Digitalisation in today’s society is constantly evolving. Research shows the positive effects of apps for people with cognitive impairments by enabling meaningful activities as well as increasing independence. The purpose of this study was to describe the occupational therapist's professional reasoning regarding the recommendation and use of apps to enable activity for people with a cognitive impairment. The study adopted a qualitative approach to capture the participants' reasoning whilst working with apps. The selection was carried out with purposeful selection based on the criteria set. A total of ten participants participated. Data was collected via semi-structured interviews with open-ended questions and then analysed with a qualitative content analysis. The analysis resulted in three categories; Identify the client's needs and prerequisites to promote activity, Match and customize the app for a sustainable use and The Occupational Therapist's prerequisites for using apps as an intervention. The results shows that the occupational therapist works closely with the client and its social network to match the appropriate app based on needs and conditions in activity. Furthermore, the occupational therapists see great benefits of using apps, primarily for the supportive features that can increase independence as well as the freedom of movement the app can contribute to. However, problem areas are in the form of uncertainty in app updates and difficulties in having sufficient knowledge of the available apps. The conclusion is that Occupational therapists in this study use a wide breadth in their reasoning. Where several aspects of the client's needs and prerequisites as well as the occupational therapist's own prerequisites are weighed together to use apps as intervention. This showed great complexity, as apps are a new and large area for the occupational therapists and therefore further studies are needed for more knowledge within the subject.

Acts of violence towards staff committed by people with intellectual disabilities in residential care settings are common. In the Swedish legal system, the requirement for criminal intent is the same for everyone over 15 years. This creates a gap between the law and the perceived ability to take criminal responsibility in this group since the consequences of the intellectual disability can be functioning on a lower level than your chronological age. This study aims to explore the factors in reasoning about controllability, responsibility and police reporting in violent situations, with a focus on staff members working in residential care settings for people with intellectual disabilities. The method for this was 7 semi-structured interviews with staff members working in care settings where violence and threats were occurring. The thematic analysis of the interviews revealed that experience of violence was common and that communication problems are perceived as a common cause. Responsibility in violent situations was perceived as something that needs to be shared between the person displaying it and the staff involved. The reasoning around police reporting of violence shows that staff takes both the person’s ability to take responsibility and level of understanding into account and in most cases this reasoning led to the decision not to file a police report. Another factor considered in staff reasoning is the legal process and the consequences of entering it for a person with intellectual disability. This implies that staff is trying to take responsibility in practice for the gap between the law and their perception of responsibility in the person they support. The study concludes that there is a need for addressing this on a governmental level as well as on a practical level in care settings, to improve the work environment and strengthen the legal certainty for people with intellectual disabilities.

In today’s health care environment of quick discharges and shortened hospital stays discharge planning has become increasingly important in acute care occupational therapy practice. Discharge planning is a complex process and an important aspect of patient care as poor discharge planning has been associated with poor patient outcomes and increased risk of adverse events and readmission. This study addressed the following research questions: (a) How do acute care occupational therapists describe their role in the discharge planning process? (b) What guides acute care occupational therapists discharge decisions and recommendations? (c) How do acute care occupational therapists define optimal discharge planning? and (d) What actions can acute care occupational therapists take to optimize the effectiveness of their discharge planning skills within the current health care system? Using an action research methodology, two groups of five occupational therapists met online to discuss acute care occupational therapy discharge planning practices, and actions that could be taken to strengthen their practice. Action plans generated, implemented, and evaluated focused on improving communication with discharge planners, language used in documentation, and incorporating the use of standardized assessments to assist with discharge planning. Schell’s ecological model of professional reasoning as the theoretical model underlying this study was used to examine factors that influence occupational therapy discharge decision making. Data were collected from audio chat transcripts, survey responses, and researcher notes, and analyzed using Stringer’s action research sequential data analysis and interpretation methodology. Five themes emerged including (a) the role of occupational therapy, (b) the complexity of discharge planning, (c) pragmatics of practice, (d) why don’t they pay attention, and (e) the importance of stakeholder communication. Participants felt that discharge planners were not reading occupational therapy documentation, occupational therapy consults were late so that occupational therapy discharge recommendations were just a formality, and physical therapy discharge recommendations had more weight than occupational therapy recommendations. Participants felt that if patients were discharged without benefit of occupational therapy recommendations they could be at increased risk for an adverse event and compromised safety. Good communication among stakeholders was seen as essential for optimal discharge planning.

Dans la foulée du mouvement de professionnalisation, l’éthique professionnelle enseignante est portée par une compétence professionnelle, plus précisément par la compétence éthique, laquelle est présentée dans le référentiel de compétences professionnelles (MEQ, 2001a). Bien que la compétence éthique comporte un caractère ambigu, telle qu’elle se décline dans le référentiel ministériel, elle est marquée d’une obligation de réussite, notamment pour les stagiaires finissants. Devant l’ambiguïté entourant le sens de la compétence éthique, nous avons mené une recension des écrits sur cette compétence afin de mettre en relief ce que signifie être compétent sur le plan éthique. Nous avons ainsi constaté que la compétence éthique entretient un lien étroit avec la réflexion. Dès lors, à l’aide d’une recension sur le concept de raisonnement, nous avons posé l’hypothèse que le raisonnement professionnel, constitué du discours et de points de repère, puisse soutenir le développement de la compétence éthique. Par conséquent, trois intentions se sont précisées : mettre en évidence les repères personnels (valeurs personnelles) et institutionnels (encadrement légal et réglementaire, normes et savoirs théoriques) que comporte le raisonnement professionnel des stagiaires en matière d’agir éthique et rendre compte de la contribution de la formation pratique ainsi que de la formation initiale au regard de ces repères. Pour ce faire, nous avons effectué deux phases de collecte de données lors desquelles ont été favorisés deux outils afin de recueillir des données de nature qualitative. Lors de la première phase, nous avons mené des entrevues semi-dirigées auprès des stagiaires, de leur enseignant associé et de leur superviseur de stage respectifs. En ce qui a trait à la deuxième phase de collecte de données, nous avons assuré la tenue d’un groupe de discussion constitué de stagiaires finissants. Nos résultats suggèrent que les repères dont disposent les stagiaires afin de soutenir leur raisonnement en matière d’agir éthique sont liés à leurs valeurs personnelles et à certaines valeurs professionnelles bien que les mots pour évoquer ces dernières ne soient pas explicites. Toutefois, les repères institutionnels que constituent l’encadrement légal et réglementaire, les normes et les savoirs théoriques sont peu présents dans leur discours. Par ailleurs, la contribution des enseignants associés et des superviseurs de stage au regard des repères se révèle modeste alors qu’elle passe principalement par la rétroaction. Les résultats à propos de la contribution des activités d’enseignement en formation initiale suggèrent que l’agir éthique est traité notamment à titre de mises en garde. Nos résultats mettent ainsi en évidence que les repères qui constituent le raisonnement professionnel des stagiaires peuvent agir à titre de levier de la compétence éthique à la condition qu’en amont les futurs enseignants aient été entraînés dans ce sens. / To follow in the footsteps of the movement of professionalisation, the professional ethical teacher is characterized by a professional competence, more precisely by the ethical competence, which is presented in the reference system of professional competence (MEQ, 2001a). Even if the ethical competence comprises an ambiguous character, as it is stated in the ministerial reference, it is marked by a successful obligation, more particularly by the graduating student teachers. In view of the ambiguity surrounding the meaning of the ethical competence, we have conducted a census of records on this competence in order to verify what it means to be competent on the ethical plan. We have therefore established that the ethical competence has a close link with reflection. From now on, by means of a review on the concept of reasoning, we have put forth the hypothesis that the professional reasoning established by the discourse and by the indicators can support the development of the ethical competence. Therefore, three intentions were specified : to showcase the personal reference points (personal values) and institutional (to target legal and regulatory , norms and theoretical knowledge) which includes the professional reasoning of student teachers the matter of ethical behavior and that would result in the contribution of pratical training in relation to the transmission of these indicators as well as the initial training to the transmission of these indicators. To achieve this, we have carried out two phases of data in which two quality tools were favored in order to collect data of qualitative nature. During the first phase, we conducted partly directed interviews with the student teachers, their cooperating teachers and their supervisor of their respective practice teaching session. Our findings suggest that student teachers make use of their references to support their reasoning in the matter of ethical behavior as well as their personal values and certain professional values since the words to evoke these are not explicit. However the institutionnel references which constitutes the legal and reglementary framework, the norms and theoretical knowledge are slightly present in their discourse. However the feedback of the cooperating teachers and stage supervisors concerning these indicators is confirmed modestly even though it passes principally by feedback. The results concerning the contribution of teaching activities in the initial training suggests that ethical behavior is particularly as a caution. Our results show that professional reasoning, with the aid of discourse and reference points can act as a lever of ethical competence on condition that progressively, the future teachers have been formed in this manner.