Kawa-(Fluss)-Modell - Überwinden kultureller Begrenzungen der zeitgenössischen Theorie der Ergotherapie

Zusammenfassung

Einleitung: Wie relevant sind die Kernideen und -konzepte der Theorie der Ergotherapie, die sich vor allem mit den kulturellen Eigenheiten und Normen nordamerikanischer soziokultureller Kontexte befasst haben, für andere soziokulturelle Kontexte der Praxis?

Methode: Eine Gruppe japanischer Ergotherapeuten ging dieser Frage nach und konstatierte ein allgemeines Gefühl der Anspannung in anderen Teilen der Welt im Hinblick auf Fragen der Kultur und des Kontinuums der Theorie-Praxis der Ergotherapie. Sie nahmen ein anspruchsvolles Projekt in Angriff, die Entwicklung eines neuen Modells der Praxis der Ergotherapie. Das Kawa-Modell ist die erste nicht im Westen entstandene substanzielle theoretische Arbeit unseres Berufs. Sie zwingt die Ergotherapie, sich über ihre vertrauten Grundlagen wie individuelle Autonomie und Selbstbestimmung hinaus zu entwickeln in Richtung am Kollektiv orientierter, interdependenter Sichtweisen der menschlichen Betätigung. Durchdrungen von östlichen philosophischen Perspektiven und Weltsichten, bringt das Modell die Aspekte Natur und Ökologie in die sich entwickelnde rationalistische Dialektik unseres Berufs ein. Das Kawa-Modell verwendet eine allen vertraute Naturmetapher als Medium für die effektive Übersetzung subjektiver Ansichten über das Selbst, das Wohlergehen und die Bedeutungen der Betätigung. Die Vertrautheit mit dieser Metapher in vielen Teilen der Welt trägt dazu bei, dass das Modell als ein viel versprechendes Projekt betrachtet werden kann.

Ergebnisse: Die Arbeit umfasst eine einleitende Zusammenfassung des Kawa-Modells, erläutert seine grundlegende Struktur und Komponenten und macht Vorschläge für die Anwendung des Modells in verschiedenen Settings. Sie schließt mit einer Diskussion über die wichtigsten Punkte des Modells und neuere Erkenntnisse hinsichtlich seiner Nützlichkeit sowie einer Untersuchung seines Potenzials, die europäische Ergotherapie anzuregen, ihre Praxis zu optimieren.

Abstract

Introduction: How relevant are the core ideas and concepts of occupational therapy theory which have predominantly held the cultural features and norms of North American socio-cultural contexts, for other diverse socio-cultural contexts of practice?

Method: A group of Japanese occupational therapists considered this question, identifying a common tension experienced in other parts of the world pertaining to culture and the occupational therapy theory-practice continuum. They embarked on a landmark project of developing a new model of occupational therapy practice. The Kawa Model is the profession’s first substantial theoretical work to emerge outside of the West that impels occupational therapy to progress beyond its familiar bases of individual autonomy and agency, toward collective-oriented, interdependent views of human occupation. Infused with Eastern philosophical perspectives and world views, the model brings nature and ecology to the profession’s evolving rational dialectic. The Kawa Model uses a familiar metaphor of nature as an effective medium to translate subjective views of self, life, well-being and the meanings of occupations. The familiarity of the metaphor in various parts of the world, appears to give the model promise.

Results: The article gives an introductory summary of the Kawa Model, its philosophical underpinnings, its basic structure and components and suggestions for its application across a variety of settings. It concludes with a discussion of the model’s main points and recent insights into its utility, as well as an examination of its potential to inform best practice in European occupational therapy applications.

Schlüsselwörter

Kawa-Modell - Ergotherapie - Kultur - Theorie - Modelle - Metapher

Key words

Kawa Model - occupational therapy - culture - theory - models - metaphor

Literatur

• 1 Canadian Association of Occupational Therapists (CAOT) .Enabling occupation: an occupational therapy perspective. Toronto; CAOT 2003 2nd ed
• 2 Clark P N. Theoretical frameworks in contemporary occupational therapy practice, Part 1.  American Journal of Occupational Therapy. 1979;  33 505-514
• 3 Doi T. The anatomy of dependence. Tokyo; Kodansha 1973
• 4 Duldt B, Giffin K. Theoretical perspectives for nursing. Boston; Little Brown 1985
• 5 Fidler G, Fidler J. Doing and becoming: purposeful action and self-actualization.  American Journal of Occupational Therapy. 1978;  32 305-310
• 6 Fujimoto H, Yoshimura N, Iwama M. The Kawa (River) Model Workshop - Addressing Diversity of Culture in Occupational Therapy. 3rd Asia Pacific Occupational Therapy Congress Singapore; 2003
• 7 Gilroy P. The Black Atlantic: Modernity and Double Consciousness. London; Verso 1993
• 8 Gray M, McPherson K. Cultural safety and professional practice in occupational therapy: A New Zealand perspective.  Australian Occupational Therapy Journal. 2005;  52 34-42
• 9 Hatsutori T, Hibino K, Iwama M. et al .Applications of the Kawa (River) Model. Findings from Case Studies and Discussions. 3rd Asia Pacific Occupational Therapy Congress Singapore; 2003
• 10 Hibino K, Tanaka M, Iwama M. et al .Applying a New Model of Japanese Occupational Therapy to a Client Case of Depression. 13th International Congress of the World Federation of Occupational Therapists Stockholm; 2002
• 11 Iwama M, Hatsutori T, Okuda M. Emerging a Culturally and Clinically Relevant Conceptual Model of Japanese Occupational Therapy. 13th International Congress of the World Federation of Occupational Therapists Stockholm; 2002
• 12 Iwama M, Fujimoto H. How Does Your River Flow? Using a culturally relevant model of occupational therapy to break through occupational barriers. Course/Workshop Occupational Therapy Atlantic Conference 2003 Oak Island/Canada; 2003
• 13 Iwama M. The issue is toward culturally relevant epistemologies in occupational therapy.  American Journal of Occupational Therapy. 2003;  57 582-588
• 14 Iwama M. Meaning and inclusion: revisiting culture in occupational therapy.  Australian Occupational Therapy Journal. 2003;  51 1
• 15 Iwama M. Meaning and inclusion: revisiting culture in occupational therapy.  Australian Occupational Therapy Journal. 2004;  51 1
• 16 Iwama M. The kawa (river) model; nature, life flow and the power of culturally relevant occupational therapy. Kronenberg F, Algado SA, Pollard N Occupational Therapy without Borders - Learning from the Spirit of Survivors Edinburgh; Churchill Livingstone, Elsevier 2004
• 17 Iwama M. Revisiting culture in occupational therapy research, a meaningful endeavour.  Occupational Therapy Journal of Research, Occupation, Participation & Health. 2004;  241 1-2
• 18 Iwama M. Occupation as a cross-cultural construct. Whiteford G, et al Occupation and Practice in Context Sydney; Churchill Livingstone, Elsevier 2005
• 19 Iwama M. Situated meaning: an issue of culture, inclusion and occupational therapy. Kronenberg F, Algado SA, Pollard N Occupational Therapy without Borders - Learning from the Spirit of Survivors Edinburgh; Churchill Livingstone, Elsevier 2005
• 20 Iwama M K. The Kawa Model - Culturally Relevant Occupational Therapy. Edinburgh; Churchill Livingstone, Elsevier 2006
• 21 Jang Y. Chinese culture and occupational therapy.  British Journal of Occupational Therapy. 1995;  58 103-106
• 22 Jungersen K. Culture, Theory and the Practice of Occupational Therapy in New Zealand/Aotearoa.  American Journal of Occupational Therapy. 1992;  46 745-748
• 23 Kielhofner G A. Model of Human Occupation: theory and application. Baltimore; Williams & Wilkins 2002 3rd ed
• 24 Kinebanian A, Stomph M. Cross-cultural occupational therapy: A critical reflection.  American Journal of Occupational Therapy. 1992;  46 751-757
• 25 Krefting L. The use of conceptual models in clinical practice.  Canadian Journal of Occupational Therapy. 1985;  52 173-178
• 26 Lakoff G, Johnson M. Metaphors We Live By. Chicago; University of Chicago Press 1980
• 27 Lebra S. Japanese Patterns of Behavior. Honolulu; University of Hawaii Press 1976
• 28 Lidchi H. The poetics and the politics of exhibiting other cultures. Hall S Representation: Cultural Representations and Signifying Practices London; Sage 1997
• 29 McCormack G. Culture and communication in the treatment planning for occupational therapy with minority patients.  Occupational Therapy in Health Care. 1987;  4 17-36
• 30 Miller R. What is Theory and Why Does it Matter?. Miller R, Sieg K, Ludwig F, Shortridge S, van Deusen J Six perspectives on theory for the practice of occupational therapy Rockville; Aspen 1988
• 31 Nakane C. Tate shakai no ningen kankei (Human relations in a vertical society). Tokyo; Kodansha 1979
• 32 Okuda M, Iwama M, Hatsutori T. et al . A Japanese model of occupational therapy. 1: The „river model” raised from the clinical setting.  Journal of the Japanese Association of Occupational Therapists. 2000;  19 (Suppl) 512
• 33 Ramsden I. Kawa Whakaruruhau: cultural safety in nursing education in Aotearoa. Wellington; Ministry of Education 1990
• 34 Smith M J. Culture; reinventing the social sciences. Buckingham; Open University Press 2000
• 35 Weber M. The Protestant Ethic and the Spirit of Capitalism. New York; Scribner 1958
• 36 Wells S A, Black R M. Cultural Competency for Health Professionals. Bethesda; American Occupational Therapy Association 2000