The Perception of Allied Health Professionals on Occupational Therapy.

Perceptions of Hand Surgery Patients About Occupational Therapy

The purpose of this chapter is to define the scope and role of the occupational therapist (occupational therapy) within a rehabilitation team. This chapter defines the different types of teams that exist, and presents information across all types. Frequently cited advantages and barriers to teamwork are also discussed. To provide context for the reader, the concepts that are discussed within this chapter are applied to teams working with clients who have experienced a stroke. The principles that are used by occupational therapists working on stroke teams are also applicable to many other clinical populations. Finally, the evidence base for teamwork is discussed, with respect to published studies.

What is the role of occupational therapists with regard to clients' spirituality? What activities address spirituality in occupational therapy? Whom do practitioners think should be responsible for helping clients with their spiritual needs? The objectives of this study were to address these and other related questions by validating a previously used questionnaire and establishing a baseline of occupational therapists' opinions and practices about spirituality and therapy on which future research can be built. A previously piloted questionnaire was revised to investigate the opinions of 500 U.S. registered occupational therapists about spirituality and therapy. The 54% return rate yielded a sample of 270 respondents. Nearly 79% of the respondents agreed that the questionnaire accurately measured their opinions about therapy and spirituality. Spirituality is an important part of life for 89% of the respondents, helps 79% with daily job responsibilities, and is viewed as a very important dimension of health and rehabilitation by 84%. However, 63% were either undecided or disagreed that addressing spirituality was within the scope of occupational therapy practice. In general, the respondents reported that spirituality is important and helpful in their personal lives and a very important dimension of the health and rehabilitation of their clients. However, less than 40% of the respondents indicated that addressing clients' spiritual needs was within the scope of their professional practice, and the majority (82%) reported that their academic training did not prepare them to address the spiritual needs of clients. The questionnaire, now validated with a national sample, may be used for follow-up studies to further investigate the role of spirituality in health and rehabilitation.

A close analysis of the significance of the relationship in the therapeutic situation is important for occupational therapists who work in mental health. The relationship in occupational therapy is actually an interactive process between therapist, client and doing or occupation. Research on infant development has shown that the emotions and relationships which are part of the interactive process between baby and carers contribute to mental functions. In therapy situations something similar happens and can be demonstrated with specific examples. The role of occupational therapists using this approach is that of creating and maintaining an interactive process which can produce the growth of mental functions in their clients.

This study investigates occupational therapy for early communication in children with autism spectrum disorders (ASD). The research explored the role of occupational therapists in supporting children with ASD to become better communicators by considering their inter-professional collaboration with speech-language pathologists. Convenience samples of 21 clinical occupational therapists and speech-language pathologists were recruited to participate in semi-structured audio-recorded focus groups, using a qualitative design. Distinct views included a child-centred focus from speech-language pathologists, whereas occupational therapists spoke of the child through societal viewpoints, which later pointed to occupational therapists’ proficiency in enabling skill generalization in ASD. An equal partnership was consistently reported between these clinicians, who identified the same objectives, shared strategies, joint treatments, and ongoing collaboration as the four main facilitators to inter-professional collaboration when treating children with ASD. Three unique roles of occupational therapy comprised developing non-verbal and verbal communication pre-requisites, adapting the setting, educating-partnering-advocating for the child, and providing occupation-based intervention. These three themes meshed with the discipline-specific occupational therapy domains represented in the Person–Environment–Occupation framework. When working in inter-professional collaboration, speech-language pathologists and occupational therapists agree that occupational therapy is indispensable to early intervention in enabling communication in ASD.

Occupational therapy is a profession that is often misconstrued by the public due to the ambiguity of its concepts and practices. In a typical day, an occupational therapist would be engaged in a dialogue with a client where he or she must explain what “occupational therapy” is and its relevance to the therapist-client relationship. This chapter aims to unpack what “occupation” means from a multidisciplinary perspective to better understand why occupational therapy remains to be a profession that is not well recognized by the Filipino public. By revisiting our colonial history, examining the richness of the Filipino language, and looking further into the social tapestry regarding work and occupation, we can reimagine our understanding of occupation and occupational therapy and see how this can evolve as we continue to construct our profession’s history.

This study aimed to assess final-year students in speech and language therapy (SLT), physiotherapy and rehabilitation (PT), and occupational therapy (OT) programs on their perceptions of teamwork in neurological rehabilitation, specifically focusing on the role of speech and language therapists (SLTs) in the team. The study involved 166 final-year undergraduate students in SLT, PT, and OT programs. A questionnaire consisting of demographics, assessing the participants' experiences and opinions of neurological rehabilitation teams, and exploring the specific role of SLTs with neurological patients provided study data. In this study, the student group that worked the most with neurologically diagnosed patients was found to be PT (%98), followed by SLT (%90.9), and OT (%78.6) students, respectively. The participants were aware of the advantages and disadvantages of teamwork. SLT and OT students emphasized the effectiveness of an interdisciplinary team approach in neurological rehabilitation. Most of the participants indicated utilizing a multidisciplinary team approach. They knew the role of SLTs in treating disorders like aphasia, apraxia of speech, and dysphagia, but their awareness of other practice areas of SLT was limited. A fundamental aspect of effective teamwork in neurological rehabilitation is understanding the role and contributions of different healthcare professions. It would be beneficial to provide students with further opportunities to gain valuable insights into the significance of teamwork and team members' roles, particularly during their final year of study. What is already known on the subject Providing high-quality and effective neurological rehabilitation services to maximize the independence and quality of life of people with disabilities is only possible by working as a team. In all team-based approaches to neurological rehabilitation, a range of health professionals, including physicians, nurses, speech and language therapists (SLTs), physiotherapists (PTs), occupational therapists (OTs), audiologists, psychologists, and dieticians, are required. It is essential that health professionals possess an understanding of the roles and responsibilities of other professionals to facilitate effective teamwork. What this paper adds to existing knowledge This study evaluated the knowledge of final-year students enrolled in the SLT, PT, and OT programs regarding teamwork in neurological rehabilitation. In particular, the study focused on the role of SLTs within the neurological rehabilitation team in Türkiye, where speech and language therapy (SLT) education has been provided at the undergraduate level for 12 years. What are the clinical implications of this work? The findings of this study provide a robust basis for advancing interprofessional education at the undergraduate level and suggest developing communication, leadership, and collaboration skills in healthcare students through theoretical and practical courses. These skills can significantly increase the impact of teamwork on patients, particularly in Türkiye.

Depression is a common mental illness characterized by low mood, loss of interest and enjoyment, and reduced energy leading to diminished activity. An estimated 322 million people worldwide or 4.4% of the world’s population experience depression at any given time. The figures for Ireland suggest that 212,555 people in Ireland are currently experiencing depression. Driving is important for many individuals with depression as it contributes to health and quality of life by maintaining independence, fostering a sense of self, facilitating social participation and access to health/medical services and the community and as such can be classified as an occupation enabler. However, the evidence would suggest the individuals with a psychiatric diagnosis have an almost double risk of being involved in a motor vehicle accident. This could be attributed to the impact of the depression itself with deficits in cognition and psychomotor retardation commonly reported or the side-effects of psychotropic medication. Currently, in Ireland there is no national consensus on the process of determining fitness to drive (FtD) for individuals with depression reflecting what is occurring internationally because of limited scientific evidence about what constitutes an adequate FtD assessment with this population As Consultant psychiatrists, General practitioners and occupational therapists in Ireland are the most likely health care professionals to be involved in FtD decision making with individuals with depression, this thesis has two components which aim to explore: o What are the current attitudes of health professionals in Ireland to driving and depression? o Are Irish health professionals aware of and adhering to the Sláinte agus Tiomáint guidelines in the assessment of fitness to drive of individuals with depression? o What are the current practices of health professionals (Consultant Psychiatrists, General Practitioners, and Occupational Therapists) in Ireland in the assessment of fitness to drive of individuals with depression? o What is the confidence and competence of health professionals in Ireland in the assessment of fitness to drive with individuals with depression? The aims achieved through three research articles are presented in this thesis. The first article is a discussion piece for occupational therapists on the introduction of the Sláinte agus Tiomáint FtD guidelines in Ireland. The article discusses the relevance of the guidelines to occupational therapy; particularly therapists working in mental health and primary care settings where the issue is often overlooked. Finally, the paper explores how occupational therapists can include the assessment of fitness to drive within their clinical practice as it is internationally recognized as within the scope of occupational therapy. The second article is an empirical study of the attitudes, knowledge, and practices of three professional groups. The article presents a quantitative survey of health professionals (n=228) (Consultant Psychiatrists, General Practitioners, and Occupational Therapists) in Ireland exploring their current knowledge, attitudes and practices related to the assessment of FtD and depression and the Sláinte agus Tiomáint FtD guidelines in Ireland. The article also contains insights from health professions via qualitative comments. The third article presents findings from a survey of occupational therapists (n=98) where open-ended questions were used to explore their knowledge, attitudes, and practices to the assessment of FtD and depression. The data collected from the study in the second article was reanalysed to focus on the roles and practices of occupational therapists working in Primary Care and Mental Health in Ireland. Summary of main results from Article 2 and Article 3: • Assessment of FtD was deemed important by the majority (75%) of respondents. • Routine discussion of driving with clients with depression was only reported by a minority of respondents (39.5%). • The majority of respondents relied on an informal discussion or assessment • Clinical reasoning was vital in making FtD decisions • Important factors that influence their FtD decision making include: impaired cognition, decreased concentration, medication side-effects, suicidal ideation/intent and decreased reaction time. • Varying levels of confidence and competence were self-reported by all professions, with the occupational therapy respondents tending to have the lowest levels of self-reported confidence and competence in the assessment of fitness to drive. • All respondents across the three professions reported the need for additional training in the area of assessment of FtD. Key recommendations from this research include: • There is a need for specific training and skill development in the assessment of FtD with individuals with depression for health professionals. Future research should focus on the requirements needed by each health profession to address driving with individuals with depression. • Occupational therapists need to include driving into their clinical practice rather than overlooking it or referring to other disciplines or professions. • Qualitative research with service users is needed to understand better the lived experience of driving with depression and to inform how the issue is addressed with individuals with depression.

The sustainability of health services globally is under increasing pressure with a rise in chronic conditions, an ageing population, ageing workforce and increased fiscal, safety and quality issues. One important strategy acknowledged to address these pressures is greater collaboration between health professions, often described as interprofessional practice (IPP) or collaborative practice. While many health professionals believe they already engage in IPP, in reality they are working alongside each other within their own professional silo (World Health Organization, 2010). The continuation of this siloed way of working impacts the occupational therapy profession, particularly evident in the lack of understanding of how occupational therapy contributes to the health of individuals, communities and the health system. Few people, including those with whom we work, understand what constitutes occupational therapy (Alotaibi, Shayea, Nadar & Tariah, 2015). Without that understanding, members of the health professional team are not able to appropriately refer to our services, or include occupational therapy in the delivery of care. An evident lack of understanding of the role of occupational therapy frustrates occupational therapists and denies clients access to services and achievement of their occupational goals (Britton, Rosenwax & McNamara, 2015; Keesing & Rosenwax, 2013). It also impacts the status of the profession, job satisfaction and retention (Moore, Cruickshank & Haas, 2006). Limited understanding of other professions not only impacts occupational therapy; health professionals generally do not fully understand the scope of practice, knowledge, skills and core values of other professions (Aguilar, Stupans, Scutter & King, 2014). Without this understanding, effective IPP is not possible. IPP does not just happen. It is widely recognised that interprofessional education (IPE) is needed to build staff capacity/capabilities for IPP. The World Health Organization defines IPE as ‘occurring when two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes’ (World Health Organization, 2010). Many Universities have embedded IPE into health curriculum including two-thirds of Universities in the UK (Barr, Helme & D'Avray, 2014) and 85% of Universities in the USA (Greer, Clay, Blue, Evan & Garr, 2014). Unfortunately the same cannot be said for Australia and New Zealand. A recent review indicated that while 80% of the universities stated they had IPE in the curriculum, only 24% met the definition of IPE (Lapkin, Levett-Jones & Gilligan, 2012). This lack of IPE and IPP extends beyond universities and into student fieldwork placements. Even when IPP experiences are reported to occur during placements, the majority of these entail tutorials and education sessions (Davidson, Smith, Dodd, Smith & O'Loughlan, 2008) rather than structured learning experiences where students are facilitated to learn about, from and with other health professionals, clients and carers. Health students need to be provided with opportunities for IPP, particularly as it happens rarely within Australian health settings. Based on our experiences, students provided with such opportunities demonstrate increased valuing of teamwork, confidence in sharing expertise, trust and respect for other professions, altered stereotypical views and appropriate referrals. Additionally, having experienced IPP, clients cite high satisfaction with their care (Brewer & Stewart-Wynne, 2013). Our experiences include a training ward, dementia unit, primary schools, integrated primary care health facility, aged care, rehabilitation, mental health and an international service learning programme running for the past decade. While barriers exist to imbedding IPE and IPP, they should not be accepted as an excuse to persist with our current siloed approach to health education and practice. Universities have a responsibility to prepare our graduates to be leaders and agents of change to better meet the needs of the community (Frenk et al., 2010). Based on our experiences, we believe that IPP can help address the vexing question of ‘What is occupational therapy?’ By learning about, from and with each other, there is the opportunity to understand and experience the breadth, depth, values and scope of occupational therapy and other professions. With IPP as the norm, health professionals, clients and carers will be much better situated to work in partnership with occupational therapy.

Purpose: The personalisation of adult social care, as confirmed in Putting People First (Department of Health 2007), will see a fundamental change in social care services, including occupational therapy. This study aimed to capture occupational therapists' perceptions of personalisation. Procedure: A qualitative study involving interviews with six practising occupational therapists was undertaken. The interviews were transcribed and the data studied for emerging themes, using thematic analysis to code and analyse the data. Findings: Four main themes were identified: similarities to occupational therapy; a lack of understanding of occupational therapy; threats and concerns; and opportunities and action needed. All participants felt that they understood the components of personalisation and identified similarities to occupational therapy. All were able to highlight opportunities and actions for occupational therapists with regard to personalisation. However, all raised concerns about the future role of the occupational therapist and highlighted a general lack of understanding of occupational therapy. Conclusion: Occupational therapists consider themselves to be well placed to support the implementation of personalisation. They feel that it is the right direction for adult social care, and that its goals are in parallel with those of occupational therapy. However, there are concerns that the possible contribution of occupational therapists could be overlooked.

This article provides insight into the impact that exposure to an occupational therapist, in personal capacity or via a professional interaction, has on the decision to enter an occupational therapy undergraduate programme. A quantitative survey was completed by 139 occupational therapy students. The survey tool focussed on the students' exposure to a range of allied health professions (e.g. occupational therapy, physiotherapy, psychology) and investigated how exposure to occupational therapy had influenced their decision to enter the programme. The results indicated that over 70% of respondents had personal professional exposure to occupational therapy prior to making a career decision. Exposure most frequently involved occupational therapy intervention of a friend or family member. The majority of students who had professional exposure to occupational therapy (e.g. family, self, friend received occupational therapy) identified that it was the most influential factor in their career choice. Forty per cent of the occupational therapy students did not enter the programme straight from school and the influence of 'working with an occupational therapist' was noteworthy for mature aged students. Occupational therapists need to consider that every interaction they have with the community provides valuable information regarding the profession and gives insight into occupational therapy as a potential career path for other people. Additionally, the current research identifies there were differences in the impact, type and number of exposures for different student groups, and this potentially offers some insight into ways in which occupational therapy could target specific groups within the community to increase future diversity in the profession.

IntroductionThe imposition of martial law on December 3, 2024, in South Korea has reignited critical discussions on the intersection of political systems and occupational justice. Authoritarian governance imposes significant restrictions and disruption of meaningful occupations and exacerbating inequities, particularly among marginalized communities. This study examines the implications of martial law through the lens of occupational justice and political occupational therapy. Additionally, the introduction engages with organizational communication theories, such as institutional discourse, public rhetoric, and crisis communication frameworks, to position occupational therapists as communicative agents of systemic change. By integrating historical events such as the Gwangju Uprising, the study aims to highlights systemic barriers to occupational engagement and the broader socio-political determinants of occupation.MethodsThis study employs an exploratory review methodology to analyze the impact of martial law on occupational justice. Drawing from historical, political, and occupational therapy literature, the review synthesizes theoretical frameworks, policy analyses, and case studies to examine how authoritarian governance shapes occupational participation. The study also explores the role of occupational therapists in addressing socio-political determinants of occupation during periods of political crisis.ResultsFindings indicate that martial law imposes systemic occupational disruptions, disproportionately affecting marginalized communities, including political dissidents, low-income workers, and individuals with disabilities. Restrictions on movement, expression, and access to essential services limit occupational engagement, reinforcing structural inequalities. Historical comparisons with events such as the Gwangju Uprising demonstrate recurring patterns of occupational injustice under authoritarian regimes. The analysis suggests that occupational therapy, when positioned as an inherently political discipline, has the potential to advocate for occupational rights and mitigate the impact of governance-related disruptions.ConclusionThis study argues for a paradigm shift in occupational therapy, urging practitioners to transcend traditional clinical roles and engage in policy advocacy. Recognizing occupational justice as a fundamental human right, occupational therapists can play a critical role in addressing socio-political determinants of occupation. By advocating for policies that safeguard occupational engagement during crises, the profession can contribute to a more just and equitable society.

Background: This qualitative study explored the knowledge to practice gaps of occupational therapists who have a vital role in neuro-developmental supportive care for high-risk infants. Methods: Via purposive sampling, 17 therapists working in public health in South Africa were recruited to participate in virtual focus groups. Data were thematically analysed using a hybrid approach. Findings: Five themes emerged, which included (i) occupational therapy and neonatal care in the public health sector, (ii) knowledge acquisition and knowledge synthesis, (iii) knowledge translation and utilisation, (iv) contextual barriers and adaptation and (v) the ideal occupational therapist in the ideal neonatal setting. Facilitators, inhibitors, referrals, and interest in occupational therapy neonatal care were also highlighted . Conclusions: Knowledge to practice gaps in occupational therapy include insufficient training, a decreased interest in neonatal care, staff shortages, multi-disciplinary team rotations and a reduced understanding of the professional role and scope of occupational therapy. Resources, training, and policy development appear to be necessary to inform a standard of care. IMPLICATIONS FOR PRACTICE: The role of the occupational therapist in supporting high risk infants is generally limited and remains somewhat unknown in current South African contexts. It is essential to identify knowledge-to-practice gaps for occupational therapists supporting high-risk infants in the public health sector for successful implementation of neurodevelopmental supportive care. By the exploration of practitioner opinions and insight through appreciating the role of the occupational therapist in managing high risk infants, contextually specific and relevant knowledge translation interventions may be developed and implemented which have implications for evidence-based practice and more successful outcomes in the high-risk infant.

Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months’ employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited. Data on capability beliefs and use of EBP were collected using the Evidence-based Practice Capabilities Beliefs Scale assessing six activities of EBP: formulate questions; search databases; search other sources; appraise research reports; participate in implementation in practice; and participate in evaluation. Descriptive and inferential statistics were used. Capability beliefs on EBP: The health professionals (n = 101; response rate 80%) reported high on search other sources but less on appraise research reports. The students (n = 124; response rate 73%) reported high on all EBP activities. The health professionals reported significantly higher on search other sources than the students. The students reported significantly higher on formulate questions and appraise research reports than the health professionals. No significant differences were identified between the health professional groups or between the student groups. Use of EBP: Health professionals reported wide-ranging use from several times each month to once every six months. The physicians reported significantly more frequent use than registered nurses and occupational therapists. Health professionals supervising students reported more frequent use of appraise research reports than the non-supervising group. There is a need for improving the use of EBP, particularly among registered nurses and occupational therapists. Supervision of students might enhance the motivation among staff to increase the use of EBP and students’ high EBP capability beliefs might inspire staff in this matter.

Large educational transitions occur when students enter and exit school or move between grades or divisions within the kindergarten to Grade 12 (K-12) school system. For students with disabilities, the quality of large educational transitions affects academic and postschool outcomes, which is germane to school-based occupational therapists. To explore the school-based occupational therapy literature to describe the roles of occupational therapists in supporting large educational transitions and to identify relevant terminology. We searched six databases (CINAHL, EMCare, Embase, ERIC, MEDLINE, and PsycINFO) for peer-reviewed publications in English with no date limitations. We included articles focused on children and youth with disabilities and school-based occupational therapy services supporting large transitions within K to 12 education. Using directed content analysis, we reported on publication characteristics, occupational therapy roles, and terminology. We included 46 publications spanning 37 yr that addressed transitions into school (n = 3), within K to 12 grades or divisions (n = 10), or to exit secondary education (n = 33). Occupational therapists assumed many roles in supporting large transitions, some much more frequently than others; 125 transition terms were used across included articles with few terms explicitly defined. School-based occupational therapists' involvement in educational transitions is extensive, with potential for expansion. Consistency in terminology would support future research and practice. Plain-Language Summary: A large educational transition occurs when students move between a school, grade, or division as part of their K to 12 education. For students with disabilities, the quality of a large educational transition affects their academic and postschool outcomes. This review provides an understanding of how school-based occupational therapists support educational transitions for youth with disabilities. The review found that occupational therapists took on many roles, with the potential for expanding their roles. The review also identified 125 transition terms that were used across the literature review and found that few terms were explicitly defined. Consistency in terminology would support future research and expanded occupational therapy practice in this area.