Occupational Therapy in Acute Care
Lu, Frank I. -Chien, New Zealand Journal of Occupational Therapy
Smith-Gabai, H. (Ed.). (2011). : AOTA Press.
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I am very excited to review this long awaited book from the United States of America. For a long time I believe many occupational therapists like myself, have used non-occupational therapy focused textbooks (e.g. Medicine and Physiotherapy) in their acute care practice, whilst wishing a book was available that was explicitly written to guide them to navigate the high pressure, fast paced tertiary healthcare facility from an occupational therapy perspective.
In this book Smith-Gabai (2011) clearly outlines that "working in a hospital setting can be challenging and frustrating because the environment remains predominantly hierarchical and paternalistic (with strong emphasis of a medical model)" (p. xi). Occupational therapists may often experience ambivalence about their role in the acute care setting (Griffin, 1993; Griffin & McConnell 2001) because of "the difficulty to reconcile the value of medical model system with core values of occupational therapy and the recognition engagement in meaningful and purposeful occupation is the most effective way to empower patients, facilitate independence and advance health" (Smith-Gabai, 2011, p. xi). Smith-Gabai positively states that the medical model can be congruent with occupational therapy philosophy and that working in this kind of setting offers us unique opportunities to be both occupation-based and client-centred in our practice.
Occupational therapists who practice in acute care have unique challenges in providing evaluation and intervention, including the patient's medical instability, the limitations in physical settings, assessing the appropriateness of referrals and requests, and the constrained timeframes for evaluation and intervention. Smith-Gabai (2011) acknowledged that it is an uneasy task for occupational therapists in acute care to look beyond specific medical condition and see the whole person and each has his own occupational profile. Still this is the key that separated our profession from other disciplines as we take into account of patient's physical, mental, psychosocial and spiritual needs when planning interventions and making discharge recommendations with the aim at enabling patient to reclaim important role and routine. Therefore, having an understanding of medical conditions and how illness affects occupational performance areas from both bottom-up and top-down approaches is essential for occupational therapists practicing in acute care.
This American-based book is a comprehensive evidence-based book on occupational therapy practice in the acute care setting. It will help therapists to demystify medical conditions and typical issues when working in this setting. It is written in easy-to understand language and terms to support students, novice, and expert occupational therapists to recognise and understand the physiology and pathology of body systems, common medical procedures and management, and how they are linked to the practice of occupational therapy. …