Title

Person-Activity-Environment Fit for Work Participation

Start Time

16-11-2002 1:45 PM

End Time

16-11-2002 3:00 PM

Abstract

In the vocation and employment literature the return to work statistics after a brain injury may vary from 12.5 to 80 percent. Among the variables that influence this broad percentage are the definitions of work and productivity constructs, pre-injury variables, patterns of deficits, rehabilitation experiences, and participation in supported employment. Thus when evaluating occupational performance and planning return to work programs the occupational therapist has many variables to consider as well as the occupational therapy focus of client-centered practice. In occupational therapy, the interventions for persons with acquired brain injury are client-centered and respond to the physical, cognitive and psychosocial performance changes that impact the person's role performance, productivity, and participation in the community. To plan and implement client-centered interventions the therapist considers person-task-environment variables to identify training strategies and the environments that best support the person's goals for participation in occupations. To gain insight into this dynamic process of occupational performance, a participatory research study was conducted to study person-task-environment relationships that influence client participation and the coaching process in a work context. The principles of client-centered practice (Law et. al, 1995) and dynamic interaction (Toglia, 1991), and a supported work model (Wehman, et al, 1990) contributed to the structure for the participatory research study that integrated adult learning principles and person-centered ecological evaluation and training for computer data entry. Prior to training, the two men completed standardized performance goal, memory, and problem-solving assessments. Each man's history of function and current performance profile influenced the initial training and environmental support given for each person to participate in a productive work role. The workers participated in 22 four-hour training sessions with guidance by a coach or research assistant. Their work role required social skills, pathfinding, mastery of basic computer procedures, implementation of data entry and self monitoring protocols, and organization of the work area at the beginning and end of the day. The coach or research assistant provided task procedural instruction, and gave cues and prompts as needed for the work process. They assisted with problem solving, provided performance feedback, and recorded observations of person, task and environment variables related to the work process. The thematic analysis of multiple observer observations and the worker productivity data give insight into the tasks and performance challenges that influence client work satisfaction and productivity. Analysis also suggests person-centered coaching strategies and the environmental structure that occupational therapists can use to increase participation in a supportive work context.

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Nov 16th, 1:45 PM Nov 16th, 3:00 PM

Person-Activity-Environment Fit for Work Participation

In the vocation and employment literature the return to work statistics after a brain injury may vary from 12.5 to 80 percent. Among the variables that influence this broad percentage are the definitions of work and productivity constructs, pre-injury variables, patterns of deficits, rehabilitation experiences, and participation in supported employment. Thus when evaluating occupational performance and planning return to work programs the occupational therapist has many variables to consider as well as the occupational therapy focus of client-centered practice. In occupational therapy, the interventions for persons with acquired brain injury are client-centered and respond to the physical, cognitive and psychosocial performance changes that impact the person's role performance, productivity, and participation in the community. To plan and implement client-centered interventions the therapist considers person-task-environment variables to identify training strategies and the environments that best support the person's goals for participation in occupations. To gain insight into this dynamic process of occupational performance, a participatory research study was conducted to study person-task-environment relationships that influence client participation and the coaching process in a work context. The principles of client-centered practice (Law et. al, 1995) and dynamic interaction (Toglia, 1991), and a supported work model (Wehman, et al, 1990) contributed to the structure for the participatory research study that integrated adult learning principles and person-centered ecological evaluation and training for computer data entry. Prior to training, the two men completed standardized performance goal, memory, and problem-solving assessments. Each man's history of function and current performance profile influenced the initial training and environmental support given for each person to participate in a productive work role. The workers participated in 22 four-hour training sessions with guidance by a coach or research assistant. Their work role required social skills, pathfinding, mastery of basic computer procedures, implementation of data entry and self monitoring protocols, and organization of the work area at the beginning and end of the day. The coach or research assistant provided task procedural instruction, and gave cues and prompts as needed for the work process. They assisted with problem solving, provided performance feedback, and recorded observations of person, task and environment variables related to the work process. The thematic analysis of multiple observer observations and the worker productivity data give insight into the tasks and performance challenges that influence client work satisfaction and productivity. Analysis also suggests person-centered coaching strategies and the environmental structure that occupational therapists can use to increase participation in a supportive work context.