An international perspective on occupational therapy: understanding of OT and contextual influences on practice.

Introduction: Occupational therapy practices reflect epistemological and ontological perspectives through social, contextual and cultural understandings. In order to embrace the diversity of occupational therapy, there is a need to explore whether universal perspectives exist in occupational therapy practice, regardless of the context they work in. As well as the range of perspectives used by occupational therapists worldwide. Objectives: The objective is to explore how occupational therapists from countries around the world (Chile, South-Africa, Tanzania, Germany, Norway, Iran, Palestine, Australia, Netherlands, United Kingdom, Romania) understand and perform occupational therapy. Method: We used a qualitative study design with open individual interviews (n=31), where the therapists elaborated on their everyday practice as an OT, the setting for performing occupational therapy, and their descriptions of their profession. The material was analyzed using thematic analysis. Results and Practice Implications: Preliminary results shows occupational therapy as embedded in different contexts; a medical discourse where medical doctors decide who will have access to occupational therapy and the focus of therapy on eg. fine motor skills training, and an everyday discourse where occupational therapists meet everyday problems. This was particularly visible in practices in South Africa, Chile and Palestine, where therapists might deal with more existential everyday problems such as poverty and living under occupation. Conclusion: Occupational therapy practices worldwide reflect an epistemology of westernized models and theories. The ontology of social, contextual and cultural understandings is in the findings reflected by a range between an everyday understanding of existential problems, and a medical understanding from another perspective.