Collins Bethan
a Directorate of Occupational Therapy, School of Health Sciences , The University of Liverpool , Liverpool , UK.
Scand J Occup Ther. 2017 Nov;24(6):398-409. doi: 10.1080/11038128.2016.1271011. Epub 2017 Jan 12.
The concept of independence is common in occupational therapy theory and practice but has rarely been clearly defined or conceptualized within in occupational therapy literature and there seems to be no standard definition. This can result in ambiguity, which potentially jeopardizes client-centred practice.
This paper proposes an occupational therapy independence framework (OTIF) that synthesizes the range of characterizations of independence in a practically useful and occupation-centred manner.
A review of literature, clinical experience, doctoral research and conversations with occupational therapists and disabled people, in particular those involved in a disability activism group and people with physical disabilities, has led to the development of the OTIF.
Independence and interdependence, as characterized in the OTIF, occur when an individual exerts choice over occupational performance and can engage in occupations in a manner acceptable to the individual. Interdependence results when occupations are performed with another person whereas independence involves solitary occupational performance. Dependence typically results from inability to choose occupations or a mismatch between performance capacity and environmental factors.
The OTIF has the potential to clarify the conceptualization of independence within occupational therapy theory and practice. This initial proposal is presented to stimulate debate and discussion.
独立的概念在职业治疗理论与实践中很常见，但在职业治疗文献中很少得到明确界定或概念化，似乎也没有标准定义。这可能导致歧义，进而可能危及以客户为中心的实践。
本文提出一个职业治疗独立框架（OTIF），以一种切实有用且以职业为中心的方式综合各种独立的特征描述。
通过对文献、临床经验、博士研究的回顾，以及与职业治疗师和残疾人（特别是那些参与残疾维权团体的人和身体残疾者）的交流，促成了OTIF的形成。
如OTIF所描述的，当个体对职业表现施加选择并能够以个人可接受的方式参与职业活动时，独立和相互依赖就会出现。当与他人一起进行职业活动时会产生相互依赖，而独立则涉及独自的职业表现。依赖通常源于无法选择职业或表现能力与环境因素不匹配。
OTIF有可能澄清职业治疗理论与实践中独立的概念化。提出这一初步提议是为了激发辩论和讨论。
