There is growing interest in occupation-based practice (OBP) as it applies to hand therapy. While leaders in occupational therapy strongly advocate for the primary use of OBP in all practice areas of occupational therapy, some question the broad application of OBP into the hand therapy specialty practice. This study sought to describe the perception and application of OBP among occupational therapy practitioners in hand therapy.
This descriptive qualitative study conducted semi-structured interviews with occupational therapy practitioners (n=10) who practice in hand therapy. Interviews were transcribed, coded by meaning units. Codes were categorized into themes. Peer review and triangulation with analytic memos were used to increase trustworthiness.
Participants ranged in years of experience (3-28 years) and half hold the CHT designation. Four themes emerged from qualitative analysis: how OBP is defined, how OBP is practiced, facilitators, and barriers to OBP. Participants defined OBP as the use of meaningful activities identified by the client and promoting a return to daily activities. Participants practiced OBP processes in the development and execution of treatment plans through activity analysis, compensatory strategies, and simulated environments. Facilitators to practice include the use of functional outcome measures, payor guidelines, therapists’ creativity, and the practitioner’s relationship with the physician and the client. Barriers to practice include insurance limitations, time and space constraints, resource limitations to implement OBP and the nature of orthopedics. Participants also experienced issues with professional identity in the context of contemporary occupational therapy practice.
The study describes the utilization and facilitators of OBP in the hand therapy context. The barriers to OBP, identified in the study, are not unique to hand therapy. However, issues surrounding professional identity requires further exploration. This study has important implications on practice, education, and research regarding OBP.
Occupation- based, Hand therapy, Qualitative.