Occupational Justice in Congregate Environments

BACKGROUND The environment impacts on occupational deprivation (Durocher et al, 2013). However, the specific effects on the environment on occupation are poorly understood. The occupational therapy profession needs to change... [ view full abstract ]

BACKGROUND
The environment impacts on occupational deprivation (Durocher et al, 2013). However, the specific effects on the environment on occupation are poorly understood. The occupational therapy profession needs to change its focus from individual disability to well-being and human rights (Hammell, 2008) which effects change on a broader environmental level (Whiteford, 2000).
To create occupational justice in congregate environments, modifications need to be based on good quality evidence (Robertson and Fitzgerald, 2010). The Assessment Tool for Occupation and Social Engagement (ATOSE) was developed to provide comparative quantitative data for whole environments (Morgan-Brown, 2013).
METHOD
The communal spaces of two traditional nursing homes (TMUs) were compared before and after renovation to household model units (HMUs) using the ATOSE snapshot observation method.
RESULTS
The post-renovation HMUs were superior to both pre-renovation TMUs in the outcome measures, interactive occupation and social engagement, for both residents and staff (p≤0.001, interrater reliability > 90%). Narrative observations identified physical, social and organisational characteristics which account for this difference.
CONCLUSION
The ATOSE method discriminates between different types of communal spaces using interactive occupation and social engagement as outcome measures. The occupational deprivation of the residents in the TMUs was significantly rectified by creating HMU environments.
APPLICATION TO PRACTICE
Occupational therapists can use observational methods to obtain quantitative and narrative evidence (Wood, 2005), enabling them to understand, promote and endorse occupationally rich environments (occupational justice). The ATOSE can effectively evaluate whole communal spaces. The ATOSE observational method provides an evidence base to underpin environmental transformations.