic approaches in cases of moral conflict.
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Morality
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Concerned with relations between people and how we ought to behave towards one another so as to protect important values cherished by society and its members.
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Values
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The properties, possessions, qualities, skills, liberties, rights and other goods cherished by persons at any point in time.
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Ethical Dilemma
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the identification, analysis, and resolution of moral problems that arise in the care of a particular patient/client.
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Ethical Tension
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Feelings of conflict, sensing threat to integrity, a feeling that all is not right, unsure of what moral principles apply. It is important to pay attention to these feelings, to step back and analyze what is the right step to take.
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What are the 8 basic ethical principles?
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Autonomy, beneficence, nonmaleficence, justice, veracity, fidelity, confidentiality, and privacy.
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Autonomy
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Right to self-determination
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Beneficence
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To do actions that benefit another, "to do good"
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Nonmaleficence
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"do no harm" refrain from inflicting harm
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Justice
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Fairness. When choices need to be made, benefits and harms are distributed.
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Distributive justice
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ex: Healthcare allocation, is it allocated fairly?
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Compensatory justice
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compensate for what went wrong
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Procedural justice
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ordering things in fairy way ex: tight schedule, client late, what to do?
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Veracity
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Truthfulness with clients and in reporting. Honesty (good or bad news).
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Fidelity
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Keeping promises and contracts, faithfulness. Maintain trust.
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Confidentiality
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Recognition of the right to privacy.
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Privacy
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Right to privacy.
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Five points of fidelity?
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1. therapist shows respect 2. client believes you are competent 3. client expects you will follow code of ethics 4. client believes you will follow policies 5. client will expect you to honor agreement between the two of you.
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Continuum of Nonmaleficence to Beneficence.
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1. Do no harm (Nonmaleficence)
2. Prevent harm. 3. Remove harm when it is being inflicted. 4. Bring about positive good (beneficence) |
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Law vs. Ethics
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Laws are rules imposed by state or federal gov't and based on principle of justice. Tells us what we should not do according to law.
Ethics are broader and involve a collection of principles that define or guide right and wrong conduct. Ethics give us standards to live by. |
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Ethical theories: Deontology
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Right and wrong are judged on the basis of moral obligation or duty. The act or means is important regardless of consequences. Let your conscience by your guide.
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Ethical theories: Teleological (Utilitarianism)
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Right action is determined by its ends and consequences; greatest good for the greatest number.
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Purpose of professional code of ethics (5)
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Common, every profession has own.
1. Define ethical stances and behavior 2. Communicates common expectation of members of profession 3. provides guidance in making ethical choices 4. expresses professionwide standards that are used as basis for quality assurance and peer enforcement or discipline 5. gives members a sense of common commitment in matters of principle, which in turn contributes to enhancing the identity and integrity of the profession. |
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Core values and attitudes of Occupation Therapy practice (AOTA 1993)
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Altruism (unselfish concern for the welfare of others), equality, freedom, justice, dignity (valuing the inherent worth and uniqueness of each person), truth prudence (use of reason, discretion.
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Seven principles of Occupational Therapy code of ethics.
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Very similar to basic ethical principles. Beneficence, nonmaleficence, autonomy, confidentiality, duty, procedural justice, veracity, fidelity.
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Ethical problems for OT's in practice (6)
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Reimbursement
Productivity Quotas Competition for clients/Patients Documentation Fraudulent Billing Patient's refusal of treatment |
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Six steps of ethical decision making
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1. Identify relevant information
2. Identify the type of ethical problem 3. Determine the ethics approach to be used. 4. Identify possible courses of action and alternatives 5. Select a plan and implement it 6. Reflection on action |
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Four-component model of moral reasoning
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Moral sensitivity
Moral judgment Moral motivation Having perseverance, ego strength, and implementation skills to do what is morally right. |
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Clinical reasoning
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the "thinking, tacit or explicit, that directs and guides occupational therapy practice" (Fleming, 1991). Complex, passes logical thought.
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Types of clinical reasoning (3)
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Procedural (physical, cognitive and emotional problem)
Interactive (client as a person) Conditional (context/environment of the person, future condition) |
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Purpose of procedural reasoning
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To treat the disability, includes problem definition and treatment selection. Remediation, compensation, or both.
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Point of view of procedural reasoning
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Treatment procedures have specific powers to influence the disability
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Objective of procedural reasoning
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To diagnose problems with functional performance as accurately and efficiently as possible.
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Cue acquisition
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Process of collecting data, acquiring info necessary to solve problems. Can sometimes be difficult, not handed to you. Talk to patient and ask questions. Don't need to find everything. Goals is to find important cues. Judge relevance of cues. Will become easier with more experience.
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Hypothesis generation
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What is causing cues? Why is it happening this way? Don't choose final answer until enough cues accumulate.
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Cute interpretation
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Interpret hypothesis in terms of cues. Make sure all cues fit in.
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Hypothesis evaluation
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Final decision. This hypothesis will be used as I move forward.
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Interactive reasoning: purpose and point of view.
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Purpose: therapy with the person/ care about person
POV: important to understand the person |
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Reason for interactive reasoning
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Therapists employ interactive reasoning: to engage the person in treatment session, to know the person as a person, to understand disability from person's POV, communicate a sense of trust, use humor to relieve tension, construct a shared language of actions and meanings, to determine if the treatment session is going well.
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Conditional reasoning: purpose and POV
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Purpose: therapeutic treatment of the person with the disability in context, to imagine the future condition of the person as a basis for treatment in the present
POV: various biological, environmental, social, cultural factors influence different people differently |
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3 steps to providing culturally sensitive care
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Knowledge
Mutual respect Negotiation (listen, teach, compare, compromise) |
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Explanatory Model of Disability
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Ask client questions about the illness and what he/she perceives the illness as.
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Professional self-talk for culturally sensitive care
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The professional thoughts that we communicate to ourselves about our experience which in turn influence the way we feel and act.
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Disability as a culture
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People with disabilities have forged a group identity. Claim disabilities with pride as part of identity.
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Environment and contextual reasoning for Disability
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How are you considering the influence of the environment and systems? What is economic, societal support client has? Client-centered.
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Consumer direction for disability
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How are you facilitating this? Ask fro things client may need. Think long-term support and care.
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Risk with dignity for disability
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How are you considering the provision of environmental supports that allow, but minimize risk?
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Disability identity
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How are you framing dysfunction or disability? Definitions differ, so how would client w/ disabilities define?
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Social interdependence
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How are you framing success in rehabilitation? Does that mean someone is completely independent or should that person get someone to help w/ daily activities?
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Social participation, support and networking
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How are you addressing relationships with individuals and social participation? Dynamics of personal relationships can change greatly if person has disability. Find new activities that can be done w/ the disability.
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Power
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How are you using your power as an OT?
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Advocacy
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How are you building client advocacy skills? Do you have a role in collective activism? Client is only with you for a little bit. How do you teach them to advocate for themselves?
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Typical OT roles (5)
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1. Clinical role: direct service to clients
2. Management role: admin duties 3. Consultant role: indirect service to clients, agencies, groups 4. Educator role: train new OTs, fieldwork supervisor, guest lecturer, etc 5. Researcher role: generate new knowledge in the field |
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Health Promotion, Wellness, and Prevention: current trends
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1. Lifestyle redesign. Look at life for elderly especially. See how they could change their behaviors for health improvement.
2. Fall Prevention 3. National Backpack Awareness Day |
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Universal design
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Env. and products designed to be usable by all people to the greatest extent possible, without the need for special arrangements, adaptations, or greater cost.
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Independent living movement
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Public health practices and other efforts to create safe, accessible and healthy communities to enable full participation.
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What is a frame of reference?
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Specific theoretical approaches used to guide treatment activities.
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Theoretical base of FOR?
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Basis for which the components of the FOR are derived. Usually several theories are used and synthesized to form the theoretical base for a FOR.
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Problems being addressed (function/dysfunction continuum)
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Identifies nature of the behaviors that are targeted for change.
Implies a gradation from total inability to engage in a particular function to complete mastery. |
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Focus of evaluation/specific assessment tools (FOR)
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Observable, measurable behaviors. Serve as the basis for the focus of the evaluation.
Specific assessment tools selected for their ability to identify behaviors that differentiate between function and dysfunction. |
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Expected outcomes of intervention (postulates regarding change)
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Nature, quantity, and sequence of the intervention strategies that are used to effect change.
Help select therapeutic modalities and techniques, analyzing activities for treatment, and designing appropriate treatment activities. |
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Why are FOR important to OT?
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-organizing mechanism
-insight into human behavior/alternative explanations -basis for therapeutic objectives and treatments -justification of services and accountability -common ground for understanding among clinicians -focus research |
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Common FOR used in OT (9)?
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Biomechanical
Rehabilitative Neurodevelopmental Cognitive-Perceptual Multicontext Behavioral Cognitive-behavioral Cognitive-disability Sensory Integration |
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Factors to consider when selecting a FOR (8)?
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1. Client and nature of pathology
2. Nature of deficits in occ. performance 3. Reasons for dysfunction 4. Client context including support system 5. Expected outcomes 6. Timeline for intervention 7. Philosophy of clinical setting 8. Therapist preference and familiarity |
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What should I take into consideration when deciding if FOR is working?
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Is it facilitating client's ability to accomplish ADLs?
Is it helping impairments? Is it increasing ability to fulfill roles desired by client? Do I need to modify intervention? Should I use different intervention? Should I switch from remediation to compensatory approach? Do the discharge goals and plans need to be changed? |
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Why is research good?
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Get more evidence, proof.
Get evidence straight. |
