Disease Description Sign & symptoms Abdominal aortic aneurysm (AAA) a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and tummy Some people with an AAA have: 主動脈的隆起或腫脹 It can get bigger over time and could burst (rupture), causing life-threatening bleeding High risk all men aged 66 or over and women aged 70 or over who a pulsing sensation in have one or more of the tummy (like a the following risk heartbeat) factors: tummy pain that does not go away -high blood pressure lower back pain that -chronic obstructive does not go away pulmonary disease -high blood If an AAA bursts, it cholesterol can cause: -a family history of AAA sudden, severe pain -cardiovascular in the tummy or lower disease, such as back heart disease or a dizziness history of stroke sweaty, pale and -they smoke or have clammy skin previously smoked a fast heartbeat shortness of breath fainting or passing out Treatment mobility? ultrasound scan of your tummy NOT small AA advised about healthy lifestyle changes to help stop it from growing large AAA (5.5cm or more) – surgery to stop it from getting bigger or bursting is usually recommended Books reading Chapter 14 Task, activity and occupational analysis The analysis process begins with understanding the sequential components of and inherent skills needed for specific activities and then builds towards meaningful person-specific activities, goal-directed occupations An activity becomes an occupation when its personal meaning is acknowledged and pursed, the goals are personally set, the required skills to perform are considered and the environmental context is acknowledged. 有意義，有目標，有技巧，有環境 Using the results of an occupational analysis, occupational therapists can grade or adapt the activity/ occupation to lead to optimal participation , engagement and autonomy for the people receiving occupational therapy Task - x environment, list of steps, analysis: An activity - doing or completion An occupation - goal-directed, meaningful, self-care, leisure, work, shaped by culture, evolve through the lifespan, reflective of personal goals, skills, roles, habits and values Activity analysis - examine skills and context > perform to enable participation and engagement Task analysis - ? skills and abilities Occupational analysis - in determining the meaningfulness of the activity for the individual, the practitioner considers the person’s age, occupational roles, cultural background, gender, interests and preferences Eight Characteristics of a purposeful and meaningful therapeutic activity 1. goal-directed and goal driven 2. unique to individual 3. reflect life experiences 4. requires the use of body structure and functions 5. requires active participation within occupational context of productivity/self-care/leisure 6. dependent on environmental context 7. is used therapeutically to evaluate, facilitate and restore or maintain functional abilities 8. gradable or adaptable to ensure participation from Hinojosa et al., 1993 occupation based = engaging a person in meaningful occupations that foster choice-making, satisfaction and restoration ~ means that practice must enable the performance of, or, needs to, or is expected to do 個人對該occupation嘅value同meaning activity analysis Tools/utensils/objects/materials used to participate in the activity Environment opportunities, demands and/or constraints (physical, social,cultural,institutional) - e.g the place is not wheelchair friendly Contextual opportunities and demands to enable meaning of activity for the client (space;objecs;tools;equipment, including virtual or electronic forms;sequence and temporal patterns; social interaction) Requisite performance skills and abilities needed for successful completion of the activity (motor, sensory, perceptual, cognitive, emotional, social/communicative) Position of the person in relation to the activity as well as the position of the activity in relation to environment 工具，環境機會，物理的/社會的/文化的/制度的需求/約束，skills/abilities occupaton嘅投入engagement係強力link to health maintaining system 同埋drive to 不僅meet生存需要同埋progression of dinity, self-identity and competence. The outcome is health and well being through choice, meaning, balance, satisfaction, opportunity and self-actualsation Explanination of doing, being and belonging doing = participating meaningful occupation, us synonymous with function and occupation Being = being true to oneself while engaging in meaningful occupations (spirituality) Becoming = process leading to self actualisation, augmenting one’s full potential,in constent development Belonging is a socially driven connection to others, connecting within a social network (can be 合作or 對立). Chapter 29 Coaching focuses on three main area: learning, improving performance and life fulfillment. Coaching is a way for OTs to communicate with people that shifts power and control to them and focuses directly on helping them to create and live a meaningful, fulfilledife through fostering personal awareness, choice making and self-trust. 培養個人意識、選擇能力和自信心 Enable occupational change: coaching mindset, relationship, and process deep, active questioning + intuitive, powerful questioning to enable people to generate their own solution Awareness entails people being cognisant of - themselves and others - their effect of others on themselves - ther Splintage Chapter 18 Splints: Mobilization, Corrective Splintage, and Pressure Therapy for the Acutely Injured Hand The phases of the wound-healing process are as follows: • The inflammatory phase is the immediate vascular and cellular response to wounding that clears the wound of devitalised tissue, debris, and foreign materials 失活的組織、碎片和異物. Edema dominates subsequent to vascular dilation血管擴張. The length of this phase depends on the severity of the structures damaged and the tissue-handling approaches that follow. It usually lasts for about 5 days if no complication exists. • The fibroblastic phase of repair 成纖維細胞維修期 lasts 2 to 6 weeks, starting 3–5 days after the wounds. This phase includes tissue granulation肉芽形成, collagen accumulation膠原蛋白積累, and epithelialisation上皮形成, that is, the wound begins to heal. Here, the tensile strength of the wound grows, an increase that may last for about 3 weeks before reaching a plateau and then linearly increasing for at least 3 months further. • The maturation phase begins as fibroblastic activity decreases and may last for years when the amount of collagen decreases and the wound becomes stronger (Smith 1995). To maximize treatment outcome, the choice of splintage should parallel the patient’s tissue healing process.
