Occupation in the Environment: A Student's Perspective
Mason, Julia, Reed, Kirk, New Zealand Journal of Occupational Therapy
The aim of this article is not to detail the full scope of an environmental analysis, but to provide an introduction to the application of conceptual underpinnings in a student learning experience. To that end the physical, social, institutional, and cultural environments of a forty nine year old bank employee are analysed to gain insight into their integrative impact on occupational performance.
The dynamic relationship between persons, environments, and occupation is well known to occupational therapists (Law, Cooper, Strong, Stewart, Rigby, & Letts, 1996), as is the fact that "Changes in any of these areas will influence a person's performance in, and satisfaction with, their occupations" (Law, Polatajko, Baptiste, & Townsend, 2002, p. 30). To learn more of this relationship, an occupational therapy student undertook this analysis as a component of the year one BHSc (Occupational Therapy) curriculum at AUT University.
After gaining informed consent, the student interviewed Rachel (pseudonym), who works in a New Zealand bank. Rachel's work environment was analysed using a conceptual framework and practice models which acknowledge the interaction between a person and their environment. These included The Canadian Model of Occupational Performance (CMOP) (Law, Polatajko, Baptiste, & Townsend, 2002), the International Classification of Functioning, Disability, and Health (ICF) (World Health Organisation [WHO], 2001), the Person-Environment-Occupation (PEO) Model (Law, 1991) and the Occupational Performance Process Model (OPPM) (Fearing, Law, & Clarke, 1997).
The CMOP views the individual within their unique context and recognises the impact of this context on the person's participation and occupational performance. In particular, the environment is viewed as extending beyond one's proximal surroundings to encompass physical, social, institutional and cultural domains. Pertinent aspects of these domains are recognised as environmental conditions contributing to occupational performance issues (OPIs) in stage 3 of the OPPM, and as resources for resolving these OPIs in stage 4 (Fearing et al., 1997). Similar to the PEO model, the CMOP assumes changes in any aspect of the person-environment-occupation dynamic may alter occupational performance. In this way a person's environment may facilitate or hinder performance (O'Brien, Dyck, Caron, & Mortenson, 2002). The domains used for the analysis are those depicted in the outer layer of the CMOP, and reflect the environmental factors of the ICF. This classification of environmental features and elements includes products and technology, natural and human changes to the environment, support and relationships, attitudes and services, and systems and policies (Stark & Sanford, 2005).
When researching environmental analysis, few examples that articulated the application of practice models in relation to the environment were found. Authors such as Pierce (2003), Hamilton (2004), and Kielhofner (2003) explored the environment's impact on people and occupation separately, they did not link examples to the dynamic person, environment, and occupation (PEO) relationship. Conversely, Law, Polatajko, Baptiste, & Townsend, (2002) and Reed and Sanderson (1999) discussed the PEO model, but did not demonstrate its application. Reed and Sanderson stated that "because this model is new, specific assessments have not yet been developed" (p. 270). Alternatively, work by O'Brien, Dyck, Caron, and Mortenson (2002), as well as Rigby and Letts (2003) ; and Stark and Sanford (2005) described the PEO model and related it to a limited number of case examples. However, there was a lack of diversity in the literature, with a predominant focus on disability rather than a wide variety of occupations or occupations performed by healthy people. These gaps in the existing literature enabled an exploratory approach when analysing a bank environment. …