A phenomenology of occupation-based hand therapy

The existing tension between holistic, occupation focused approaches and the medical model in occupational therapy is most evident in the area of hand therapy. Occupation-based hand therapy has been proposed as a means to alleviate this tension. However, there is a lack of research on occupation-based hand therapy. Clearly describing and defining what constitutes occupation-based hand therapy can facilitate efficacy research and help promote occupation-based practice in keeping with the philosophy of the profession.

The qualitative approach of phenomenology as described by Moustakas was used. Participants who were occupational therapists with more than 5 years of experience who self -identified as occupation-based practitioners were recruited to the point of saturation using criterion and chain sampling for a final total of 10 participants. Data were collected through audio recorded telephone interviews and electronic mail. The data were reduced and distilled into a description of the experience of providing occupation-based hand therapy.

Participants described the experience of providing occupation-based hand therapy around the concepts of influences, psychosocial benefits, procedural elements of practice and challenges.

Findings of this study can assist occupational therapists to develop a more occupation-based intervention program through focusing on occupation-based theory, being intentional, using occupation-focused interventions and building an occupation focused context. Findings can also inform future research into the efficacy of occupation-based hand therapy, appropriate timing for balancing occupation with tissue protection, and the effects of therapist experience on their ability to use an occupation-based approach in hand therapy.