Title

Using a Transactional Approach to Address Occupational Injustices of Nursing Facility Institutions

Start Time

15-10-2009 3:45 PM

End Time

15-10-2009 5:15 PM

Abstract

Occupational injustice describes ways in which individuals may have limited access or ability to engage in occupations due to varying degrees of environmental, sociopolitical power, and prestige relations. Occupational science continues to be conceptually concerned with occupational injustice. However, there appears to be a gap on how occupational science is empirically investigating and disseminating such phenomena. The intent of this paper is to discuss how occupational participation is not a solitary action of engagement between an individual and their activity. Occupational participation is continuously in a web of transactions with multiple contextual forces. Although a new or chronic disability complicates an older adult’s ability to reconstruct a better sense of health and well-being while residing in a nursing facility, their level of occupational participation is often contingent on the degree of resident’s perceived and actual environmental constraints and affordances within the institution. The institutional constraints and affordances including the social participants (e.g. staff, administration, other residents, etc.) that reinforce them, underscore the degree of occupational injustice. The physical and social environment can limit a nursing facility resident’s occupational competence, perceived control, and well-being. I recommend the employment of a transactional approach to both clinical practice and research to expose occupational injustice and ways to minimize its negative effects. Clinically, a transactional approach can guide the care and enablement of nursing facility residents. A transactional approach can help the resident to negotiate with the physical and social environment to maximize their ability to engage in daily occupation. In addition, a transactional approach can intervene with relevant aspects of the physical and social environment. In doing so, the resident can be best supported from that physical and social environment. In research, attention needs to focus on which transactional elements support or reduce the older adults’ frequency, ability, and attributed importance to various occupations. In conclusion, occupational science research can inform the nursing facility industry on how to reduce the negative effects of occupational injustices by exposing its existence, developing new ways to measure it, and imparting clinical practice with potential methods to reduce its negative effects on resident health and wellbeing.

References

Cutchin, M. (2004). Using Deweyan philosophy to rename and reframe adaptation-toenvironment. American Journal of Occupational Therapy, 58, 303-312. DOI: 10.5014/ajot.58.3.303

Dickie, V., Cutchin, M. P., & Humphry, R. (2006). Occupation as transactional experience: A critique of individualism in occupational science. Journal of Occupational Science, 13(1), 83-93. Access Article

Townsend, E. & Wilcock, A. A. (2004). Occupational justice and client centered practice: A dialogue in progress. Canadian Journal of Occupational Therapy, 71(2), 75-87. Article Access

Wilcock, A. A. (2007). Occupation and health: Are they one and the same? Journal of Occupational Science, 14(1), 3-8. Access Article

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Oct 15th, 3:45 PM Oct 15th, 5:15 PM

Using a Transactional Approach to Address Occupational Injustices of Nursing Facility Institutions

Occupational injustice describes ways in which individuals may have limited access or ability to engage in occupations due to varying degrees of environmental, sociopolitical power, and prestige relations. Occupational science continues to be conceptually concerned with occupational injustice. However, there appears to be a gap on how occupational science is empirically investigating and disseminating such phenomena. The intent of this paper is to discuss how occupational participation is not a solitary action of engagement between an individual and their activity. Occupational participation is continuously in a web of transactions with multiple contextual forces. Although a new or chronic disability complicates an older adult’s ability to reconstruct a better sense of health and well-being while residing in a nursing facility, their level of occupational participation is often contingent on the degree of resident’s perceived and actual environmental constraints and affordances within the institution. The institutional constraints and affordances including the social participants (e.g. staff, administration, other residents, etc.) that reinforce them, underscore the degree of occupational injustice. The physical and social environment can limit a nursing facility resident’s occupational competence, perceived control, and well-being. I recommend the employment of a transactional approach to both clinical practice and research to expose occupational injustice and ways to minimize its negative effects. Clinically, a transactional approach can guide the care and enablement of nursing facility residents. A transactional approach can help the resident to negotiate with the physical and social environment to maximize their ability to engage in daily occupation. In addition, a transactional approach can intervene with relevant aspects of the physical and social environment. In doing so, the resident can be best supported from that physical and social environment. In research, attention needs to focus on which transactional elements support or reduce the older adults’ frequency, ability, and attributed importance to various occupations. In conclusion, occupational science research can inform the nursing facility industry on how to reduce the negative effects of occupational injustices by exposing its existence, developing new ways to measure it, and imparting clinical practice with potential methods to reduce its negative effects on resident health and wellbeing.