Arab healthcare professionals’ knowledge and perception of occupational therapy

Abstract

Background

Occupational therapy (OT) services are not widespread and not well-represented or integrated into many healthcare settings. As a result, OT is not available at many clinical and rehabilitation institutions, which has led to both poor access and reduced knowledge and benefit from OT in many countries worldwide and in the Arab region.

Objective

To examine Arab healthcare professionals’ level of knowledge and perception of OT in an attempt to identify what action is required to enhance awareness and promote OT profession.

Methods

A descriptive online survey was conducted for healthcare professionals from different disciplines and Arab countries to obtain their knowledge and perceptions of OT.

Results

A total of 281 healthcare professionals completed the survey (57% were male). Of the total, only 96 (34.2%) have had worked with OT before, 144 (51.2%) were uncertain about the main domain of OT, 98 (34.9%) were not fully aware of the diverse OT healthcare work settings and different health conditions handled by OT, and 126 (44.8%) were not sure about the difference between OT and physical therapy (PT). Almost two third of the sample (187; 66.5%) were not satisfied with their knowledge of OT, 195 (69.4%) showed interest in learning further about OT, and 209 (74.4%) agreed that OT plays a vital role in the interdisciplinary rehabilitation team. There were significant associations between the participants’ knowledge of OT and their specialty (p = 0.01) and years of experience (p = 0.02).

Conclusion

Most Arab healthcare professionals perceive OT as playing a vital role in the interdisciplinary rehabilitation team. However, OT is not clearly understood and healthcare professionals are not well-educated about OT services and benefits. There is an emerging need to educate healthcare professionals on the focus areas of OT practice. Promoting and advocating for OT is key and crucial.

Introduction

Occupational therapists (OTs) help people of all ages from newborns to older adults improve health and quality of life. OTs help individuals to participate in daily occupations through the therapeutic use of everyday activities [1]. It is an absolute essential to helping people regain their independence and ability to do what they love and enjoy in life. Occupational therapy (OT) profession is viewed as equal as other health professions. OT is a holistic and client-centered health profession concerned with promoting health and well-being [2]. OT is recognized by the World Health Organization (WHO) as a health profession which is represented through the World Federation of Occupational Therapists (WFOT) [3]. WFOT was established in 1952 and is the official international organization that supports and promotes the OT profession [4]. The profession originally developed from a combination of other professional backgrounds such as nursing, psychiatry, creative arts, and crafts as well as architecture. As members of interdisciplinary health teams, OTs work with other health professionals and share OT’s unique body of specialist knowledge on occupation [5, 6]. Evidence-based OT has been used along with other health and medical interventions in treating patients with diverse diagnoses and age groups and has demonstrated its use and effectiveness in managing symptoms and enhancing and/or maintaining functional performance for persons with disabilities [7]. The cases and conditions that the OT evaluates and handles vary, such as but not limited to mental health, psychiatric and psychosocial conditions (i.e., depression, anxiety), pediatric and developmental conditions (i.e., developmental delays, autism), geriatric conditions (i.e., dementia Alzheimer type), neurological conditions (i.e., stroke, spinal cord injuries, hand injuries), physical conditions (i.e., burns, fractures), and any other conditions that lead to poor functional performance for individuals [8].

Occupational therapy is a growing healthcare profession and the job outlook for OT practitioners is promising. The number of WFOT member organizations has been increasing dramatically. The WFOT report of 2020 indicates that worldwide, there are more than 580,000 practicing OTs, 63,000 practicing OT assistants, 900 approved OT education programs, and 100,000 OT students studying in WFOT-approved programs [9]. Despite this dramatic development, recent studies reported that OT is still not well-known or understood and people lack knowledge and awareness of the OT profession [10]. A study indicated that health care professionals have poor knowledge about OT (49.35%) with the highest percentage of knowledge about OT in physicians (51.97%) [11]. Another study indicated that few members of the public, including even patients who receive OT services, know how to describe the occupational therapist’s role. On the other hand, you would find most people are able to identify the role of doctors, nurses, and physiotherapists [12]. A more recent study indicated that knowledge and awareness about OT are essential for the delivery of quality care to all patients [13]. However, this study reported that only 59.1% of the medical and health sciences students have heard of OT, 67.3% were not satisfied about their knowledge in OT, and 89.8% showed interest to be educated about OT. Unfortunately, overall, little mention is made on the important role of rehabilitation and OT in helping persons with disabilities improve their quality of life [14]. Additionally, OT services are not widespread and not well-represented or integrated into many rehabilitation services. As a result, OT is not available at many clinical and rehabilitation institutions, which has led to both poor access and reduced benefit from OT in many countries worldwide [15]. This may be due to lack of governmental and private sector support, weak promotion, and limited public educational campaigns that would enhance awareness of the OT profession [12, 16].

Therefore, the main purpose of the current study was to examine the level of knowledge and perceptions of healthcare professionals of the OT profession. The secondary objectives were to contribute to the ability to promote learning and knowledge development in the field of OT and to enhance awareness of this important healthcare profession among healthcare professionals.

Methods

An online survey consisting of a four-part questionnaire was developed incorporating personal information, knowledge about OT, OT domain of concern, and the current state of OT. The survey was administered and shared online through Google Forms. Participants were healthcare professionals from different disciplines and countries and were asked to complete the survey during a 3-week period in January 2021. The survey consisted of 18 questions and took only 5–10 min to be completed. These questions examined healthcare professionals’ knowledge about the OT profession and explored possible ways on enhancing their awareness of OT and interest in learning more about it. This study was approved from the research and ethical committee at Batterjee Medical College. Consent forms were obtained from all participants. The inclusion criteria for participants recruited for this study were Arab healthcare professionals practicing in Arab countries, 18 years of age or older, high school degree as a minimum academic qualification with minimum 1 year of experience, and willingness to express ideas and opinions about OT profession. Descriptive statistics of simple percentages and frequencies of participants’ responses were calculated to analyze demographics and survey results. Cross-tabulations of the response variables performing the Pearson’s chi-square test were used to determine whether awareness and knowledge rates were different across different specialties and years of experience. The data was analyzed using IBM SPSS Statistics 22.

Results

Demographics of participants

A total of 281 healthcare professionals participated and filled the online survey. Of the total, 57% were male and 43% were female. Healthcare professionals were from different Arab countries (see Fig. 1) and specialties and had different years of experience (see Table 1).

Fig. 1

Arab countries of healthcare professionals participated in this study

Table 1 Survey participant demographics (N = 281)

Participant responses

Table 2 provides a summary of healthcare professionals’ responses participated in this study (see Table 2). There were significant associations found in this study between the participants’ knowledge of OT and their specialty (p = 0.01) and their years of experience (p = 0.02). However, there were no significant associations between the participants’ knowledge and academic qualification (p = 0.20).

Table 2 Participants’ responses (N = 281)

Discussion

Promotion of the OT profession in the local and global community is essential and enhances health and quality of life for all people. This paper reports on a third phase of a research project entitled “Promoting and Enhancing Awareness/Perceptions of Occupational Therapy Profession”. In the first phase, we launched a series of public awareness campaigns to promote OT by (1) conducting a series of extracurricular activities targeting high schools and university students; (2) communicating and answering questions related to OT practice and services; (3) utilizing social media and digital marketing to reach large audience; (4) developing webpages (in both Arabic and English); (5) providing OT webinars, instructive infographics, educational videos, therapeutic tools, and community resources that highlight OT benefits to the public; and (6) advocating the OT profession and identifying its positive significant contributions to health through research and community service [17, 18]. In the second phase, a study entitled “Perceptions of the occupational therapy profession among medical and health science students in Saudi Arabia” was conducted. In this study, the health care students perceived OT as playing a vital role in the interdisciplinary rehabilitation team. However, OT was not clearly understood. This study identified a need to educate medical and health sciences students and the public on the purposes and benefits of OT [8, 13].

The findings of the current study suggest that many Arab healthcare professionals do not understand OT. Few previous studies have explored healthcare professionals and public knowledge and understanding of OT and indicated that although OT is now more than 100 years old, it is still not well-known or understood [11, 12]. In this study, more than half of the sample (51.2%) reported uncertainty and were not sure about the main domain and focus areas of OT and this is most probably was due to the fact that OT is a relatively new healthcare profession in the Arab region and it has been taught in only a handful of Arab universities [13, 19]. It is really important to shed light on the diverse core areas of OT, such as but not limited to activities of daily living, feeding and swallowing assessments, range of motion, manual muscle testing, sensory integration, hand therapy, splinting, pediatric development, leisure and recreational activities, expressive language skills, ergonomics, positioning, home safety evaluation, accessibility and quality of living for persons with disabilities, psychological assessments, cognitive behavioral therapy, anxiety management, community-based rehabilitation, physical exercises, family and patient education/counseling, work, vocational rehabilitation, education, social participation, play, rest and sleep, wound management, and prosthetics and orthotics trainings [8]. Furthermore, in our study, 98 (34.9%) did not know the exact OT healthcare work setting as the OT role was not clear for them. The exact identity of OT and OT role still remains unclear in some settings such as mental health, child development, schools, and rehabilitation. The importance of a unique role identification among the members in interdisciplinary rehabilitation settings is crucial and should be highlighted [20]. OTs work in a variety of clinical, research, and academic settings, such as but not limited to rehabilitation centers, psychiatric and mental health hospitals, community-based centers, nursing homes, school-based rehabilitation, learning difficulties centers, halfway homes and de-addiction, centers for assistive technology, academic and research institutions, work and industry, and patients’ homes [8]. In the current study, 126 (44.8%) healthcare professionals did not know the difference between OT and PT which may result in role confusion for the healthcare team as reported in a previous study [14]. The fields of OT and PT are often confused. While both roles complement each other and provide essential services to clients, each field takes a diverse approach. Both professions are important, complement each other, and work together within the rehabilitation team, and there is a big professional role overlap between both [21]. In order to further educate both the public and other healthcare professionals, we highlighted the similarities and differences between the two professions in our recent publication entitled “Promoting occupational therapy profession: Answering the ten questions about occupational therapy” as part of the second phase of this project [8].

One expected finding of the current study was that Arab healthcare professionals with focus in rehabilitation sciences (PT, SLP, OP, RT) were more familiar with OT when compared with other healthcare professionals from other specialties. This may be due to the fact that OT and rehabilitation sciences collaborate closely, have many aspects in common, and communicate on a regular basis in almost every academic and clinical setting as part of the interdisciplinary rehabilitation team and curricula. Also, there was a significant association found in the current study between the healthcare professionals’ knowledge of OT and their years of experience. It is expected as the more experience the healthcare professionals have, the more opportunities they have to get to know more about other healthcare professions especially in interdisciplinary teamwork and integrated intervention planning as considered the ideal best practice where all disciplines act as one functional unit [22].

Although the majority of the current study sample indicated that the OT role in the rehabilitation team is vital (74.4%), almost two third of the sample (187; 66.5%) were not satisfied with their knowledge of OT, and 195 (69.4%) showed interest in learning further about OT indicating a gap in their level of knowledge and how they understand the diverse aspects of the OT profession. This finding is similar to previous studies that reported lack of healthcare workers and public understanding of the OT profession [8, 11,12,13]. A previous study indicated that lack of awareness limits youth entering OT which leads to multiple problems. Shortages of OT professionals are expected to increase. Hence, OT will not be fully accessed by clients if it is unknown or unavailable [15]. Other studies reported that OT also is not highly visible in media [10, 16]. Therefore, there is a critical need for intensive public awareness campaigns to create accurate and powerful images of the distinct value of the OT profession. When participants in our study were asked to specify the best method that they would prefer to be educated about OT, they selected different methods, such as reading an article about it, providing oral presentations and workshops by an occupational therapist, observing/watching a video of an OT session, and searching in the Internet about the role of OT in medical teams.

Action plans should be focused towards educating interdisciplinary medical teams and healthcare professionals in Arab countries about OT through integrating OT education and services into university curricula, research, and clinical settings. It is critical that regulatory bodies and healthcare sectors establish specific statements and regulations which clarify the exact role of OT within different settings of the healthcare system [20]. Developing OT continuing educational programs would provide the region with unique, qualified, and competent occupational therapists. In addition, it would enhance services provided to persons with disabilities, improve satisfaction, and empower their functional performance and everyday living skills in terms of independence, safety, and quality of life. Furthermore, an OT perspective could contribute to develop a more holistic approach and comprehensive care for patients. The inclusion of OT professionals into existing interdisciplinary medical and rehabilitation teams in Arab countries is crucial and should be considered. This approach would foster collaboration and integrated intervention planning which in turn would have a positive significant impact on persons with disabilities [19].

This study had some limitations. Some healthcare professionals were not available at the time of conducting our study, and we had limited access to them due to their busy schedules and other workloads. Healthcare professionals who participated in this study were from different countries; however, this data was not analyzed to investigate whether or not such differences have an impact on their knowledge and perception of OT. For future studies, a larger sample through extending the data collection period to enhance response rate, exploring possible reasons for differences in knowledge and perception of OT profession among different countries, and the inclusion of more healthcare professionals from more Arab countries to better represent this population are recommended.

Conclusion

Healthcare professionals perceive OT as playing an important role in the interdisciplinary rehabilitation team. However, most of them are uncertain about the main domain of OT, not satisfied with their knowledge of OT, and showed interest in learning further about OT indicating a gap in how they understand OT and a need for the inclusion of OT in the healthcare curricula and programs. Launching outreach campaigns and conducting educational programs to raise local awareness and enhance community perception and knowledge of the OT profession is a priority area and should be considered.