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What are the characteristics of occupation-centred practice in hand therapy? A Delphi study

Why is the research being conducted?

Occupation-centred practice encourages occupational therapists to ensure occupation sits at the centre of the way they think about and work with clients across all stages of the occupational therapy process. Therapists who practice in an occupation-centred way prioritise the use of occupation-based assessments and interventions; drawing on related knowledge and skills when required.

For occupational therapists working in hand therapy, biomedical and biomechanical knowledge strongly influences the way clinicians work with their clients. Assessment tools and intervention strategies most commonly target impairment at the level of body functions and structures with the assumption that improvement in these domains will translate to improved occupational performance and engagement. However, there is an emerging body of evidence which suggests a top-down occupation-centred approach to hand therapy may contribute to superior outcomes for clients compared to a bottom-up impairment focused approach.

There is a need to add to the body of research and knowledge around occupation-centred practice in hand therapy. Before this can take place, agreement should be reached regarding the description of characteristics central to this perspective. This study aims to use a Delphi methodology to achieve consensus from experts who practice hand therapy in an occupation-centred way.

Procedure for completing the survey

Participants will be asked to complete three online surveys with the intent of describing and prioritising key characteristics of occupation-centred hand therapy.

The first survey will briefly outline features of occupation-centred practice. Participants will then be asked to name and describe up to ten characteristics of occupation-centred practice specific to hand therapy.

Questions for the second survey will be based on the characteristics and descriptions identified by all participants in the first survey. Participants will be provided with a series of characteristics and asked to rate the extent to which they agree that each is a feature of occupation-centred hand therapy. Participants will also be asked to rate the importance of each characteristic using a Likert scale. There will be an opportunity for participants to make comments for clarification and/or elaboration if required.

Information gathered from the second survey will be used by the research team to refine characteristics and descriptions of occupation-centred hand therapy practice. Participants will be presented with these in the third survey, and asked to indicate the extent to which they agree with each characteristic and/or description using a Likert scale.

It is anticipated surveys will be distributed over a 3-6 month period to allow for data analysis to take place in between each round. Results will be shared with participants between each round. Support will be offered by the research team through regular email communication.

Eligibility criteria

To ensure knowledge and skills are consistent with perceived expertise, inclusion criteria have been established and are as follows:

  • Registered occupational therapist or equivalent
  • Currently working as a clinician in hand therapy or;
  • Currently teaching content related to the practice of hand therapy in a World Federation of Occupational Therapists (WFOT) approved education program or;
  • Published on the topic of occupation-centred hand therapy;
  • Sufficient knowledge of the English language to complete surveys

How anonymity of data will be ensured

Privacy and confidentiality will be maintained at all stages of the research project. Potential participants will need to initially contact the research team via email or through an ‘expression of interest’ form; however once enrolled in the study, all data will be de-identified. The data will be stored securely on a password-protected storage service that is only accessible by the researchers. The findings will be reported in published research with no identifying information. All data will be stored for five years after the publication of the research and will then be destroyed.

Deadline for completion/closure of survey

To be confirmed depending on timing of advertisement publication, and time taken to analyse data between rounds. Approximate timeline is as follows:

Round 1- Commences: 18/09/2023 - Closes: 15/10/2023

Round 2 - Commences: 6/11/2023 - Closes: 19/11/2023

Round 3 - Commences: 4/12/2023 - Closes: 17/12/2023

For more information and to submit your interest please click here.