Type of Findings Generated by the Occupational Therapy Workforce Research Worldwide: Scoping Review and Content Analysis

Situational analysis for informing the global strengthening of the occupational therapy workforce

BACKGROUND

Occupational Therapists are needed for meeting the health, rehabilitation, and occupational needs of the population worldwide, but there is no strategy for strengthening the occupational therapy workforce against a backdrop of an insufficient and inequitable supply worldwide.

OBJECTIVE

To perform a situational assessment of occupational therapy workforce development and research toward informing a global human resources strategy for the occupational therapy workforce strengthening.

METHOD

A multi-methods design incorporating Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis based on scoping review findings, workforce development frameworks, and expert feedback.

RESULTS

Strengths included identified workforce research trends, gaps, and findings. Weaknesses included a shortage of workforce research, lack of uniform and readily available workforce datasets, absence of workforce research programs, over-reliance on descriptive and non-experimental research, lack of research on workforce topics (e.g., diversity), and lack of labor market or economic analyses. Opportunities are the availability of guidance and tools for strengthening the health and rehabilitation workforce worldwide, and increased membership from low- and middle-income countries (LMICs) in the World Federation of Occupational Therapists. Threats include the suboptimal funding of occupational therapy workforce research, the lack of occupational therapists data on international datasets and studies, suboptimal educational capacity in LMICs, lack of professional regulation and uniform workforce data collection in many contexts, and a perceived lower priority of this health workforce focused on health and wellbeing rather than medical outcomes.

CONCLUSION

This SWOT analysis identifies strengths and opportunities to be seized and weaknesses and threats to be addressed by development of a strategy for the global strengthening of the occupational therapy workforce.

Quality of Occupational Therapy Research in India - A Descriptive Review

Background

Occupational therapy (OT) enhances functional independence in the daily activities of people with disabilities and subsequently their quality of life. Research in OT generates evidence to provide safe and effective services to the disabled. However, OT research in India has been shown to have various methodological limitations. These methodological limitations are expected to impact the quality of OT research as well as the evidence derived from this research to inform decision-making in rehabilitation. The majority of the OT research is disseminated and promoted through the All India Occupational Therapists' Association's (AIOTA) annual national conference (ANC). Analyzing the abstracts, selected for the presentation at the ANC could help understand and strategically improve the quality of OT research in India.

Objectives

To explore and describe the quality of OT research in India.

Study Design

Descriptive analysis.

Methods

Descriptive, nonsystematic review and analysis of the key methodological aspects of the conference abstracts submitted for the AIOTA ANC published in the Indian Journal of OT (IJOT) from 2017 to 2021 was carried out. Information related to the methodological aspects of the research abstracts was extracted using a data extraction form and the data were synthesized and reported descriptively.

Results

About 218 abstracts had been selected for either poster or oral presentations in the AIOTA ANC. All the abstracts were included for the review. A total of 8055 participants were recruited for the studies conducted from 2017 to 2021. About 5757 (72%) of the participants were recruited for cross-sectional studies. Nearly 72 (33%) of the abstracts presented were related to cross-sectional studies, 52 (24%) were case studies and 66 (30%) were experimental studies. However, research designs implying highest level of evidence such as systematic reviews were only 4 (2%) and randomized controlled trials were only 9 (4%) with 297 participants. Notably, 203 (98%) of the all the studies evaluating effectiveness of interventions or aiming to investigate associations reported positive results with statistically significant improvements and associations.

Conclusion

The review provides invaluable information related to the quality of OT research in India. It implies the need to improve the scientific rigor of the evidence generated in relation to OT research in India. This review also implies the need for a radical change and strengthening of OT research within OT education and professional practice in India. National and global OT associations need to prioritize good quality OT research by enhancing the research skills and competencies of OTs in India. This could help promote evidence-based OT science and develop the OT profession in the world's second-most populous country. In addition, it is also expected to encourage those OT researchers who have been striving to build OT research standards in India.

Limitations and Recommendations for Advancing the Occupational Therapy Workforce Research Worldwide: Scoping Review and Content Analysis of the Literature

Occupational therapy workforce research can help determine whether occupational therapists exist in sufficient supply, are equitably distributed, and meet competency standards. Advancing the value of occupational therapy workforce research requires an understanding of the limitations and recommendations identified by these investigations. This scoping review and content analysis synthesizes the study limitations and recommendations reported by the occupational therapy research worldwide. Two independent reviews included 57 papers from the past 25 years. Stated limitations included: focus on cross-sectional studies with small and convenience samples; participants from single settings or regions; local markets or preferences not specified; focus on self-reported data and intentions (rather than behaviors or occurrences); challenges in aggregating or synthesizing findings from descriptive data; lack of statistical adjustment for testing multiple associations; and the lack of detailed, up-to-date, and accessible workforce data for continuous monitoring and secondary research. Stated recommendations included: strengthening routine workforce data collection; developing longitudinal studies that include interventions (e.g., recruitment or retention packages); developing context-sensitive comparisons; studying the impact on ultimate outcomes; promoting nation-wide, coordinated workforce plans and requirements; and fostering international coalitions for workforce research and developments at scale. These study limitations and recommendations reported by the literature must be considered in the design of a local and global occupational therapy workforce research agenda.