British Journal of Occupational Therapy

The recent UK Royal College of Occupational Therapists survey found a significant proportion of respondents expressed an intention to leave the profession despite the majority agreeing that occupational therapy is a rewarding career. This scoping review aimed to synthesize the literature on enablers and barriers to career planning and development for occupational therapists working in mental health.

We searched Embase, CINAHL, Medline, Scopus, Web of Science, TROVE, Research Direct and websites of relevant professional organizations.

Twenty-six papers were included. Most of the articles were set exclusively in Australia and can be categorized into: career planning and development, workforce planning, onboarding, recruitment and retention. Resource shortages, gender, age, unmet expectations, organizational demands and the lack of a career pathway framework were identified as barriers. Enablers of career success include undergraduate mental health practice placements, early career programmes, personal motivation, greater flexibility, professional resilience, leadership training and research opportunities.

A better understanding of the factors that influence career development can facilitate focused recruitment and help retention.

There is a small and low-quality body of evidence to support bed positioning as an intervention. Difficulties in developing the evidence base through experimental studies have been recognised and further research has been recommended.

Using a qualitative descriptive design, 13 occupational therapists were recruited from a health board in Wales, UK. Two separate focus groups (n = 5 and n = 8) were held using a semi-structured interview schedule. The data were analysed using Braun and Clarke’s six-stage approach to thematic analysis.

Five key themes were established. These relate to role ambiguity, variations across services, the need for training, recognising bed positioning as an individualised intervention, and effectiveness of the intervention.

The following key findings and recommendations are outlined: (1) Bed positioning interventions are individualised. (2) The optimal timing of bed positioning assessments and interventions for inpatients is debated. (3) Multidisciplinary involvement is needed for effective implementation of bed positioning interventions. (4) Variations across services exist, causing inconsistencies in service provision. (5) More training and support in this area of practice are desired by occupational therapists. (6) More research into the clinical effectiveness of bed positioning interventions is welcomed to support clinical justification.

The Empathic Communication Coding System (ECCS) is a promising measure of such behaviors, yet its reliability remains largely unestablished. The aim of the study was to examine the intra-rater and inter-rater reliability of the ECCS.

Transcripts of occupational therapy audio recordings were used to examine the reliabilities. Two occupational therapists were trained to evaluate the data for inter-rater reliability, and one of them evaluated the data twice for intra-rater reliability. Transcripts of 20 patients treated by 18 therapists were evaluated for intra-rater reliability. Transcripts of 25 patients treated by 22 occupational therapy interns were evaluated for inter-rater reliability. Adult rehabilitated patients with basic verbal communication ability were recruited. The percentage of agreement and Cohen’s κ were calculated as the indices of reliability.

The results showed acceptable intra-rater reliability but poor inter-rater reliability of the ECCS.

The ECCS demonstrates potential as a reliable tool for assessing empathic behaviors over time when evaluated by the same raters.

Increased cancer survivorship has prompted focus on optimising quality of life, including work reintegration. Despite frequently cited return-to-work barriers for women with breast cancer, there are no conclusive work-focused interventions for this cohort. The aim of this study was to assess feasibility and acceptability of a self-management intervention supporting return-to-work for women with breast cancer.

A mixed-methods single-arm feasibility study evaluated intervention feasibility. Participants completed an online occupational therapy-led ‘Work and Cancer’ intervention over 6 weeks. Feasibility was determined by recruitment, adherence, retention and acceptability. Acceptability was also assessed through semi-structured interviews. Data were analysed using descriptive statistics and thematic analysis.

Ten out of twelve participants who were approached, participated in the study. Retention and adherence was 100% and 90%, respectively. Every participant completed pre- and post-measures. Qualitative data indicated online and group format as enablers to intervention completion and juggling employment as a barrier.

It is feasible to recruit and retain participants to the ‘Work and Cancer’ intervention which was widely accepted by women with breast cancer. Large-scale evaluation will determine intervention effectiveness on work and health-related outcomes.

Professional reasoning is important in making informed and autonomous decisions and practice-based learning provides an opportunity for students to develop this. This study explores the experience of professional reasoning during practice-based learning from the student’s perspective.

A dialogical approach was used, and this is a qualitative approach rooted in the analysis of dialogue and subjectivity. It is based on the philosophy of Mikhail Bakhtin. Bakhtin suggests speech is composed of different genres indicating how we position ourselves in relation to others. Twelve occupational therapy students were interviewed after their final practice placement.

Professional reasoning during practice-based learning was experienced as complex, multifactorial and contextually influenced. It was a means of enacting, affirming, and negotiating a professional identity, and of being socialised into the reasoning of the profession. Person and occupation-centred values, narrative and empathy influenced students’ reasoning but could conflict with educator and institutional demands. The findings also illustrate the emotionality of learning to reason.

Both the cognitive and affective aspects of learning to reason need consideration when supporting students. Educators and universities need to address the emotionality associated with reasoning and support students to develop person and occupation-centred practice within the pragmatic constraints of practice.

Occupational balance, a foundational concept in occupational therapy and science, plays a critical role in enhancing health and well-being. Recent studies have revealed its association with epidemiological factors. This study evaluated the validity and reliability of the Japanese version of the Occupational Balance Questionnaire 11 (OBQ11-J).

Adhering to the COnsensus-based Standards for the selection of health Measurement INstruments and Rasch Reporting Guidelines for Rehabilitation Research, analyses were conducted on the OBQ11-J using a cohort of 462 generally healthy individuals.

The mean OBQ11-J score was 17.7 ± 5.1, ranging from 2 to 33. Two items (Items 1 and 9) exhibited ceiling effects. The 4-point rating scale was validated. Although two items (Items 1 and 10) did not strictly conform to the Rasch model, the overall one-dimensionality and single-factor structures were supported. This confirms the structural validity of the OBQ11-J with its 11 items and 4 rating stages. Reliability, assessed through internal consistency, person separation reliability and test–retest reliability, further affirmed the instrument’s robustness.

The OBQ11-J demonstrated validity and reliability in a sample of healthy Japanese individuals. Future investigations should establish normative values for the Japanese population and examine criterion-related validity, responsiveness and interpretability.