Occupational Therapy in an Ecological Context: Ethics and Practice

The Perceived Role of Occupational Therapists in Climate Change

Introduction. In 2022, the World Health Organization (WHO) predicted that climate change would cause thousands of additional deaths per year from malnutrition, malaria, diarrhea, and heat stress alone between the years of 2030 and 2050. With such health consequences and environmental changes, climate change is impacting human occupations globally. However, there is a gap in the literature regarding the occupational therapists' role in climate change, particularly in the Canadian context. Objectives. Our research aimed to explore what is the perceived role of occupational therapists in climate change and climate action from the perspective of Canadian occupational therapists and international experts. Methods. This qualitative study used interpretive description methodology. We recruited 12 occupational therapists, including 4 research experts in the field. We conducted semi-structured interviews with each participant. Data were analyzed thematically. Results. This study uncovered three themes that focused on the complex interconnections between climate challenges and climate actions that occupational therapists are wrestling with personally, clinically, and professionally. Specifically, this study emphasized the importance of supporting individual occupational therapists with their personal challenges, integrating climate actions into clinical practices, and incorporating climate change and climate justice into occupational therapy curricula and professional advocacy. Conclusions. The environment, including the planet's ecosystem, is a fundamental component in many models of occupational therapy practice. This research provides a rich understanding in the themes of occupational therapists' perceptions of climate change and climate actions, particularly within a Canadian context.

Fostering the discussion of planetary health in occupational therapy and physiotherapy

INTRODUCTION

Occupational therapists and physiotherapists aim to promote health, prevent various diseases and help people in their rehabilitation processes. So far, there is a paucity of understanding of the big picture of how the new paradigm of planetary health (PH) is connected to the education and practice of these professionals.

METHODS

This research aimed to address this gap by investigating and deploying a bibliometric analysis to elucidate the pivotal role of occupational therapists and physiotherapists in addressing PH challenges. The ultimate goal is to construct a comprehensive framework crosschecking the bibliometric analysis and the collection of 10 case studies selected by experts to outline how best practices in occupational therapy and physiotherapy, related to the three pillars of sustainability and the UN's Sustainable Development Goals (SDGs), can contribute to increasing PH.

RESULTS

The bibliometric analysis revealed four major research strands: 1) enhancing patient care and quality of life; 2) integrating sustainability in health care and rehabilitation; 3) professional development and clinical competence; and 4) evidence-based practice and quality improvement. Moreover, further temporal analysis revealed how the topic evolved, from advancing evidence-based practice and clinical effectiveness, exploring the strengthening of health care and person-centred practices, to connecting the topic to aspects also predicted by the SDGs, such as integrating environmental and climate concerns in therapy and addressing psychological and self-care impacts on health. The case studies confirmed this trend, and a framework of PH in occupational therapy and physiotherapy through the lens of the SDGs was developed to support future research and practitioners in advancing this research field.

CONCLUSIONS

Occupational therapists and physiotherapists are essential players in public health and can integrate sustainability at every level of practice, from using resources during therapy sessions to advocating for more sustainable lifestyles.

Occupation in the Anthropocene and Ethical Relationality

Purpose. Occupations have "implications for individuals, societies, and the earth". This article focusses on implications of occupation in relation to the earth and examines the potential to expand occupational justice beyond anthropocentric viewpoints to honour interspecies justice. Approach. A 'theory as method' approach is used to explore the literature. Transgressive decolonial hermeneutics informs analysis. Key issues. The discussion advances understandings about human occupation in relation to more-than-humans, intersections with human occupations and animals, and ethical relationality. Implications. Occupational justice includes honouring interdependence of species, engaging in occupations in ways that are sustainable, considering future generations, and refraining from occupations that have a destructive or detrimental impact on the earth and more-than-humans. The profession has a collective responsibility to honour Indigenous worldviews and Indigenous sovereignty, recognising and welcoming the potential for Western conceptualisations of occupation to be transformed.