Introduction: With ever increasing pressures on healthcare services and a rising demand for placement opportunities to enable the education and registration of greater numbers of healthcare professionals, it is vital that students gain maximum learning during placement opportunities. A grounded theory approach was used to explore what was learned and how the learning occurred during pre-registration occupational therapy programmes at one university in the UK’s West Midlands. This article presents and discusses a theory of practice learning developed during research with pre-registration occupational therapy students. Method: Eleven students and three practice educators participated in individual interviews following the first practice placement. Transcripts were analysed using constant comparison methods. Findings: The relationships between learning in four different categories previously reported were found to be interdependent and were further abstracted to develop a theory of practice learning that is characterised by the student’s availability for learning, which was impacted on and by each of the four categories and can be enhanced by actions taken by the student, the education establishment, and the practice educator. Conclusion: The theory of practice learning can be used to help students, practice educators and academics better understand and support student learning on placement.
Introduction: The Vona du Toit Model of Creative Ability (VdT MOCA) is a widely used theoretical framework that has the potential to improve meaningful participation among nursing home residents. No published research evidence supports its use in occupational therapy with older people. Method: We used a quantitative cross-sectional observational cohort study design to identify factors influencing the level of creative participation of 30 nursing home residents ( M age = 87.2, SD = 8.42) in South Africa, using the Creative Participation Assessment (CPA), demographic and participation data, the Allen Cognitive Levels Screen (ACLS-5) and the Barthel Index. Statistical analysis included correlations and multiple linear regression. Results: The CPA showed residents presented with a range of levels of creative ability from Tone to Active Participation. Although being independent living before nursing home residence was correlated with the CPA ( p = 0.04), the regression analysis showed that only functional cognition ( p < 0.001) and independence in self-care ( p = 0.008) independently predicted CPA levels. Conclusion: Our findings support the use of the VdT MOCA with the oldest old. Using this model, occupational therapists can support older people in nursing homes to continue achieving their potential using cognitive stimulation and carer training to optimise residents’ participation in self-care.
Introduction: Originating in South Africa, the occupation-based community development (ObCD) framework offers a guide for practice that contributes through a critical, justice-oriented occupational therapy practice. Its translation into diverse global settings has been anecdotally noted, but has not been empirically studied. Method: This qualitative descriptive study examined the experiences of practitioners/scholars who utilised the ObCD framework in the United States, the United Kingdom, the Netherlands, India, and South Africa. In-depth interviews and a focus group were conducted with six occupational therapists and one speech therapist. Inductive thematic analysis was employed. Findings: The theme, “Reasoning through a dialogical process with ObCD,” comprised three categories: (1) Drawing on the critical, occupational and participatory stance of the ObCD to (re)orient practice; (2) Prompting the navigation of a different kind of practice through “seeing more”; and (3) Using ObCD within the contextual limitations of what’s possible. Participants, located mostly in academia, were working out how to use the framework as a way to shift their praxis. Discussion and Conclusion: The translation of the framework therefore occurred through a transpositional, pragmatist approach where the ObCD prompted a critical consciousness that drove a dialogical orientation to working out what needed to occur with students and communities.
Background: Diabetes self-management is shaped by routines, habits, environments, and participation in everyday life. Occupational therapy-informed interventions may offer a valuable yet underexplored approach to supporting sustainable self-management. Methods: A systematic review was conducted according to a prospectively registered protocol (PROSPERO CRD420251152974) and PRISMA 2020 guidelines. MEDLINE, EMBASE, Scopus, Cochrane CENTRAL, CINAHL, and PsycINFO were searched to October 2025. Eligible studies included adults with diabetes receiving occupational therapy-informed interventions targeting self-management, routines, habits, or participation. Results: Nine studies involving 281 participants were included (two randomised controlled trials, one quasi-experimental study, and six pilot or pre–post studies). Interventions commonly addressed routines, habits, goal setting, participation, and engagement within daily life contexts. Improvements were reported in self-management behaviours, self-efficacy, psychosocial outcomes, and participation. Several studies, including both randomised trials, also reported reductions in HbA1c. Conclusions: Evidence from nine studies suggests that occupational therapy–informed interventions may improve diabetes self-management behaviours, self-efficacy, participation in daily activities, and in some cases glycaemic control in adults with diabetes. However, evidence remains limited due to small samples, heterogeneous interventions, and predominantly pilot or non-randomised designs. Larger controlled trials are needed to establish the effectiveness of occupational therapy-based approaches in diabetes care.
Background: The use of pressure garments in post-stroke upper limb rehabilitation is controversial, with quantitative studies often conflicting with clinical observations and patient experiences. Occupational therapists, as key implementers, provide essential insights into their real-world effects. Objective: To explore occupational therapists’ perspectives, experiences, and decision-making when using three pressure garment designs (dorsal-double-layered and single-layered, both with 10% circumferential reduction, and placebo) in stroke rehabilitation. Methods: A qualitative study using semi-structured interviews with six occupational therapists from an 8-week randomised controlled trial. Data were analysed thematically. Results: Four main themes and 13 subthemes were identified: (1) Therapeutic effects of the pressure garment, reflected in oedema control, influence on muscle tone, enhancement of sensory input, and improvement of motor function; (2) Real-world challenges in clinical practice, where patient adherence was the central issue, addressed through therapists’ guidance and feedback strategies; (3) Assessing patient suitability, involving a comprehensive framework of clinical presentation, personal goals, rehabilitation timing, and willingness to cooperate; (4) Evaluation and recommendations for the pressure garment, where therapists critically reviewed existing designs and proposed future intelligent, user-friendly improvements. Conclusion: Therapists’ reasoning links technology to patient outcomes, offering practice-based evidence to resolve research inconsistencies and guide clinical practice, research, and product development.
This study longitudinally examined the associations between paretic upper limb use, upper limb motor function, and Internal Health Locus of Control (IHLC) in hospitalised patients with subacute stroke. Forty patients were assessed using the Motor Activity Log-Amount of Use, the Fugl-Meyer Assessment-Upper Extremity, and IHLC. Hierarchical multiple regression analyses showed that paretic upper limb use was associated with motor function at both 1 and 2 months, whereas no association with IHLC was observed. Secondary (exploratory) analyses suggested that depressive symptoms, self-efficacy, and activities of daily living independence may differ according to the degree of improvement in paretic upper limb use.
Introduction: Occupational therapy is named a key profession within primary care, with growing demand due to an ageing population and increase of people living with long-term conditions. Despite this, occupational therapy within primary care remains an evolving, under researched area of practice. This scoping review explored the role of occupational therapy within primary care including the populations and interventions currently provided. Methods: The Joanna Briggs Institute (JBI) methodology for scoping reviews was followed with systematic searches conducted across CINAHL, PubMED and AMED databases with grey literature also sourced. The findings are presented in tabular format and analysed using descriptive statistics and frequency counts to identify patterns and trends alongside narrative reporting. Findings: This scoping review identified 40 relevant articles, with older adults reported as the most frequent population supported by occupational therapists. Interventions focused on physical health including providing equipment/assistive devices, supporting mental health through stress and anxiety management, with limited reported interventions with children and young people. Conclusion: This review has highlighted key interventions provided by occupational therapists and the breadth of the role within primary care. Research and sharing of best practice is required to showcase occupational therapists evolving contribution within primary care.
Introduction: Older adults in hospital experience functional decline that affects their independence, quality of life (QoL) and health outcomes. This study aimed to examine the effectiveness of occupational therapy activities of daily living (ADL) retraining programmes on functional status, length of stay (LOS), self-efficacy and QoL in hospitalised older adults. Methods: A systematic review was conducted with three databases searched. Studies included older adults aged 65 years or above, in hospital where ADL retraining was explored. Meta-analyses of relevant studies were conducted with the random effect model at 95% confidence interval. Results: Seven studies were included. ADL retraining programmes were delivered in either an individual ( n = 7) or group format ( n = 3). Intervention protocols and intensity varied across studies. Meta-analysis included four studies, which showed statistically significant improvement in functional status (effect size (ES) = 0.75, p = 0.03), but were insignificant for LOS (ES = −0.03, p = 0.84), self-efficacy (ES = −0.34, p = 0.08) and QoL (ES = 0.04, p = 0.71). Conclusion: ADL retraining in hospital had significantly large effects on functional outcomes, with no significant effects on LOS, self-efficacy and QoL. Further rigorous, large-scale research is needed to explore the impact of ADL retraining on rehabilitation outcomes.
Introduction: Women face limitations in occupational participation due to intersecting social and structural factors, which negatively influence health and well-being. This systematic review examined how occupational therapy-based advocacy and occupational justice approaches have been applied to support women across diverse contexts. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, using 13 keywords across 4 databases. Fifteen studies met the inclusion criteria. Quality assessment and risk of bias were evaluated for all studies. Findings: Most studies were rated as high quality ( n = 10), with the remainder rated as moderate ( n = 5). The majority was qualitative (Level VI), with a small number of conceptual or theoretical studies (Level V), and overall risk of bias was low to moderate. The studies focused on women experiencing intersecting forms of marginalization, including disability, migration, violence, homelessness, and gendered and racialized inequities in employment. Three themes emerged: (1) individual-level empowerment, (2) societal and policy-level advocacy, and (3) professional responsibilities of occupational therapists. Overall, evidence was largely recommendation-based, with limited intervention-focused models. Conclusions: Integrating advocacy and occupational justice frameworks into clinical and community-based occupational therapy have the potential to enhance women’s occupational participation and inform future intervention development, education, and policy engagement.
Introduction: Individuals with severe mental illness (SMI) often experience limited community participation and reduced quality of life. Occupation-based group interventions informed by culturally responsive models such as the Kawa Model may support well-being and engagement. This study aimed to examine the effects of a Kawa Model-guided occupation-based group intervention on quality of life and community participation in individuals with SMI.Method: A single-group pretest-posttest design was used. Eight adults with SMI participated in a 10-week group intervention guided by the Kawa Model. Quantitative outcomes were assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the Community Integration Questionnaire. Qualitative data were collected through Kawa-based interviews and real-time reflections.Results: Post-intervention improvements were observed in community integration and social relationships. Participants reported enhanced self-expression, motivation, and a greater sense of belonging. River drawings illustrated changes in occupational identity and perceived life flow.Conclusion: A Kawa-guided group intervention may enhance participation and well-being among individuals with SMI. Findings support the utility of culturally grounded, metaphor-driven approaches in occupational therapy mental health practice.
Introduction: Occupational therapy has a central focus on occupation. This calls into question the role and value of anatomy education and knowledge holds for the profession. This research reports on the key findings of a larger, doctoral study which explores the role of anatomy within occupational therapy and examines curricula implications. Method: A hermeneutic, phenomenological approach was employed. Semi-structured interviews gathered data from participants in four categories (occupational therapy students, practitioners, lecturers, and profession experts). Thirty-two participants (eight participants per category) were interviewed. Reflexive thematic analysis was utilised. Data were analysed separately for each category and then blended to produce key findings. Findings: Challenges and complexities exist with the inclusion of anatomy education in occupational therapy curricula and there remains ongoing debate as to the core knowledge of the profession. Findings revealed continuing challenges with professional identity in medicalised settings and strong influences of the multidisciplinary team and the practice context. Conclusion: Occupation-centred anatomy education is suggested to equip students with a strong professional identity, which centralises occupation, whilst still meeting practice-based realities. Developing students’ lifelong learning skills is essential to ensure future occupational therapists take ownership of their learning needs to meet practice-based demands.
Introduction: Distal radius fractures, common in females and males aged >= 65 and 40-50 years, respectively, cause prolonged pain and activity limitations. Although occupational therapy is a standard postoperative intervention, the relationship between time use, and pain intensity and self-efficacy during the acute recovery phase remains unclear. This study examined these associations shortly after distal radial fracture surgery.Methods: This multicentre, prospective, cross-sectional, observational study included 9 facilities. Patients, who underwent volar locking plate fixation and occupational therapy with a splint, were assessed within 1 week postoperatively. The measures included the Occupational Questionnaire, Pain Self-Efficacy Questionnaire, and Numerical Rating Scale. Spearman's rank correlation coefficient was used because of nonnormal data distribution.Results: Twenty-seven participants (25 female; mean age 64.15 +/- 9.03 years) were analyzed. Significant positive correlations were found between the time spent on work-related activities and pain self-efficacy on weekdays, and weekends. Contrastingly, we detected no significant correlations between pain-related measures and leisure activities or activities of daily living.Conclusion: Work-related activities were positively associated with pain self-efficacy during acute postoperative phase, consistent with findings from populations with chronic pain. As the work activity types were not specified, further research is warranted to clarify on which activities satisfy this relationship.
Introduction: Multiple Sclerosis (MS) is one of the most common neurological disorders, and it has a wide effect on performance. MS affects higher cognitive functions, interfering with independence and participation. The Executive Function Performance Test (EFPT) is a functional test that assesses executive function in performance. This study aims to translate and prepare a preliminary version of EFPT, assess its face and content validity, and examine inter-rater and intra-rater reliability and internal consistency. Methods: The English version of EFPT was translated into Persian using the IQOLA standard method. To assess face validity, participants evaluated the test’s appearance and functionality. The content validity ratio and index were analyzed using the Lawshe method. For reliability assessment, 30 individuals with MS were evaluated over a 2-week interval, and agreement between the two therapists was also examined. Results: The results showed the range of ICC in each category of the EFPT questionnaire between two examiners, between 0.964 and 0.998, and intra-rater, between 0.758 and 0.872. In test-retest reliability, each score’s ICC was between 0.877 and 0.977. Cronbach’s alpha was more than 0.7 for all items. Conclusion: The results showed that the Persian version of EFPF was properly valid and reliable for participants with MS.
Introduction: Instrumental activities of daily living (IADL) training faces clinical barriers that vary by context, sometimes limiting its implementation. Therefore, the criteria and challenges remain unclear, leaving decisions to individual therapists and hospitals. This study aimed to clarify preferred criteria for introducing IADL training and perceived importance of related challenges in convalescent rehabilitation wards in Japan. Method: A nationwide survey was conducted among heads of occupational therapy departments in 1000 rehabilitation wards. Using best–worst scaling, six introduction criteria and 11 challenges were evaluated. Relative importance (RI) scores were calculated using counting analysis; higher RI values indicated stronger preferences. Results: Of 339 responses, key introduction criteria were ‘patient and family preferences’ (RI: 1.00) and ‘anticipated post-discharge IADL performance’ (RI: 0.92); ‘sufficient physical and mental functions’ (RI: 0.36) and ‘independence in basic ADL’ (RI: 0.33) were less prioritised. Major challenges were ‘insufficient time and opportunities for real-life practice’ (RI: 1.00) and ‘discrepancies between patient and family expectations’ (RI: 0.69); ‘heavy workload and high task demands’ (RI: 0.25) and ‘challenges related to infection control measures’ (RI: 0.15) ranked lower. Conclusion: Client-centred considerations and anticipated post-discharge performance outweigh physical or mental prerequisites for IADL training. Addressing practice and expectation gaps may facilitate implementation.
Introduction:Occupational therapy has traditionally focused on child development but motherhood as an occupation is rarely analyzed. This study aimed to identify practices, theoretical perspectives, and concepts described or used in occupational therapy research concerning the early periods of motherhood and explore the literature to contribute to the advancement of practice. Method:A scoping review was conducted to map and synthesize multiple perspectives, provide current insights into motherhood as an occupation, and inform occupational therapists' practice. Search across five databases and manual research in periodicals in the area were conducted up to mid-2024. Thematic analysis was used for data analysis. Findings:Eleven articles were included. The analysis revealed three themes: occupational therapy practitioner goals; occupational therapy practices; and theories and concepts supporting the relationship between motherhood, occupation and occupational therapy. The study underscores the limited number of studies available and highlights the need for clearer conceptual definitions and more explicit links between intervention strategies and underlying theoretical frameworks. Conclusion:There is a compelling need for more research to enhance our understanding of the significance of motherhood as an occupation. This understanding will serve as a foundation for refining the role of occupational therapy in supporting motherhood.
Introduction: Yoga is a non-pharmacological intervention that promotes holistic health and helps manage clinical symptoms. There has been growing interest in integrating yoga into occupational therapy to address specific disorders. This systematic review aims to evaluate the current literature on yoga and mood disorders, identifying the potential use of yoga in occupational therapy to manage symptoms and support occupational participation in adults experiencing mood disorders. Methods: Six databases were searched. Data were extracted from 22 peer-reviewed articles published between 2002 and 2024 using the Population, Intervention, Comparison and Outcomes framework. The Critical Appraisal Skills Programme checklist was used for quality appraisal of included studies. The ‘metafor package’ was used to conduct a meta-analysis and generate a forest plot for data synthesis. An I 2 statistic was used to quantify heterogeneity of the meta-analysis, and the trim and fill non-parametric method was used for sensitivity analyses. Results: Yoga has a moderate positive effect in supporting symptom management (i.e. depressive and anxiety symptoms) and daily functioning, including cognitive functioning, of adults experiencing mood disorders. Conclusion: Yoga can mitigate barriers to occupational participation for adults with mood disorders through supporting symptom management. Rigorous studies are needed to establish yoga’s effects on mood disorders.
Introduction: While occupation-based intervention is the core concept of occupational therapy, the ongoing challenge of the medical model’s dominance over occupation-based practices persists worldwide. To facilitate the optimal implementation of occupation-based intervention within the Malaysian context, it is essential to explore pragmatic approaches that consider the developmental stage of the healthcare system, government policies, and the diverse cultural values and psychosocial statuses of the Malaysian population. Methods: Twenty-one experienced Malaysian occupational therapists were recruited through snowball sampling method for three focus group discussions, with each group comprising six to eight participants. Data were analysed by incorporating content and micro-interlocutor analysis. Results: This study presents findings from a large qualitative inquiry, focusing on solutions to enhance OBI in Malaysian occupational therapy practice. These solutions are further classified into five categories: (1) individual level, (2) public level, (3) professional level, (4) system and policy level, and (5) education level. Conclusion: This study highlights the measures that should be implemented at all these levels to ensure comprehensive solutions.
