Experiences of Thai occupational therapists on occupation-based practice in clients with physical dysfunction: a mixed methods study

Abstract

Occupation-based practice (OBP) is a central element in the practice of occupational therapists (OTs), where meaningful and purposeful occupations are associated with assessment, intervention and outcomes. In 2022, there were a total of 1,674 licensed OTs in Thailand, 561 of which worked with clients with physical dysfunctions. This study investigated Thai OTs’ perspectives and experiences of using OBP in clients with physical dysfunctions. An explanatory sequential mixed method was used. In the quantitative study, a questionnaire survey was mailed to 250 participants throughout hospitals and clinics. Descriptive statistics were used to analyze the data. In the qualitative inquiry, nine participants were interviewed and analyzed via thematic analysis. The results showed that 62 participants responded to the questionnaire. Most participants provided services based on clients’ real-life context derived from the OBP (50% strongly agree) and provided clients with the opportunity to choose occupations related to their own context (47% strongly agree). Utilizing OBP enables clients to address the health and conditions of clients with physical dysfunction (37% strongly agree, 47% agree), and OBP is an effective method for treating clients with physical dysfunctions (36% strongly agree, 50% agree). However, factors such as high caseloads and insufficient use of therapists also hindered the use of OBP (32% strongly agree, 34% agree). Furthermore, workplaces and spaces impeded participants from implementing OBP (32% strongly agree, 34% agree). There are also insufficient tools and equipment to train clients (20% strongly agree, 32% agree). Two themes emerged from the interviews: Attitude toward occupation driving OBP into action and factors influencing the use of OBP. When implementing OBP for clients with physical dysfunction, OTs envisage that it is not only about improving occupational performance but also about presenting occupational therapy identity and strengthening beliefs in the power of occupation.