Volition via Culture Survey

Enhancing occupational engagement amongst community dwelling elders of diverse cultural backgrounds

Please complete the survey below, Thank you!

Your participation in this survey is completely voluntary. If you wish to exit this survey prior to completion, you may exit it at any time.

This survey is designed to gather information to help explore awareness, knowledge, and practice application of cultural competence, and the efficacy of culturally adapted interventions implemented by OT practitioner’s treating community-dwelling elders of diverse cultural backgrounds.

The survey should take approximately 10-15 minutes to complete.

Please answer each of the following questions to the best of your ability. If you are unsure of how to answer each question, please provide your best estimate. Your responses will be kept confidential.

This research was approved by the Institutional Review Board at the University of Salem State

3.What is your ethnicity? (Check all that apply.)(Required.)

Other (please specify)

7.Please list the setting in which you currently are employed as an occupational therapy practitioner.(Required.)

Prefer to Self Describe practice setting

8.Please list the age population in which you treat (Check all that apply)(Required.)

60-65

66-71

72-78

79 and above

10.How would you describe your patient population's ethnicity and race? (Check all that apply)(Required.)

Prefer to Self- Describe

11.My workplace supports using resources to produce cultural adaptations to occupation-based interventions.(Required.)

12.My workplace supports my participation in cultural celebrations of my clients.(Required.)

13.My workplace acknowledges spiritual and religious affiliations as culturally significant components of treatment planning.(Required.)

14.I am effective in my nonverbal communication with clients whose culture is different from my own.(Required.)

15.I am effective in utilizing my therapeutic use of self to support the cultural values of my clients/ patients.(Required.)

16.I have the skills to provide therapeutic occupational therapy services to elders of diverse cultural backgrounds and clients in my setting of practice.(Required.)

17.I have opportunities to learn culturally responsive behaviors from peers.(Required.)

18.I examine my own biases related to ethnicity and culture which may influence my behavior as an occupational therapy practitioner.(Required.)

19.I openly discuss how to enhance my patient's/ client’s performance patterns (habits, routines, roles, and rituals).(Required.)

20.I learn about different ethnic cultures through educational methods and/or life experiences.(Required.)

21.I am aware of the health disparities affecting elders of diverse cultural backgrounds which I treat.(Required.)

22.I acknowledge my patient’s/client’s cultural context throughout the treatment planning process.(Required.)

23.I am cognizant of my patient/ client’s (volition) motivation occupation participating in culturally significant tasks/ activities.(Required.)

24.Please specify the category of occupational tasks being addressed in your practice setting (Check all that apply):(Required.)

Prefer to Self Describe

26.Briefly describe how you incorporate cultural adaptations into the occupation-based activities selected in “Question 25”(Required.)

27.Culturally adapted tools/supplies that I have incorporated into occupational activities (Check all that apply) include:(Required.)

ADLS (es. sari or slacks) (chopsticks or fork)

IADLS (ex. tortilla press or rice cooker)

Work (ex. newspaper or virtual apps)

Education (ex. textbooks, newspapers, technology, cards )

Health Management ( ex. meditation, holistic practices)

Play/ Leisure (ex. leisure participation: Mahjong or dominoes)

Social Participation (ex. salsa dancing or prayer club, gospel music, playing cards,)

28.Briefly describe how you incorporate the supplies/tools into the occupational tasks selected in “Question 27”(Required.)

29.Assessment tools I use in my practice setting are considerate of the cultural differences amongst my patient/client.(Required.)

True

False

30.I utilize interpreter services to better understand my patient/client’s cultural customs and values in their preferred language.(Required.)

True

False