A Qualitative Study Exploring How Occupational Therapists Embed Spirituality Into Their Practice

Abstract

Introduction Spirituality is a concept central to healthcare practice, and in particular to occupational therapy. As a profession, influenced from early Judeo-Christian religious beginnings, occupational therapy has retained yet translated this as a commitment to holistic, person-centred practice. Occupational therapy holds the uniqueness of the individual, and meaningful and purposeful expressions of health and well-being through occupation, as central to professional practice. Set in the context of 21st century healthcare, this thesis explored how occupational therapists (n=4) working in the English National Health Service (NHS) embedded spirituality into daily practice. Methods Two studies were undertaken, first a structured literature review and concept analysis, applying the method outlined by Walker & Avant (2011), to conceptualise spirituality as described in occupational therapy practice. Second, a qualitative study was undertaken, underpinned by an ethnographic approach, using participant-as-observer observation and follow up interviews to explore how occupational therapists embedded spirituality into everyday practice. Framework approach was used to guide analysis and interpret the large volume of unstructured textual data. Findings Despite the difficulties defining spirituality occupational therapists appeared able to apply the underpinning core values and philosophy of the profession and embed spirituality in their practice. Practitioners found it more meaningful to describe spirituality in terms of how they applied the concept in, and through, practice by comprehending the values, needs and concerns of the individual as opposed to a consistent definition. Occupational therapists engaged with spirituality by concerning themselves with supporting patients experiencing vulnerability due to disruption in their health and well-being. This support was achieved by the occupational therapist uncovering the individual needs of the patient and through delivering person-centred care by explicitly addressing spirituality. The scope to embed spirituality was on occasion limited by organisational and contextual factors that restricted the potential to practice fully. Achieving organisational targets by adopting time constrained interventions was perceived as having a particularly limiting impact on embedding spirituality in practice. Conclusion The Embedding Spirituality into Occupational Therapy (ESpiOT) model which emerged from the findings of this study is offered as a tool to guide practice, education and research into how spirituality is, and could be, embedded into occupational therapy practice