Exploring the contribution of case study research to the evidence base for occupational therapy: a scoping review

BACKGROUND

Case study research is generating interest to evaluate complex interventions. However, it is not clear how this is being utilized by occupational therapists or how feasible it is to contribute to the evidence base. This scoping review explores case study research within occupational therapy in terms of how it is defined, the methodological characteristics adopted, such as data collection and analysis, and the range of practice contexts in which it is applied. We consider the viability of case study research for contributing to our evidence base.

METHODS

Opinion, text and empirical studies within an occupational therapy practice context were included. A three-step extensive search following Joanna Briggs Institute methodology was conducted in June 2020 and updated in July 2021 across ten databases, websites, peer-reviewed and grey literature from 2016 onwards. Study selection was completed by two independent reviewers. A data extraction table was developed and piloted and data charted to align with research questions. Data extraction was completed by one reviewer and a 10% sample cross checked by another.

RESULTS

Eighty-eight studies were included in the review consisting of (n = 84) empirical case study and (n = 4) non-empirical papers. Case study research has been conducted globally, with a range of populations across different settings. The majority were conducted in a community setting (n = 48/84; 57%) with populations experiencing neurodevelopmental disorder (n = 32/84; 38%), stroke (n = 14/84;17%) and non-diagnosis specific (n = 13/84; 15%). Methodologies adopted quantitative (n = 42/84; 50%), mixed methods (n = 22/84; 26%) and qualitative designs (n = 20/84; 24%). However, identifying the methodology and 'case' was a challenge due to methodological inconsistencies.

CONCLUSIONS

Case study research is useful when large-scale inquiry is not appropriate; for cases of complexity, early intervention efficacy, theory testing or when small participant numbers are available. It appears a viable methodology to contribute to the evidence base for occupation and health as it has been used to evaluate interventions across a breadth of occupational therapy practice contexts. Viability could be enhanced through consistent conduct and reporting to allow pooling of case data. A conceptual model and description of case study research in occupational therapy is proposed to support this.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework 10.17605/OSF.IO/PCFJ6.

The potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation

Purpose: The aim was to examine the potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation.Materials and methods: Interpretive description was applied as the methodology in a 5-month ethnographic fieldwork study, and guided by social practice theory. In total, 115 people with disabilities were included for participant observation, of which 15 participants were recruited for individual walking interviews.Results: Analysis revealed four overlapping themes. Firstly, "Revisiting the Outdoors" appeared to be an overarching theme, which created a basis for "Building Autonomy" among the participants. The varied outdoor experiences empowered the participants to take a more active role in their rehabilitation. These experiences afforded unique opportunities for "Connecting with Community" and, finally, "Embodied Learning" - that could be transferred to home and to other everyday contexts.Conclusion: Outdoor contexts within community-based rehabilitation appeared to hold strong potential for connecting people with disabilities to communities. Although barriers exist, we argue that revisiting the outdoors supports collective awareness and action with the capacity to influence community attitudes more broadly.IMPLICATIONS FOR REHABILITATIONOutdoor contexts within community-based rehabilitation for people with disabilities capitalise on the features of both indoor and outdoor environments with activities that meet shifting individual priorities and needs.Outdoor contexts within community-based rehabilitation offer people with disabilities empowering experiences that are part of the landscape of everyday life and transfer well to home and other environments.Community-based rehabilitation directly involving outdoor contexts and supported by professional skills provides a crucial bridge from individual rehabilitation to community belonging.