Role-based practice: A conceptual illustration of occupational therapy in HIV/AIDS care
2006
Ranka, J., McDonnell, E., Tan, C., Kerrison, J., & Sydney-Jones, A. (2006), 11-14 October. Role-based practice: A conceptual illustration of occupational therapy in HIV/AIDS Care. Poster presented at the 18th Annual Conference of the Australasian Society of HIV Medicine, Melbourne.
1School of Occupation & Leisure Sciences, University of Sydney, Australia
2Occupational Therapy, Royal Prince Alfred Hospital, Sydney, Australia
3Occupational Therapy, St. Vincent’s Hospital, Sydney, Australia
4Positive Central, Redfern Community Health Centre, Sydney, Australia
5Sacred Heart Palliative Care, Sydney, Australia
Advances in medicine have resulted in a shift in the allied health focus of care with people who have HIV/AIDS from a palliative model to a rehabilitation model. Occupational therapists working in the Sydney area addressed this shift by establishing a core focus group that aimed to re-conceptualize practice and articulate clearly what services occupational therapy provides and could provide to best meet the performance and participation needs of clients with HIV/AIDS at any level of health and living. A spiraling and reflective action research design was used to structure this process. The core services being provided were listed, contextual constraints identified and views about what services could be developed were discussed. A literature review was carried out and the theoretical and research evidence base for practice established. This was followed by a conceptual modeling process whereby views about occupational therapy in general and practice that is specific to HIV/AIDS were listed, synthesized, categorized and illustrated schematically. The result is a framework for practice is best described as ‘role-based practice'.
Role-based practice is a client-centred, occupation-focused perspective on practice where a client’s past, present and future roles and role performance needs form the pivotal point around which services are organized. Contextual variables that impact on role performance are also considered including physical, sociocultural and political-economic factors. Although specific to occupational therapy, the key assumptions and processes reflected in this model may be of interest and relevant to all allied health personnel.
The purpose of this paper is to present this model for practice and illustrate its use in the development of comprehensive and integrated occupational therapy services across the spectrum of HIV/AIDS care including acute management, primary rehabilitation and community-based programs, as well as in palliative care.