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The proliferative knowledge about Schizophrenia explains a mental illness that certainly affects more than 30000 individuals per year. It is the most common mental health disorder in Australia with a specification of life freaks that covers 7.3 3% per thousand population. The worldwide record for this disorder has been accustomed to the percentage approximately 1.02 per cent (Foruzandeh and Parvin, 2013). The specific understanding about chronic Schizophrenia intricates an enduring syndrome mainly reflects delusional behaviour, flatness, incoherent speech. Further, the symptoms can include mood swings, problems with cognition, and also defective movement. The background understanding about chronic Schizophrenia or simply Schizophrenia can be signified with periodic symptomized effects, or it can be continuous. Based on the acknowledgement of various symptoms, this mental disorder is also known as multiple personality disorder.
The guidance through Occupational therapy is mainly associated with the patients with chronic Schizophrenia and coherently explains about 2-3 fold risk in association to mortality is a marked recognition (Kumar, 2008). The workers or therapists involved with occupational therapeutic measures work with their clients while ensuring them with social participation and most coherent interaction. It also enhances the participants to explain their situation and extend their knowledge with proper health education.
Occupational Therapy and Accessibility
The inductive knowledge about Occupational therapy introduces and specifies the therapeutic measures, which are a "client-centred evaluation". The occupational-based self-assessment or OSA extensively measures the two specific constructs: the first manages to understand the occupational competence, and the second the occupational identity (Tatsumi et al., 2011). In the reflective medical practice, the typical understanding of occupational therapy explains the recovery process that has deliberately materialized discussable elements from one approach to another. The main focus perseveres with clinical therapies, social work, which is also recognized as a personal contribution, and finally the functional recovery. However, more significance to the measure is still a discoverable matter, and the setting related to the recovery framework is still an unclear aspect.
The contribution of knowledge about the intervention being promoted by the practitioners of occupational therapy denotes their educational ground skills and the perseverance of knowledge that significantly promotes the specific care for the adult individual typically diagnosed with serious mental health disorders (Hubacher et al., 2013). The evidence-induced intervention demonstrates the role of the practitioners involved with occupational therapy in their ability to properly engagement two meaningful occupations, participate in community living and advertently contribute to society. The systematic review is based on the findings of the intervention for adults with serious mental health disorders that were once published in the "American Journal of Occupational Therapy" in the year 2018. Further understanding of this intervention has also contributed to the "Occupational Therapy Practice Guidelines" systematically reviewed for adults who have been diagnosed with serious mental health illness.
The Occupational Therapists mainly works with a setting relevant for the mental health recognition of the participants and typically focuses on the individual being engaged in various occupations to ensure proper skill development, inducing positive habits with routine activities, setting the therapeutic goals, and using the "cognitive-behavioural technique (CBT)". The therapists generally set up goals with proper health settings that are optimized for both young and adult individuals. The health care setting for the child and the adolescent individuals mainly contributes with physiological influences and engages the patients into certain events with active participation. Although the work review of the occupational therapists has been observed, the real association to accessibility and transportability of the services shows limited indulgence. Mobility in the community is a critical approach that connects the potential occupation of individuals along with their capacity to active participation in community programs. However, certain limitations have paused the significant accessibility of individuals to such events and also affect the "healthcare and social services” (tandfonline.com, 2021).
The effective contribution of search strategy has been contemplated while using specific search terms and other credentials. The search strategy has been identified and being applied with the application of an electronic database system which typically includes the Academic Sources: Google Scholar, Pubmed, Cinahl, and other medical journal databases. The identification and use of the journals have been configured based on the search terms, limitation of the date, and the number specification for the articles that are fully accessed. For a more comprehensive search, the application of Boolean Operator, AND, has been used to combine the search.
The limiting factors are used for easy identification and acknowledgement of the article that holds accurate information regarding the topic of interest. The medium of the articles that will be used is based on the English language and actual specification of the terms. Further, the date has been limited to 2-3 years to get clear and accurate results. The reviewing of the data mainly adhered to occupational therapy, the intervention of the therapist, the concept of chronic Schizophrenia, and other related medical terms. Although the main focus has been given on most recent articles, few journals are 5-7 years older due to limited data based on the subject. Finally, a critical appraisal section has been configured to mention the articles that have been initially collected, articles reviewed, and finally used for this research. The search terms are also incorporated within the appraisal.
Occupational Therapy and Schizophrenia
Competence and Identity of Occupational Therapy
Combining 1-2 with “AND”
Limitation: Full text, abstract available with additional information; Published date: 2019-2021
Total article: 55
Mainly acknowledges occupational therapy and its impact on neuronal recognition, functional response with Schizophrenia.
Articles reviewed: 6
Only inclusion persisted with the cause of mental illness and the symptoms with Schizophrenia, competencies with occupational therapy and excluded those with the only functional response.
The article included and relevant: 2
Includes the cohort and randomized qualitative study about the patients with Chronic Schizophrenia and their treatment with the significance of Occupational Therapy
The study conducted by (Lannigan and Noyes, 2019) has identified the intervention related to occupational therapy, especially for the adults diagnosed or treated with a mental health disorder. The real explanation has been perceived with the active participation of Rosa, a participant of "Assertive Community Treatment or ACT", who has been diagnosed with chronic Schizophrenia and treated with medication and other interventions (Shargh et al., 2016). The little reference about Rosa explains that she is a 42-year-old female with mental health issues, especially the effect of Schizophrenia since the age of 23. She has been diagnosed with the disorder, and during the initial period, she has undergone three subsequent admissions in a general hospital and kept in the record of the in-patient unit for specific observation regarding acute episodes. The main interventions at the time included certain medications for stabilization purposes and the discharged referral for participation in mental health service.
The study has contoured with a proper understanding of the information brief about the participant, the primary intervention being promoted with confirmation about Schizophrenia, and finally, the mental health services being rendered to Rosa on her active participation to ACT. The study specified Rosa's acknowledgement of occupational therapy and insisted on addressing her wellness as well as the employment goal (Shimada et al., 2018). While considering the self-awareness and retention of goals by Rosa towards this therapy, the progressive intervention of the therapist is also conveyed. The paper has configured the active association of Doug; the therapeutic practitioner of Rosa for her Occupational therapy has assessed her condition and intervened with active involvement in association to his assistant for proper implementation of the practice.
The proper evaluation of the therapy and the significant setting of the goal has been administered by Doug through “Canadian Occupational Performance Measure” “(COPM, 2014) while determining the strength and occupational challenges being measured for Rosa. It has been encouraged to accomplish a complete occupational profile for Rosa. According to the profile, it has been comprehended that the main role of Rosa involves guiding her sister and her active participation in the ACT program. The evidence-based approach of the study has recognized the sensory goal of the program that mainly focused on occupation and also induced client-centred therapeutic interventions (Tan et al., 2020). With this approach, Rosa has finally attempted her goal after a continuous intervening period of four months. The planning and care given to the individual through Occupational Therapy have helped her to perform significant employment responsibilities without taking proactive coaching from Doug's assistant.
The report given by Rosa explains her active communication within the workplace, which mainly includes her comfort and provoking the capacities in self-indulgence as a supervisor. She has also shared the information about her improvement with effective regulation and routine maintenance before going to the office. Further, her attire, appearance, and responsible handling of the situations in the workplace have suggestively influenced her progressive employment success. Further, the accessibility to public transportation on time has also enabled Rosa to actively overdone her accomplishment. The easy and swift handling of work improved daily living with normal activities, social participation, and coherent behaviour with her worker has improved her confidence level along with work amplification (asclepiusopen.com, 2021).
A significant assessment after reevaluation of Rosa's condition at the terminal period of four-month has been done by Dough and his assistant. The acknowledgement about her daily life situation, social interaction, and employment success shows great improvement with iterative development of skills and confidence (Eklund et al.,2017). While assessing her current situation and the improvement the therapy has proactively induced, it is a highly considerable area that occupational therapy has a long-term and better effect on patients with Schizophrenia. Although her condition is stable, Rosa has irrevocably insisted on attending the therapeutic sessions for proper addressing of her communication level and employment concerns. The significant observation of all these outcomes has promoted an opportunity for the ACT team to research proactively regarding the opportunities to improve the social interaction system for Rosa and other individualism with effective recreation in the local community as well as in the adult education centre.
The suggestive evaluation of the study that has been presented with critical appraisal has highlighted a representation of the influence of occupational therapy and its intervention on patients with mental health disorders. The main evaluation of the record has been evaded with the strategic implementation of the intervention plan for a particular patient through the Assertive Community Treatment (ACT) program (Shimada et al., 2019). The significance of the study has promoted a sensible understanding of the active measures being associated with this therapy with the achievement of daily life activities. However, the study reflects the condemnation of a particular individual and the intervention plan promoted through this occupational therapy. It has failed to implement an effective plan for a group or simply the therapeutic measures for a group of individuals at the same time. The critical understanding of the environmental barrier such as transportation barrier or other accessibility during this therapeutic session or indulgence of social work in different areas has been promoted with limited information. Thus, this research proposal not only indulges in bringing light on the factor assessing the current intervention of occupational therapy to treat chronic Schizophrenia but to reflect the barrier associated with the implementation and the reintegration system of the community to restrict the barrier (aota.org, 2021).
This research aims to focus on the intervention plan of occupational therapy to evaluate the progress in treating schizophrenia patients.
The research has been underpinned with the following objectives:
The proper acknowledgement of the therapy has been obtuse with the associated research question:
What can be the role of the therapists in promoting Occupational Therapy for effective management of Chronic Schizophrenia?
The research design for the proposal has been followed with a qualitative approach where the participants of a focused group have been introduced in the paper. The introduction of a qualitative study in research shows the inadequacy of knowledge about the topic of interest, which thereby resulted in further research of previous studies and the necessary gathering of information (Morris et al., 2018). The main configuration of this paper has promoted the understanding of the significant role of occupational therapy with proliferating action regarding the management of individuals with mental health disorders like Schizophrenia. The research design has been focused in a manner that necessarily promotes necessary focus on a group or rather on a particular individual to bring out the assessment outcome with the therapeutic intervention.
The qualitative study brings out one's thoughts and views regarding the subject and rationally optimizes the conceptual understanding of the topic and the related information. It essentially generates the ideas and inner perception that help an individual to critically emphasize the discussable elements and widespread the difference among the groups.
The significance of data collection promotes a clear understanding of the process, the dynamic of the flow of knowledge, and an effective understanding of the outcome regarding the subject matter (Huang et al., 2018). The major emphasis of the research proposal has been reflected on the cohort studies and randomized processes that have been reviewed about the schizophrenia patients that have been managed through occupational therapy. Different articles have been reviewed where the major emphasis has been given on the therapeutic intervention and implementation plan by the therapists and the community team to induce an outcome at the end of the period. In the above section, one particular article has been reviewed and coherently discussed, which typically signifies the care implementation plan, the prior diagnosis process, the deliberate process that needs to be intervened, and the success factors. The collection of data from this particular study has shown the main significance of the qualitative study and thus promotes a descriptive knowledge about the assessment program that has been followed therein (tandfonline.com, 2021).
The specific sampling method and proper recruitment of the data through which the study can be conducted have been discussed. The data sample has been collected after reviewing the articles and following a significant search strategy to promote those articles that have adequate information regarding the context. The data samples show the management process through specific therapeutic sessions where the focused group of participants has been assessed after observing their state and situation (Wang et al., 2018). The primary observation has reflected the treatment option of the patient before the therapeutic option. While doing so, the patient sample has been collected from the local hospital, and the mental health record of the patient has been reviewed. This particular emphasis has been given to a single article over which the study has perceptually focused on. The suggestive contribution deliberately incorporated the information about occupational therapy, the intervention it assisted for patient's care and mental health improvement and also induced the outcome at the end of four-month.
The proper sampling of data helps in identifying a particular aspect over which the main focus has been given and also ensures the relevance adhered to the related subject. The data will be suggestively recorded with the basic observation of the natural setting, particularly the home environment of the patient (Samuel et al., 2018). This will certainly promote an explanation about how the patient is feeling after receiving the care and intervening measures. This will be carried out after reviewing the studies where the patients have given their opinions and the best-fitted measures that essentially create a vast understanding of Occupational Therapy. Thus, only the appropriate data with adequate information has been collected and sampled, which equally acknowledges the patient's perspective as well.
The main review of the data will be presented through descriptive analysis with thematic representation. The primary understanding of the information has been opinionated with a criteria-based evaluation which will mark a relative knowledge and accomplishment about the significance of occupational therapy and distinctly induces a difference between this particular therapy and the rehabilitation process to manage Schizophrenia patients (Machingura and Lloyd, 2017). The proper assessment will reflect the role of mental health practitioners, therapists, and community health workers in delivering the occupational therapy intervention to the patients. Further, the analysis will also acknowledge the perception of the patients after receiving the intervention and the deliberate outcome at the end of the period. This will predominantly incur a knowledge progression about the therapy and also reflects the inferences that have perceived a relatable understanding.
The relevance of a focused group will share thoughts and views that will generate a conversation with a deliberate understanding of the overall process. The analysis will follow an inductive approach where the priority will be given to the instances that primarily inflict the knowledge about consensus, the divergence, or any kind of disagreement. The analysis has shown the purposive nature of the study, which only utilizes small samples to get an accurate result. Further, the output received from the data analysis will give a higher level identification of the theme with a generalized focus on the recreational activities being condemned for the patients through occupational therapy. Thus, the final representation will give the auditor a thorough analytical process and also a proper assessment value with higher credibility (aota.org, 2021).
Ethical consideration can be explained as the key obligations to promote research. This may reflect various ethical norms, code of conduct, and proper research orientation to protect the subject's identification, rights, and also the welfare of the subject. The typical consideration of a subject can vary based on the research outflow. Since the proposal has followed a qualitative discussion, it is necessary to administer the ethical orientation best suitable for this study. While doing so, the ethical approval has been considered from the preferred hospitals with proper follow up of their ethics bestowed by the committee, "Institutional Ethical Committee (IEC), 2018". Further, the articles that will be used for this research will consider the information without disclosing the confidential details and maintaining privacy as per ethical guidance. The participants will be interviewed and will be subjected to in brief the outcome of their therapies with proper convenience.
Conflict of Interest
The conflict of interest being promoted for this research will show the researcher's interest and certain concerns about the topic of interest. The main gain or preference, which is obtrusive, mainly reflects the knowledge and perception of the student regarding the significant role of Occupational Therapy and the way of managing Chronic Schizophrenia. Thus, it will be achieved through direct engagement with the participants and their effective response during the interview and acknowledging the reviews of the academic sources used.
Eklund, M., Tjörnstrand, C., Sandlund, M. and Argentzell, E., 2017. Effectiveness of Balancing Everyday Life (BEL) versus standard occupational therapy for activity engagement and functioning among people with mental illness–a cluster RCT study. BMC psychiatry, 17(1), pp.1-12.
Foruzandeh, N. and Parvin, N., 2013. Occupational therapy for in-patients with chronic schizophrenia: a pilot randomized controlled trial. Japan Journal of Nursing Science, 10(1), pp.136-141.
Huang, W.Y., Chen, S.P., Pakpour, A.H. and Lin, C.Y., 2018. The mediation role of self-esteem for self-stigma on quality of life for people with Schizophrenia: A retrospectively longitudinal study. Journal of Pacific Rim Psychology, 12.
Hubacher, M., Weiland, M., Calabrese, P., Stoppe, G., Stöcklin, M., Fischer-Barnicol, D., Opwis, K. and Penner, I.K., 2013. Working memory training in patients with chronic schizophrenia: a pilot study. Psychiatry journal, 2013.
Kumar, P.S., 2008. Impact of vocational rehabilitation on social functioning, cognitive functioning, and psychopathology in patients with chronic Schizophrenia. Indian journal of psychiatry, 50(4), p.257.
Lannigan, E.G. and Noyes, S., 2019. Occupational Therapy Interventions for Adults Living With Serious Mental Illness. American Journal of Occupational Therapy, 73(5), pp.7305395010p1-7305395010p5.
Machingura, T. and Lloyd, C., 2017. Mental health occupational therapy and supported employment. Irish Journal of Occupational Therapy.
Morris, K., Reid, G. and Spencer, S., 2018. Occupational therapy delivered by specialists versus non?specialists for people with Schizophrenia. Cochrane Database of Systematic Reviews, (10).
Samuel, R., Thomas, E. and Jacob, K.S., 2018. Instrumental activities of daily living dysfunction among people with Schizophrenia. Indian journal of psychological medicine, 40(2), pp.134-138.
Shargh, N.A., Rostami, B., Kosari, B., Toosi, Z. and Majelan, G.A., 2016. Study of relationship between depression and quality of life in patients with chronic Schizophrenia. Global journal of health science, 8(3), p.224.
Shimada, T., Ohori, M., Inagaki, Y., Shimooka, Y., Ishihara, I., Sugimura, N., Tanaka, S. and Kobayashi, M., 2019. Effect of adding individualized occupational therapy to standard care on rehospitalization of patients with Schizophrenia: A 2?year prospective cohort study. Psychiatry and clinical neurosciences, 73(8), pp.476-485.
Shimada, T., Ohori, M., Inagaki, Y., Shimooka, Y., Sugimura, N., Ishihara, I., Yoshida, T. and Kobayashi, M., 2018. A multicenter, randomized controlled trial of individualized occupational therapy for patients with Schizophrenia in Japan. PloS one, 13(4), p.e0193869.
Tan, B.L., Lim, M.W.Z., Xie, H., Li, Z. and Lee, J., 2020. Defining occupational competence and occupational identity in the context of recovery in Schizophrenia. American Journal of Occupational Therapy, 74(4), pp.7404205120p1-7404205120p11.
Tatsumi, E., Yotsumoto, K., Nakamae, T. and Hashimoto, T., 2011. Effects of occupational therapy on hospitalized chronic schizophrenia patients with severe negative symptoms. Kobe J Med Sci, 57(4), pp.E145-54.
Wang, S.M., Kuo, L.C., Ouyang, W.C., Hsu, H.M. and Ma, H.I., 2018. Effects of object size and distance on reaching kinematics in patients with Schizophrenia. Hong Kong Journal of Occupational Therapy, 31(1), pp.22-29.
aota.org , 2021, Integrated Supported Employment for People With Schizophrenia in Mainland China: A Randomized Controlled Trial, Available at: https://ajot.aota.org/article.aspx?articleid=2657259 [Accessed on: 20-5-21]
asclepiusopen.com , 2021, Occupational Therapy and Social Skills Training for Enhancing Constructive Engagement of Patients with Schizophrenia: A Review, Available at: https://asclepiusopen.com/clinical-research-in-psychology/volume-1-issue-1/8.php [Accessed on: 20-5-21]
tandfonline.com , 2021, impact of using the Model of Human Occupation: A survey of occupational therapy mental health practitioners' perceptions, Available at: https://www.tandfonline.com/doi/abs/10.3109/11038128.2011.645553 [Accessed on: 20-5-21]
tandfonline.com, 2021, The Phenomenology of Early Psychosis Elicited in an Occupational Therapy Expressive Evaluation, Available at: https://www.tandfonline.com/doi/abs/10.1080/0164212X.2017.1338982 [Accessed on: 20-5-21]
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