Occupational Therapy in Oman: The Impact of Cultural Dissonance

Occupations and occupational therapy practice with Chinese older adults living with life-limiting illnesses in Singapore: A focus group study

INTRODUCTION

While Singapore is rapidly ageing and the need for palliative care services is projected to rise, there has been limited exploration of the occupations of Chinese older adults with life-limiting conditions. This study is the third in a series of three studies aimed to address this issue. This study also sought to discuss future directions for occupational therapy practice with Chinese older adults living with life-limiting illnesses in Singapore.

METHOD

The study adopted a qualitative exploratory design using focus groups. Participants were recruited using convenience and snowball sampling. Inclusion criteria were occupational therapists who had attained full registration status with the Allied Health Professionals Council in Singapore, had two or more years of practice as an occupational therapist, and had a current or recent palliative care caseload.

FINDINGS

Three focus groups with 16 participants were conducted, and three themes were constructed from the data through reflexive thematic analysis. Reflections on culture and occupations is about the impact of a collectivist culture on occupations, such as tensions new caregivers experience between keeping clients safe and respecting clients' choices. It also highlights that there will always be individual differences within any cultural group. Challenges of occupational therapy practice in palliative care describe the need for therapists to be comfortable with rest and ethical tensions participants faced with billing for sessions that mainly involved time spent conversing with clients and when clients and caregivers' goals differed. Finally, Moving forward is about the importance of having mentors and the learning needs of occupational therapists in palliative care.

CONCLUSION

Occupational therapists experienced in providing services to palliative care clients in Singapore emphasised the collectivist nature of Singaporean Chinese families and contributed more information to its possible impact on occupations and occupational therapy practice and made suggestions for future practice.

The Effects of Culture and Gender on Occupational Therapy Practice for Adults: From Palestinian Therapists' Perspective

As the occupational therapy profession is rooted in Western ideals, it may encounter complexities in culturally traditional settings like Palestine, especially for adults. This study reveals the challenges faced by occupational therapists in Palestine. A phenomenological qualitative approach was used, interviewing six experienced female therapists using semi-structured interviews. Purposive sampling ensured a diverse participant selection. Thematic analysis revealed several key themes, such as the continuous adaptation to Western practices to fit the Palestinian context, the value of interdependence, and the unique life balance. Results show that cultural and gender norms significantly shape occupational therapy practices in Palestine. The discussion emphasizes the theoretical necessity for cultural sensitivity in occupational therapy, advocating alignment with local values and addressing resource limitations for effective service delivery.

Developing the First Digital Occupational Therapy Dictionary Worldwide: A Promising Mobile Application Model for Occupational Therapy Service Providers and Recipients

The purpose of this study was to develop the first English-Arabic occupational therapy dictionary mobile application that could be used by occupational therapy service providers and recipients and help fill the gap in understanding and communicating occupational therapy services. Google Play Store and App Store application stores were searched first to identify any current electronic occupational therapy dictionary. While developing the dictionary concept and structure, end users' needs, language, and culture were taken into consideration applying a user-friendly design, functionalities, and an easy-to-understand language with illustrative visual representations. Our search for currently available electronic occupational therapy dictionaries did not identify any mobile application on the official application stores for iPhone and Android. As a result, a conceptual model was created to develop a mobile application aiming to develop a comprehensive and user-friendly mobile electronic dictionary with over 2400 scientific terms translated and annotated from English to Arabic, more than 350 illustrative pictures, and special features to assist occupational therapy professionals and occupational therapy services recipients in looking up and understanding terminology used in rehabilitation and occupational therapy in the most convenient, fastest, and easiest way possible. The occupational therapy dictionary mobile application has helped create a unified terminology and a common language of shared understanding, proved to be a helpful tool of communicating important messages between Arab occupational therapy professionals and community members through providing an easy access to up-to-date comprehensive English-Arabic lexicography in occupational therapy. It has become the first digital occupational therapy dictionary worldwide and has been made available for everyone to download from Google Play and App Store on their smartphones, computers, or tablets free of charge. Further research is urgently needed for quality improvement and to further enrich Arabic content in occupational therapy through developing evidence-based mobile tools to be used in occupational therapy practice by Arabic-speaking population.

Occupational therapy practice with terminally ill Chinese older adults in Singapore: A qualitative exploratory study

INTRODUCTION

As the majority of occupational therapy philosophy has Western origins, occupational therapists working with palliative care clients in Singapore can provide invaluable insight into the practice of occupational therapy within a non-Western, family-centric population. This study aimed to describe occupational therapists' perceptions of the occupations of terminally ill Chinese older adults and their caregivers and explore occupational therapy practice with terminally ill Chinese older adults in Singapore.

METHODS

Eleven occupational therapists were recruited via convenience and snowball sampling. Inclusion criteria were being fully registered with the Allied Health Professionals Council (Singapore) with at least 2 years of working experience and currently working with/had experience working with terminally ill patients within the past 2 years. Interviews were transcribed verbatim, and data were analysed using reflexive thematic analysis.

FINDINGS

Five themes were constructed from the data: (1) Independence may not be for everyone, (2) it is a family unit, (3) contributing to others' lives is important, (4) what respecting clients means, and (5) a different way of engaging. These themes describe how occupational therapists adapted their practice to better meet the needs of clients and families in Singapore.

DISCUSSION

In family-centric societies, it may be more relevant for occupational therapists to facilitate interdependence instead of independence in activities of daily living. In addition, activities that contribute to others' lives tangibly/intangibly may be more meaningful and relevant. Finally, occupational therapists could engage clients through the 'being' instead of 'doing' dimension of occupation.

CONCLUSION

While occupational therapists in Singapore faced some challenges working with terminally ill clients and families due to differences between occupational therapy philosophy and practice context, by reframing their thinking, they were able to adapt their practices to meet the needs of a family-centric population.

The Efficacy of a Preoperative Occupational Therapy Educational Session for Saudi Patients Undergoing a Lower Extremity Joint Replacement

Purpose

Prior to a lower extremity joint replacement, many surgical candidates participate in a preoperative occupational therapy educational program that is meant to increase patient awareness, promote positive health behaviors, and improve health outcomes after surgery. With the limited number of occupational therapists in Saudi Arabia, patients may only receive one preoperative educational session. The objective of the study was to explore the efficacy of one preoperative occupational therapy educational session for patients undergoing a lower extremity joint replacement.

Methods

A total of 19 participants were included in the study, 7 participants to the intervention and 12 participants to the control groups. Participants underwent either a total knee or total hip replacement. The intervention group received one preoperative educational session prior to the surgery and the control group received usual care. After the surgery, both groups were assessed on pain (SF-MPQ), Satisfaction (SPSQ), Quality of life (QOLS), functional performance (FIM). Mann-Whitney U-tests were used to compare between groups.

Results

The findings showed significant improvements in both pain (12.14 ± 7.22 vs 21.25 ± 8.60; p=0.02) and satisfaction (106.28 ± 25.17 vs 78.08 ± 31.49; p=0.03) when compared to usual care. Although both FIM and QOLS scores indicated improvements when compared to usual care, these results were not statistically significant. Effect sizes showed moderate and large effects for score differences on both the SF-MPQ and SPSQ (r= 0.47, r=0.52) respectively. Whereas effect sizes for score differences on both the FIM and QOLS were small.

Conclusion

An occupational therapy preoperative education session shows promise for patients undergoing lower extremity joint replacement; however, further research is needed to confirm these findings.

Occupational Therapists' Perceptions of Home Program Provision for Stroke Survivors in a Lower- and Middle-Income Country: An Exploratory Study

This qualitative study aimed to understand occupational therapists' experiences of providing home programs to stroke survivors in India. Using an interpretative phenomenological approach, eight practicing occupational therapists were interviewed in depth about home programs for individuals recovering from stroke. Two broad themes with subthemes emerged describing the organizational factors, sociocultural and economic influences on home program provision as well as describing how the occupational therapists addressed the challenges to facilitate home program provision and adherence. The findings can inform occupational therapy practice in lower- and middle-income countries like India and other countries where existing practice recommendations for stroke rehabilitation and core professional tenets may be challenged.

From the challenge of assessing autonomy to the instruments used in practice: A scoping review

Autonomy is one of the essential components to live a quality life. Monitoring this autonomy is, in effect, essential, to allow the nurses to conceive, implement and evaluate interventions aimed at its promotion or even maintenance. For this reason, this scoping review aims to map the evidence to identify and analyze the instruments used to assess the person's autonomy, which emerges from scientific production.

Methods

Scoping review based on the recommended principles by the Joanna Briggs Institute. The research was realized in the databases: Scopus (excluding MEDLINE), CINAHL complete (via EBSCO, Excluding MEDLINE), and MEDLINE (via PubMed). Two independent reviewers evaluated the articles' pertinence for the study's investigation, the extraction, and synthesis of articles.

Results

After the analysis, according to the inclusion criteria established, 34 articles were selected, allude to 7 different instruments to assess autonomy.

Conclusions

The need for further development at this level is highlighted, namely through the construction and validation of more comprehensive instruments, integrating the different components of the concept of autonomy.

The Influence of Culture on Occupational Therapy Practice in Jordan

Background

Occupational therapy's origins draw from Western culture, values, and beliefs which may impact the application of traditional occupational therapy practice in non-Western cultures.

Purpose

This study explored how occupational therapists in Jordan facilitate occupational therapy practice within Islamic Eastern culture.

Method

A phenomenological approach was used in this study. Semistructured interviews were conducted with eleven occupational therapists that work in Jordan and have at least two years of experience. Data were analyzed using thematic analysis methods.

Results

Three central themes emerged: impact of Jordanian culture and Islamic beliefs about independence and disability on occupational therapy practice, the therapists' notions of ideal occupational therapy practice vs. daily reality, and challenges posed by workspace and the availability of equipment.

Conclusion

This study highlights the growing need to translate and expand the core values of occupational therapy to align with cultures in non-Western countries and cultures.

Barriers and facilitators to cultural competence in rehabilitation services: a scoping review

BACKGROUND

There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services.

METHOD

Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer.

RESULTS

After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems.

CONCLUSION

To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner perspectives as such data can help inform culturally competent practices.

Trauma care in Oman: A call for action

Many Arab countries have undergone the epidemiologic transition of diseases with increasing economic development and a proportionately decreasing prevalence of communicable diseases. With this transition, injuries have emerged as a major cause of mortality and morbidity in the Gulf Cooperation Council countries in addition to diseases of affluence. Injuries are the number one cause of years of life lost and disability-adjusted life-years in the Sultanate of Oman. The burden of injuries, which affects mostly young Omani males, has a unique geographic distribution that is in contrast to the trauma care capabilities of the country. The concentration of health care resources in the northern part of the country makes it difficult for the majority of Omanis who live elsewhere to access high-quality and time-sensitive care. A broader multisectorial national injury prevention strategy should be evidence based and must strengthen human resources, service delivery, and information systems to improve care of the injured and loss of life. This paper provides a unique overview of the Omani health system with the goal of examining its trauma care capabilities and injury control policies.

Client-centred occupational therapy: the importance of critical perspectives

BACKGROUND

The occupational therapy profession has proclaimed itself to be client-centred for over 30 years, but until recently this assertion remained largely unchallenged. Critical thinkers, who have begun to explore client-centred practice in occupational therapy, highlight the necessity for further critical reflection.

AIMS

This paper aims to define what constitutes "critical" thinking; and to persuade occupational therapists of the importance of employing critical perspectives towards the profession's assumptions and assertions regarding occupational therapy's "client-centred" practices.

MAJOR FINDINGS

Critical thinking is not solely a process of carefully and thoughtfully weighing various arguments or evidence, but of additionally appraising the ideological and structural contexts in which these positions or evidence have arisen. Critical perspectives towards occupational therapy's client-centred practices identify the ways in which power is exercised by the profession, and culturally specific and disabling ideologies are perpetuated.

PRACTICE CONCLUSION

Critical thinking enables occupational therapists to reflect on their own inequitable access to privilege and power, and reduces the potential for the profession to re-inscribe dominant ideologies that devalue disabled people and justify their inequitable opportunities. Because critical thinking demands a readiness to restructure one's thinking, and decreases the risk of acting on faulty assumptions, it is an essential component of client-centred practice.

The cultural brokerage work of occupational therapists in providing culturally sensitive care

Background.

The important place of culture within occupational therapy is widely recognized, and there is increasing emphasis on addressing the diversity of clients.

Purpose.

This study explores how occupational therapists perform cultural brokerage when providing culturally sensitive care to immigrant families.

Method.

A descriptive qualitative methodology was used for this study. A purposive sample of 17 occupational therapists from two Canadian paediatric rehabilitation centres were interviewed.

Findings.

Participants encountered several cultural and structural constraints in providing culturally sensitive care. To overcome these constraints, clinicians used four strategies: (a) translating between health systems for clients, (b) bridging different meanings of occupational therapy to make it relevant for clients, (c) establishing long-term relationships by building trust and rapport, and (d) working with clients’ relational networks to help them navigate the health system.

Implications.

Occupational therapists should advocate for both the individual needs of immigrant families and for institutional level resources to better meet the needs of diverse clients.