Independence: an analysis of a complex and core construct in occupational therapy

Author: Bonikowsky Sarah   Musto Amanda   Suteu Kerry Ann   Mackenzie Sherry   Dennis Donna  

Publisher: College of Occupational Therapists

ISSN: 1477-6006

Source: The British Journal of Occupational Therapy, Vol.75, Iss.4, 2012-04, pp. : 188-195

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Abstract

Introduction: Independence is a core concept in occupational therapy, but there is little consensus within the profession upon a universal definition. The present study employed a critical interpretive synthesis to examine two fundamental research questions: 'How is independence conceptualised in quantitative and qualitative research within occupational therapy?' and 'How does the term “independence”, in its present use, critically impact occupational therapy policy and practice?'Method: Articles pertaining to occupational therapy and contributing to the definition of independence within the profession were examined. Three successive levels of coding – open, axial and selective – were used to analyse 19 final articles.Findings: From the literature, nine definition themes emerged: function, autonomy and competence, control, context, culture, environment, personal attributes and safety. These themes were then organised into three categories: personal factors, environmental factors and continuum, which were synthesised together to create a model that addresses all factors critical to the composition of independence. In addition, four clinical themes developed: goal of occupational therapy, client-therapist relationship, variable definitions in occupational therapy practice and limitations of present practice.Conclusion: Through the formalisation of the integral components of independence, this study enables a standardised foundation for the examination of this core concept across the profession.