Colaianni Donna J, Provident Ingrid, DiBartola Leesa M, Wheeler Steven
Department of Occupational Therapy, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Department of Occupational Therapy, Chatham University, Pittsburgh, Pennsylvania, USA.
Aust Occup Ther J. 2015 Jun;62(3):177-86. doi: 10.1111/1440-1630.12192. Epub 2015 May 5.
BACKGROUND/AIM: The existing tension between holistic, occupation focused approaches and the medical model in occupational therapy is most evident in the area of hand therapy. Occupation-based hand therapy has been proposed as a means to alleviate this tension. However, there is a lack of research on occupation-based hand therapy. Clearly describing and defining what constitutes occupation-based hand therapy can facilitate efficacy research and help promote occupation-based practice in keeping with the philosophy of the profession.
The qualitative approach of phenomenology as described by Moustakas was used. Participants who were occupational therapists with more than 5 years of experience who self -identified as occupation-based practitioners were recruited to the point of saturation using criterion and chain sampling for a final total of 10 participants. Data were collected through audio recorded telephone interviews and electronic mail. The data were reduced and distilled into a description of the experience of providing occupation-based hand therapy.
Participants described the experience of providing occupation-based hand therapy around the concepts of influences, psychosocial benefits, procedural elements of practice and challenges.
Findings of this study can assist occupational therapists to develop a more occupation-based intervention program through focusing on occupation-based theory, being intentional, using occupation-focused interventions and building an occupation focused context. Findings can also inform future research into the efficacy of occupation-based hand therapy, appropriate timing for balancing occupation with tissue protection, and the effects of therapist experience on their ability to use an occupation-based approach in hand therapy.
背景/目的：整体的、以职业为重点的方法与职业治疗中的医学模式之间现存的紧张关系在手部治疗领域最为明显。基于职业的手部治疗已被提议作为缓解这种紧张关系的一种手段。然而，关于基于职业的手部治疗的研究却很匮乏。清晰地描述和界定什么构成基于职业的手部治疗有助于疗效研究，并有助于推动与该专业理念相符的基于职业的实践。
采用了穆斯塔卡斯所描述的现象学定性方法。招募了自我认定为基于职业的从业者且有超过5年经验的职业治疗师作为参与者，使用标准抽样和链式抽样直至饱和，最终共有10名参与者。通过电话录音访谈和电子邮件收集数据。对数据进行简化和提炼，形成对提供基于职业的手部治疗体验的描述。
参与者围绕影响因素、心理社会效益、实践程序要素和挑战等概念描述了提供基于职业的手部治疗的体验。
本研究结果可帮助职业治疗师通过关注基于职业的理论、保持目的性、使用基于职业的干预措施以及构建以职业为重点的环境，来制定更基于职业的干预方案。研究结果还可为未来关于基于职业的手部治疗疗效、平衡职业与组织保护的适当时间以及治疗师经验对其在手部治疗中运用基于职业方法能力的影响的研究提供参考。
