Patient experiences and perceptions of occupational therapy services in Chinese rehabilitation: a qualitative study

Patient satisfaction is a critical determinant of rehabilitation outcomes in occupational therapy (OT). In non-Western contexts such as China, cultural norms including high power distance may profoundly shape the therapeutic relationship and patient experience. Few qualitative studies have explored the lived experiences of Chinese rehabilitation patients regarding OT services. This study aimed to explore the experiences and perceptions of Chinese rehabilitation patients regarding their OT services and to identify key factors that promote or hinder patient satisfaction from the patients' perspective. A qualitative descriptive study was conducted using semi-structured interviews with ten participants purposively recruited from a rehabilitation department in China. Data collection continued until data saturation was achieved. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative descriptive thematic analysis, facilitated by NVivo software. The study adhered to the COREQ guidelines, and trustworthiness was ensured through triangulation, member checking, and reflexivity. Thematic analysis yielded four major themes: (1) Pathways to Initiation and Motivation for OT, characterized by passive entry via professional referral and trust in authority; (2) The Lived Experience of the Therapeutic Process, marked by passive compliance, monotonous activities, and a perceived lack of individualized, person-centered care; (3) Perceived Outcomes and Functional Gains, reflected patient-reported gains in physical function, daily living skills, and participation in community life; and (4) Facilitators and Barriers to Satisfaction, with therapist attentiveness and communication emerging as the strongest facilitators, while financial burden constituted the most significant barrier. This study reveals significant tensions between person-centered care ideals and standardized service delivery in Chinese OT practice. To enhance patient satisfaction with occupational therapy services in China, a multi-pronged approach is needed, encompassing strengthened public education and physician rehabilitation literacy to improve referrals, enhanced therapist training in clinical reasoning and individualized activity design, prioritized development of therapeutic communication skills, and integration of modern technology into treatment. Future research should develop culturally adapted shared decision-making models, design interventions to sustain motivation during functional plateaus, and evaluate the impact of policy reforms such as expanded insurance coverage on long-term outcomes.