Ashby Samantha E, Ryan Susan, Gray Mel, James Carole
School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia.
Aust Occup Ther J. 2013 Apr;60(2):110-9. doi: 10.1111/1440-1630.12012. Epub 2012 Dec 20.
BACKGROUND/AIM: Mental health practice can create challenging environments for occupational therapists. This study explores the dynamic processes involved in the development and maintenance of professional resilience of experienced mental health occupational therapy practitioners. It presents the PRIOrity model that summarises the dynamic relationship between professional resilience, professional identity and occupation-based practice.
A narrative inquiry methodology with two phases of interviews was used to collect the data from nine experienced mental health practitioners. Narrative thematic analysis was used to interpret the data.
Professional resilience was linked to: (i) professional identity which tended to be negatively influenced in contexts dominated by biomedical models and psychological theories; (ii) expectations on occupational therapists to work outside their professional domains and use generic knowledge; and (iii) lack of validation of occupation-focussed practice. Professional resilience was sustained by strategies that maintained participants' professional identity. These strategies included seeking 'good' supervision, establishing support networks and finding a job that allowed a match between valued knowledge and opportunities to use it in practice.
For occupational therapists professional resilience is sustained and enhanced by a strong professional identity and valuing an occupational perspective of health. Strategies that encourage reflection on the theoretical knowledge underpinning practice can sustain resilience. These include supervision, in-service meetings and informal socialisation. Further research is required into the role discipline-specific theories play in sustaining professional values and identity. The development of strategies to enhance occupational therapists' professional resilience may assist in the retention of occupational therapists in the mental health workforce.
背景/目的：心理健康实践会给职业治疗师创造具有挑战性的环境。本研究探讨了经验丰富的心理健康职业治疗师职业复原力发展与维持过程中涉及的动态过程。它提出了PRIOrity模型，该模型总结了职业复原力、职业认同和基于职业的实践之间的动态关系。
采用分两个阶段进行访谈的叙事探究方法，从九位经验丰富的心理健康从业者那里收集数据。使用叙事主题分析法对数据进行解读。
职业复原力与以下方面有关：（i）职业认同，在以生物医学模式和心理学理论为主导的背景下，职业认同往往受到负面影响；（ii）对职业治疗师在其专业领域之外工作并运用通用知识的期望；（iii）缺乏对以职业为重点的实践的认可。职业复原力通过维持参与者职业认同的策略得以维持。这些策略包括寻求“良好”的督导、建立支持网络以及找到一份能使有价值的知识与在实践中运用这些知识的机会相匹配的工作。
对于职业治疗师而言，强大的职业认同以及重视职业健康视角能够维持并增强职业复原力。鼓励对实践基础理论知识进行反思的策略可以维持复原力。这些策略包括督导、在职会议和非正式社交活动。需要进一步研究特定学科理论在维持职业价值观和认同方面所起的作用。制定增强职业治疗师职业复原力的策略可能有助于留住心理健康工作队伍中的职业治疗师。
