Rheumatology Practice in Occupational Therapy

Notes on contributors ix Preface xi 1 Living with a rheumatic disease: the personal perspective 1 Lynne Goodacre and Margaret McArthur 1.1 Introduction 1 1.2 Living with a rheumatic condition 3 1.3 Developing new skills and learning 9 1.4 Summary 12 2 Living with rheumatic diseases: the theoretical perspective 13 Margaret McArthur and Lynne Goodacre 2.1 Introduction 13 2.2 Understanding and being understood 13 2.3 The impact of a rheumatic condition on a person’s sense of self 17 2.4 The experience of living with a rheumatic condition 23 2.5 Acknowledge the loss, promote the gain 25 3 Understanding rheumatic diseases: the occupational therapy perspective 29 Margaret McArthur 3.1 The centrality of occupation 29 3.2 Occupational potential 30 3.3 Occupational science 30 3.4 Understanding need 31 3.5 Occupational identity 33 3.6 Occupational adaptation 34 3.7 Occupational balance 34nts 3.8 Occupational gain 35 3.9 Clinical reasoning – the thinking that guides practice 36 3.10 Personal perspectives 39 4 Managing rheumatic conditions: the policy perspective 47 Lynne Goodacre 4.1 Introduction 47 4.2 Increase in the ageing population 47 4.3 Increase in long-term conditions 49 4.4 The delivery of efficient client-centred approaches to health and social care 56 4.5 Shaping policy to meet the needs of people with rheumatic conditions 58 4.6 Conclusions 59 5 Occupational therapy assessment and outcome measurement 63 Annette Sands and Lynne Goodacre 5.1 Introduction 63 5.2 Outcome measurement: the policy context 64 5.3 The occupational therapy assessment process 65 5.4 Commonly used data-collection tools 67 5.5 Factors influencing the choice of data-collection tool 72 5.6 Summary 77 6 Psychological approaches to understanding and managing rheumatic conditions 81 Deborah Harrison 6.1 Introduction 81 6.2 Health psychology and biopsychosocial perspectives 81 6.3 Coping with illness 83 6.4 Transactional model of stress 83 6.5 Self-efficacy and hardiness 85 6.6 Locus of control 86 6.7 Crisis theory 87 6.8 Coping styles 90 6.9 Moving beyond coping: hope 91 6.10 Conclusion 91 7 Approaches to promoting behaviour change 95 Sarah Drake 7.1 Introduction 95 7.2 Relevance to occupational therapists 96 7.3 Health behaviour change 96 7.4 Social Cognition theories 97 7.5 Implications for practice 98 7.6 Implications for practice 100 7.7 Motivational interviewing 101 7.8 Clinical example of the TTM 101 7.9 Limitations of the TTM 107 7.10 Conclusion 108 8 Joint protection 111 Alison Hammond 8.1 Introduction 111 8.2 What is joint protection? 111 8.3 The aims of joint protection 112 8.4 Why and when to use joint protection 112 8.5 Joint protection and energy conservation principles 114 8.6 Understanding and perceptions of joint protection 115 8.7 Goals of joint protection education 116 8.8 Evidence for joint protection effectiveness 117 8.9 The Looking After Your Joints Programme and the Lifestyle Management for Arthritis Programme 119 8.10 Teaching joint protection 119 8.11 Practical techniques 125 8.12 Conclusion 130 9 Pain management 133 Lucy Reeve and Margaret McArthur 9.1 Introduction 133 9.2 What is pain? 133 9.3 Pain and rheumatology 134 9.4 Living with rheumatic pain 135 9.5 Pain assessment 136 9.6 Pain and occupational therapy 138 9.7 Patient education 139 9.8 Fatigue management 139 9.9 Sleep hygiene 140 9.10 Medication 140 9.11 Changing behaviour 140 9.12 Vocational rehabilitation 142 9.13 Psychological interventions 143 9.14 Social support 146 9.15 Summary 147 10 Maintaining independence 153 Jill Jepson and Lynne Goodacre 10.1 Introduction 153 10.2 What is assistive technology? 154 10.3 Reducing non-use of assistive technology 154 10.4 Matching person and technology 156 10.5 Applying the MPT to AT for people with rheumatic conditions 157 10.6 Assistive technology outcomes 160 10.7 Methods of obtaining AT 161 10.8 Commonly used AT and home adaptations for people with rheumatic conditions 163 10.9 Inclusive design 163 10.10 Conclusion 166 11 Vocational rehabilitation 171 Lucy Reeve and Janet Harkess 11.1 Introduction 171 11.2 The importance of employment 172 11.3 The current context of vocational rehabilitation 172 11.4 Predictors of work disability and work instability 173 11.5 Vocational rehabilitation 174 11.6 Occupational therapy and vocational rehabilitation 175 11.7 Work evaluation and monitoring 177 11.8 Condition-specific interventions 178 11.9 Work-specific interventions 178 11.10 Advice on redeployment or retraining 180 11.11 Counselling and advocacy 180 11.12 Post-work support 181 11.13 Summary 182 12 Rheumatology splinting 189 Sarah Bradley and Jo Adams 12.1 Introduction 189 12.2 Splinting rationale 189 12.3 Clinical decision making 193 12.4 Approaches to evaluation 199 12.5 Splint construction 201 12.6 Summary 203 13 Maintaining a sense of self 207 Penny Sloane and Lynne Goodacre 13.1 Introduction 207 13.2 Impact of rheumatic conditions on body experience 209 13.3 An introduction to strategies to increase confidence in personal presentation and clothing style 212 13.4 The impact of rheumatic conditions on personal and sexual relationships 215 13.5 Conclusions 217 Index 221