Factors Influencing Occupation-Based Practice in Physical Dysfunction: Perspectives of Thai Occupational Therapists

Occupation-based practice (OBP) is a core concept in occupational therapy, integrating meaningful and purposeful occupations into assessment, intervention, and outcomes. There were 561 Thai occupational therapists who specialize in treating clients with physical dysfunction who participated in this study. This study was aimed at examining the perspectives and experiences of occupational therapists using OBP for clients with physical dysfunction.

In the survey phase, there was an online survey conducted using a Google survey found on a social media platform that was listed as the official website, and the results were analyzed using descriptive statistics. In the interview phase, nine participants were interviewed, and their responses were analyzed through thematic analysis.

Sixty-two participants responded. Quantitative and qualitative results were integrated. Forty-seven percent strongly agreed, and 39% agreed that allowing clients to choose relevant occupations was essential. Fifty percent strongly agreed and 40% agreed that OT services should be based on real-life contexts. OBP was also used to encourage clients to pursue more occupations (47% strongly agreed, 48% agreed). The interviews support the notion that attitudes toward occupation drive OBP. When addressing the role of facilitators, 37% strongly agreed and 47% agreed that clients were key in enabling OBP. Therapists found OBP effective for treatment (36% strongly agreed, 45% agreed). Barriers included insufficient time for OBP (21% strongly disagreed, 39% disagreed) and that there are inadequate clinical settings (23% strongly disagreed, 34% disagreed). These findings concurred with interview data which highlighted limited time and inadequate space as key factors influencing OBP.

The core features of OBP are client-centered goals, implementation, motivation, and engagement, highlighting the importance of occupation in practice. Influencing factors include clients, therapists, policies, service systems, and clinical settings. When implementing OBP, therapists should consider these factors and their relationships.