British Journal of Occupational Therapy

Republic Act No. 11241, the Philippine Occupational Therapy Law of 2018, grants occupational therapists professional recognition and autonomy. However, systemic barriers continue to limit the integration of occupation-based practice (OBP) in hospitals. This study examines institutional challenges occupational therapists face in implementing occupation-based interventions within the Philippine hospital system.

An interpretive phenomenological study using semistructured interviews was conducted with hospital-based occupational therapists across various healthcare institutions in the Philippines given 4 years of the law’s enactment. Purposive sampling ensured representation of therapists with experience in OBP. Data were analyzed thematically, guided by Bourdieu’s theory of practice, to explore how institutional structures influence occupational therapy practice.

Findings reveal that hierarchical referral systems and biomedical dominance restrict occupational therapists’ autonomy, reinforcing impairment-based rehabilitation over occupation-based interventions. Physician-dependent referral pathways further limit their ability to initiate OBP, restricting interdisciplinary collaboration. Institutional policies, resource constraints, and limited mentorship opportunities exacerbate these challenges.

Despite legal recognition, systemic barriers hinder OBP in Philippine hospitals. Addressing these challenges requires structured hospital policies, referral pathway reforms, and professional development programs. Strengthening interdisciplinary collaboration and mentorship can support occupational therapists in advocating for and integrating OBP into hospital rehabilitation services.

Multicentric Carpotarsal Osteolysis (MCTO) is a rare, genetic disabling disease beginning in early childhood, resulting in the destruction and resorption of carpal and tarsal bones. The aim of this study was to describe the occupational therapy intervention on a child with MCTO to evaluate the impact of the treatment on daily function, autonomy, and participation in activities of daily living.

Interventions focused on self-care, power wheelchair mobility, and environmental adaptations. The Canadian Occupational Performance Measure measured the child’s progress. After 5 months, he was independent in directing his care and driving his power wheelchair; he also increased participation in games and social activities with peers.

The intervention process and the occupational therapist’s role are detailed. This study contributes to future research to create standards of care aimed at improving patients’ functional independence and quality of life.

This study examined the association between mobility decline and occupational participation among community-dwelling older adults using multivariable analysis that adjusted for potential confounders.

A total of 212 older adults were assessed using the locomotive syndrome stage test. Two comparisons were analyzed: (1) Non-mobility decline (stage 0) versus mobility decline (stages 1–3) and (2) preclinical decline (stage 1) versus apparent decline (stages 2–3). Hierarchical binary logistic regression was used to identify associated factors.

In the early comparison, older age (odds ratio (OR) = 1.20) was associated with higher odds of mobility decline, whereas greater monthly group exercise time (OR = 0.99) was protective (both p < 0.05). In the advanced comparison, older age (OR = 1.09) and ongoing illness (OR = 3.31) were associated with higher odds, while current employment (OR = 0.10), greater monthly group exercise (OR = 0.99), stronger grip strength (OR = 0.89 per kg), and higher occupational participation scores (Self-Completed Occupational Performance Index, a subjective measure of participation; OR = 0.94) were protective (all p < 0.05).

Occupational participation was not associated with early mobility decline but was related to advanced decline. These findings provide stronger evidence than previous univariate studies and suggest preventive occupational therapy may prioritize accessible exercise in early stages, while highly individualized support for participation becomes critical in advanced stages.

Self-efficacy plays an integral role in the development of occupational therapy students’ clinical competency during fieldwork education. However, there is still a lack of knowledge surrounding this topic within the context of non-traditional fieldwork education. This study aims to investigate and make meaning of the experiences of occupational therapy students’ and their perceived development of self-efficacy in non-traditional fieldwork placements, known as LEAP placements.

This qualitative phenomenology study, through a descriptive lens, explored sixteen occupational therapy students’ experiences using thematic analysis.

Self-efficacy during LEAP placements was shaped by several factors: a lack of role clarity detracted from development, while the opportunity for self-direction enhanced it. The level of support, preceptor role and availability, perceived value of the learning experience, and placement environment both enhanced and detracted from self-efficacy development.

This study provides an increased understanding of self-efficacy development among occupational therapy students and innovative practices within LEAP placements. Students’ perceptions of self-efficacy development is shaped by complex and nuanced factors.

A client-centred approach ensures that individuals can express what’s most important to them, with therapists providing collaborative support. This study examined factors influencing the quality of collaborative relationships between clients and occupational therapists and explored how the strength of these relationships affects therapy outcomes.

A prospective longitudinal observational study was conducted at day care centres across Japan, with participants followed for 1 year. Occupational therapists delivered occupational therapy guided by a client-centred approach. Outcomes, including daily activities and health-related quality of life, were measured before and after the intervention. The Collaborative Relationship Scale (CRS) was used to assess baseline relationship quality.

Among 101 participants (aged 47–93 years), CRS scores categorised them into good, neutral, and poor relationship groups. Logistic regression revealed that goal achievement and clients’ understanding of occupational therapy were associated with relationship quality. Over 50% of participants in the good relationship group had activities of daily living goals, whereas more than 50% in the poor relationship group had mobility goals.

Strong collaborative relationships may positively influence occupational therapy processes and outcomes. These findings highlight the importance of goal setting within occupational therapy guided by a client-centred approach in enhancing therapeutic relationships.