OT and Interprofessional Collaborative Practice in Low-Vision Service Delivery in Rural,Micropolitan,and Urban Practice Settings

Low vision influences quality of life through its effects on nearly all areas of occupation. Prevalence of low vision is on the rise, and global rates have been found to be higher in rural areas, often due to lack of access to health services. Providers of low vision services work to improve functional deficits, and when done collaboratively can further enhance quality of life. Although occupational therapists are service providers for individuals with low vision, it is recognized that no one health care profession alone can meet the needs of persons with low vision. Thus, an interprofessional team model of care has emerged as the goal when treating clients with low vision. Interprofessional collaboration involves partnering as a team to ensure the most efficient and effective approach for improving health and quality of care. Collaboration results from a team-based and client-centered approach that incorporates the client, his or her family, and the broader context of community with healthcare professionals to build partnerships and develop shared decision making. Limited research exists regarding the extent to which low vision providers collaborate in order to enhance client care, even more so regarding rural practice. As such, the purpose of this study was to explore collaborative practice among occupational therapists treating clients with low vision.

This study utilized a cross-sectional, survey design, which was disseminated to occupational therapy practitioners across the United States. In total, 84 completed surveys were returned and included in data analysis. Respondents included occupational therapists (n=73) and occupational therapy assistants (n=11). Years of practice ranged from one to 46 years (M = 17). Occupational therapy practitioners from all populations strongly agreed or agreed that collaborative practice is important when treating clients with low vision. Despite this, only 69% (n=58) reported collaborating with at least one other professional, while 23 reported that they did not collaborate with other professionals during service provision among clients with low vision. Largely, collaboration occurred as a means of providing holistic care, with 36.9% of respondents highlighting this option as to why they decide to collaborate with other members of the low vision team. Overall, the majority of practitioners reported agreeing with the importance of collaboration (M =1.90, SD = .989), a few (n=5) practitioners reported disagreeing or even strongly disagreeing that they would benefit from learning more about the roles of other professionals who serve clients in low vision. Additional analysis included Chi Square testing.

Despite research emphasizing the importance of collaborative models to foster quality of life and holistic outcomes for clients affected by low vision, literature regarding variation in these proposed models based on location of service delivery is lacking. Findings of this study indicate that collaboration does in fact occur in all settings, despite differences in the method of such collaboration. Not surprisingly, optometrists were the most frequent professional with whom occupational therapists collaborate. Literature emphasizes the need to include physical therapists, orientation & mobility specialists, social workers, and occupational therapists in a low vision rehabilitation team. Overall, these professionals are included in collaboration less often than optometry or ophthalmology when treating clients experiencing low vision. Continued research in the area of collaborative practice in rural areas is needed to guide low vision services, interprofessional collaboration, and interprofessional education in order to improve care and overall quality of life for individuals with low vision.

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