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Person – Environment – Occupation Model (PEO)

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Introduction
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Founded by Law, et al. in 1995 Revised by C. Christiansen & C. Baum (1997) Part of an environmental research program in the School of Science, McMaster University Developed in response to occupational therapy literature investigating the interaction between the person, environment, occupation towards the relation between the person and environment Emphasizes the interdependence between environments and persons Highlights the complexity of person-occupation-environment relationships
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transactional approach
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-towards the relation between the person and environment -Emphasizes the interdependence between environments and persons -Highlights the complexity of person-occupation-environment relationships -can’t take env’t away from person or vice versa -our occupations are embedded in env’t
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Belief that occupational performance is a result from interaction of 3 components
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Person Environment Occupation
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what is unique about the PEO
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Client identifies the most important occupational performance issue within the areas of work/productive activities, personal care, home maintenance, sleep, recreation, and leisure -this one defines more components -Suited for a variety of individual, group, and institutional needs across the life span (can be applied across diverse or specific client)
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Theoretical basis
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-General Systems Theory -Environmental Theory -Ecological Systems Theory -Developmental Theory
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General Systems Theory
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Holism or the idea that entities cannot be explained nor understood from their separate parts or properties but only when regarded as an entire unit -we can’t be understood w/o env’t. or occupation
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Environmental Theory
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– study of environmental factors and their effect on occupation as a means to hinder or facilitate participation
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Ecological Systems Theory
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– Interdependence of the social environmental systems of home, family, school, work, community, and country
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Developmental Theory
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– normal developmental tasks of each stage of development over the life span where Physical, psychological, social, moral and spiritual aspects of the self are considered together -Freud: Psychosexual stages Jung: -Spiritual development -Erikson: Psychosocial Development -Kohlberg & Wilcox: Moral reasoning -Piaget: Intellectual Development -Levinson: Life Transitions -Laslett: Third Age Theory
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theoretical influences
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-Strong influence from personality theorists and motivational learning (Maslow) Strong contributions from psychologists and social scientists -A person’s innate desire to explore their environment and demonstrate mastery within it (human agency) needs to be activated to enhance motivation -Experiencing a sense of accomplishment will create a reinforcing positive cycle for the client who will experience intrinsic (internal) satisfaction and extrinsic (external) rewards as well (when we can influence env’t we feel happy, positive
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ASSUMPTIONS
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-Persons have an innate drive to explore their environment and demonstrate mastery within it -Competence is reached when a person is able to perform skills that meet his own personal needs -A person is also able to use the resources (personal, social, material) within one’s environment (we have personal goals) -Persons derive a sense of self fulfillment from mastery and a sense of self identity from meaningful participation in occupations -Adaptation is defined as a process whereby persons confront the challenges of daily living and are able to use their resources to master these demands
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Occupational Performance is influenced by..
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-Person -Unique environment in which one functions -Occupations that consist of one’s actions and tasks and ultimately create one’s life roles
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what does occu. performance describe and what are 2 components it can be separated into?
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-Occupational performance describes the actions that are meaningful to the individual as he self manages, cares for others, works, plays and participates fully in home and community life -It can be separated into two components: 1. Occupations 2. Performance (of that occupation)
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Major constructs
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PERSON OCCUPATION ENVIRONMENT
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Person
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-A unique being who assumes multiple roles, experiences -Cannot be separated from contextual influences(if you take us out of it, roles/activites change) -Roles and vary in degree of importance depending on the environment and developmental stage of the person
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What is the essential focus for a person
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Focus is on the analysis of a person’s behavior: -Motivation – interests, cultural relevance of activity -Conditions that precipitate emotional responses failure, stress, distraction (what makes them happy) -Degree of autonomy (do they feel valued by society? do they feel like they can participate without challenges?) -Continual development and intrinsic motivation(certain things motivate us at each stage)
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Environment
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-The context within which occupational performance takes place -Categorized into cultural, socioeconomic, institutional, physical, and social -All categories are equally important -can’t perform w/o some envt.’l influence
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what unique perspective is the env’t considered?
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Person Household Neighborhood and/or community -Demands and cues about expected and appropriate behavior are received from the environment – continuous!!!!
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Occupation
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-Self-directed meaningful tasks and activities engaged in throughout a lifespan -Done to satisfy an intrinsic need – self maintenance, expression, and life satisfaction -Are carried out within many contexts to fulfill developmentally appropriate roles -Need to consider temporal aspects of routines
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what areas do occupation consist of?
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Self-care, Productivity, Leisure
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Focus of occupation should be on?
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-Characteristics of tasks (occupations) -Degree of structure (need shoes to drive) -Duration of activity (how much time involved in activity) -Complexity of tasks(what does it demand?) -Characteristics of task demands
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function – dysfunction continuum
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1. Optimal function or occupational performance results from a good fit between the 3 components -Maximal Fit = optimal performance -Minimum Fit = poor performance 2. Dysfunction results from a miss-matched or minimum fit between the person, occupation, and/or environment -Poor performance -Too much is not a good thing either!!! 3. Outcomes are measured by occupational performance -Not only object observations, but subjective performance that is perceived by the person!!!
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diagram of PEO
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-all 3 circles are equal and overlapping -sudden change in any circle the occ. performance will be affected -have to address all -one dysfunction in one area can cause more dysfunction in others
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Assessments used
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MOHO assessments COPM (wants, needs, desires) Activity Card Sort Any type of assessment that looks at occupational performance…
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how do OTs enhance ability?
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-Appreciate the restorative benefits of occupational performance as a means to enhance the person’s ability to: a) Control movement, to modulate sensory input, to coordinate and integrate sensory information, to compensate for sensorimotor deficits, and to modify neural structures through behavior b) Maintain physical health and fitness c) Maintain cognitive skills d) Increase motivation, develop personal identity, enhance well-being and self efficacy e) Enhance personal meanings and collective or shared meanings
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what do OTs recognize, enhance, and adapt?
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Recognize the role of the environment as it impacts a person’s health condition and participation in meaningful activities, tasks, and life roles Enhance occupational performance by structuring occupations for meaningful participation and competent mastery Enhance role functioning by increasing and modeling skill development, managing multiple role participation, clarifying role expectations from an internal and external perspective Adapt and/or modify the actions, tasks, and ultimately one’s occupations to match the abilities of the client (intrinsic factors)
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what do OTs teach
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Teach compensatory techniques when appropriate. Foster temporal adaptation (process of adjusting to changing temporal requirements in daily life or throughout the lifespan