Theoretical Models | Otinbariatrics

Ecology of Human Performance (EHP) Model

The Ecology of Human Performance (EHP) model was selected to align with our goal of integrating occupational therapy services into current interdisciplinary teams.

The EHP model was developed by Winnie Dunn, Ph.D., OTR, FAOTA for interprofessional collaboration and focuses on the person, task, context, and performance (Dunn, 2017). The EHP model embraces both personal and contextual strengths as resources for addressing patients' wants and needs, rather than their diagnosis or condition determining the intervention process. EHP allows practitioners to identify patient needs and design strategies to support functional performance in daily life (Dunn, Gilbert, & Kathy, 1997).

Main Concepts

Person: An individual with a unique configuration of abilities, experiences, and sensorimotor, cognitive, and psychosocial skills (Dunn, 2017).

Examples for people with bariatric needs would be physical abilities, level of cognitive functioning, prior bariatric surgeries, childhood experiences, etc.

Task: An objective set of behaviors necessary to accomplish a goal (Dunn, Gilbert, Parker, 1997).

Examples for people with bariatric needs would be the intervention process, meal planning prior to and after surgery, and follow-through with treatment after surgery.

Context: A set of interrelated conditions that surrounds a person (Dunn, 2017).

This would include someone's physical, social, and cultural environment as well one's temporal contexts (age, development stage, life cycle, and health status).

Performance: Both the process and the result of the person interacting with context to engage in tasks (Dunn, 2017).

Examples for people with bariatric needs would be weight loss, an increase in quality of life, and health management.

How EHP Benefits Bariatric Surgery Care

For individuals with bariatric needs, their physical, social, and cultural contexts impact their quality of life greatly; therefore, the intervention approaches utilized within this model allows for multiple methods of change to occur within daily life regarding these contexts.

Bariatric patients are currently cared for through an interdisciplinary team; therefore, the use of this model is an optimal fit, as it was designed for application to interdisciplinary teams.

Each bariatric patient has unique abilities, experiences, and skills; therefore, this model can address these strengths and challenges accordingly through EHP.

Bariatric treatment is centered around patient goals, which is accomplished through tasks to meet objectives in order to enhance performance; these concepts are fluid with EHP.

Malcom Knowles' Andragogy Learning Theory

Andragogy learning theory is a theory for adult learning that focuses less on content and more on processes using strategies such as self-evaluation, case studies, and simulated role-playing (Knowles, 1980).

Primary Assumptions

Adults must know the “why” behind their learning
Adults learn experientially
Adults learn through problem-solving
Adults learn best when the subject matter is of immediate value

(Knowles, 1980).

How Andragogy is Applied Here

The “why” for inclusion of occupational therapy to bariatric teams is clearly defined utilizing recent evidence. Resources for further self-driven learning are also available. The content regards a topic of immediate value to practitioners and students, with advocating resources available that can be utilized immediately. Learners can problem-solve utilizing the template format on the advocative resources provided and edit them as seen fit for the individuals’ unique needs (Knowles, 1980).

The Andragogy learning theory was selected to be a guide to the development of this product due to the intended audience being current bariatric care teams, occupational therapy practitioners, and occupational therapy students. These age groups may vary; however, adult learning principles are most appropriate.

E-HOW Model

This theory was considered for this project but was chosen to not be the primary theoretical foundation due to the occupational therapy lens that it utilizes, rather than interprofessional inclusive langauge.

References

Dunn, W. (2017). The ecological model of occupation. In J. Hinojosa, P. Kramer, & C. Brasic Royeen (Eds.), Perspectives on human occupation (pp. 207-235). Philadelphia: FA Davis

Dunn, W., Brown, C., & McGuigan, A. (1994). The ecology of human performance: A framework for considering the effect of context. American Journal of Occupational Therapy, 48, 595-607.

Knowles, M. S. (1980). The modern practice of adult education: From pedagogy to andragogy. Englewood Cliffs, NJ: Cambridge Adult Education

Pizzi, M. A., & Richards, L. G. (2017). Promoting health, well-being, and quality of life in occupational therapy: A commitment to a paradigm shift for the next 100 years. American Journal of Occupational Therapy, 71(4), 1–5. doi:10.5014/ajot.2017.028456

The E-HOW model focuses on promoting health, well-being, and quality of life through occupational therapy (Pizzi & Richards, 2017).

The E-HOW Model was considered for this project due to the supporting literature under the work of Dr. Pizzi for further development of health promotion and prevention for this population.