Maggie McDougall, MScOT, OT Reg. (Ont.), is Occupational Therapist, Outpatient Neurological Rehabilitation/Hand & Upper Limb Rehabilitation, Health Sciences North, Sudbury, Ontario, Canada.
Raven Brooks, MScOT, OT Reg. (Ont.), is Occupational Therapist, NEO Kids Children's Treatment Centre, School Based Rehabilitation Services and Preschool Assessment and Therapy, Health Sciences North, Sudbury, Ontario, Canada.
Am J Occup Ther. 2023 Jul 1;77(4). doi: 10.5014/ajot.2023.050015.
Wicked problems are those that are messy and complex and have no obvious solution. Occupational therapists and their clients encounter wicked problems in all areas of practice, and therefore it is essential that they know how to address them.
To identify the key constructs involved in addressing wicked problems, discover considerations for occupational therapists, and develop a conceptual model that supports how to address these problems.
This study had a critical review design and focused on literature from sectors such as health care, social services, policy, business, management, and leadership. It followed a traditional critical review process and extracted records from Scopus, CINAHL and Ovid databases.
A total of 36 articles were included in the review. The results indicated that, to address wicked problems, one must first identify the problem as wicked. The key constructs identified in the literature include collaboration, leadership, perspectives, and innovation, with collaboration and leadership as the most prominent constructs. Subthemes include interdisciplinary teams and diverse perspectives, visualizing interdependencies, team communication, leadership style, leadership communication, and shared vision.
The key constructs identified in this review are interconnected and imperative when addressing wicked problems as depicted in the new Addressing Wicked Problems conceptual model. Occupational therapists are well suited to extend between the traditional role and be key stakeholders in addressing wicked problems by using their leadership and collaboration skills and attitudes. What This Article Adds: Collaboration, leadership, perspective, and innovation are the key constructs for addressing wicked problems. The Addressing Wicked Problems conceptual model highlights the interconnectedness of these constructs.
重要性：棘手问题是指那些混乱且复杂，没有明显解决方案的问题。职业治疗师及其客户在实践的各个领域都会遇到棘手问题，因此，他们必须知道如何解决这些问题。
目的：确定解决棘手问题所涉及的关键结构，发现职业治疗师应考虑的问题，并开发一个支持解决这些问题的概念模型。
设计：本研究采用批判性审查设计，重点关注医疗保健、社会服务、政策、商业、管理和领导等领域的文献。它遵循传统的批判性审查过程，从 Scopus、CINAHL 和 Ovid 数据库中提取记录。
结果：共有 36 篇文章纳入综述。结果表明，要解决棘手问题，首先必须将问题识别为棘手问题。文献中确定的关键结构包括协作、领导力、观点和创新，其中协作和领导力是最突出的结构。子主题包括跨学科团队和多样化的观点、可视化相互依存关系、团队沟通、领导风格、领导沟通和共同愿景。
结论和相关性：本综述中确定的关键结构是相互关联的，在解决新的“解决棘手问题”概念模型中描述的棘手问题时至关重要。职业治疗师通过运用他们的领导和协作技能和态度，非常适合在传统角色之外，成为解决棘手问题的关键利益相关者。本文增加的内容：协作、领导力、观点和创新是解决棘手问题的关键结构。“解决棘手问题”的概念模型突出了这些结构的相互关联性。
