How occupational therapists in Aotearoa/New Zealand have taken up ideas in the international occupational therapy literature
Orton, Yasmin Truelove
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Occupational therapy literature is full of ideas and information to guide occupational therapists in how to practice and what to think about, with new ideas being layered on top of old. This exploratory study looked at how occupational therapists in a metropolitan District Health Board, in Aotearoa/New Zealand, took up ideas from international literature as a theoretical and ethical basis for the work they do. This topic is, centrally, about knowledge transmission and application, which, in the context of occupational therapy, refers to the combination, distribution and interchange of validated information, which is then applied in a clinical setting with the aim of providing a high quality service (Tetroe, 2007). To understand the scope of the knowledge occupational therapists are expected to translate, from within the profession, I conducted a review of international English language literature published over a twenty-year period, looking for ideas that have become prominent over that period. I found that there were ideas connected to practice models, occupation and enablement, intervention strategies, assessment, communication, clinical reasoning, culture and politics. There was little discussion of how occupational therapists brought any of these ideas together to inform their practice and be able to articulate themselves to colleagues and clients their reasons for enabling and engaging clients in occupations. The literature search revealed very little about how New Zealand occupational therapists connected with the worldwide theoretical underpinnings of the occupational therapy profession. As a result, I believed that the time was right to examine this aspect of the relationship between the development of the profession in Aotearoa/New Zealand and the information available in the wider world. For this study, I used a qualitative descriptive methodology. I interviewed ten participants, selected by purposive sampling, who were occupational therapists of varied age and experience. The method for data collection was one-on-one, face-to-face interviews, conducted at the participants’ workplaces. I used content and thematic analysis for data analysis, which yielded seven themes: 1. Sourcing ideas and ideas implicit in occupational therapy 2. Providing occupational opportunities 3. Providing enablement, justice and safety for clients 4. Use and uptake of occupational theory, tools and strategies 5. Occupation and medicine: an uneasy alliance 6. Engagement with clients and colleagues 7. Recognition of culture The study revealed that this group of participants sourced ideas primarily from colleagues but also used courses, online sources, books and literature, which included articles. They took up ideas that were both intrinsic and extrinsic to occupational therapy as well as ideas that applied to their particular practice specialty versus broader occupational therapy concepts. They used an occupational base but also incorporated a mechanistic approach when working alongside colleagues who worked in a biomedical model. However, they were limited in take up of ideas by national and local political guidelines. Participants were strongly culturally sensitive and focused their practice to incorporate this approach. My findings are in agreement with the literature on knowledge uptake, in that knowledge acquisition is a vital and empowering part of current practice. If clinicians are to provide effective, evidence-based interventions for their clients, there should be an emphasis on lifelong learning, opportunities in the workplace to engage in continuous learning, sharing of knowledge and application of learning in the clinical situation. Key limitations of this study were that it was small, with participants coming primarily from physical practice in one District Health Board. It is as yet unknown whether the ways these participants take up ideas aligns with what other practitioners might be doing in other situations. Additionally, due to the constraints of the study, the full impact of the local context and the cultural background of the participants were not examined. As this is an exploratory study, further research is required to investigate this area of interest more widely with participants from different practice areas, cultures and geographical areas.