Abstract
Rationale and objective: Occupation-based practice (OBP) is a treatment
approach unique to occupational therapy. It harnesses the power of
occupation to achieve health and well-being. Most hand therapists are
occupational therapists, however, current hand therapy treatment methods
are component-based, focussing on physical impairments. This is despite
an emerging body of evidence that supports the effectiveness of OBP with
hand conditions. To explore the use of OBP in hand therapy, the
knowledge, attitudes and practices (KAP) of South African occupational
therapists towards OBP needed to be first established. There was no
contextually-relevant instrument for this, thus this paper reports on
the development processes of a new instrument to capture KAP in OBP in
South African hand therapists. Method: Questionnaire development
followed the Burns et al (2008) methodology. Items were identified
following a comprehensive literature search. Face and content validity,
clinical utility, and validation of the subsequent Afrikaans translation
were undertaken by two purposively-selected sets of participants
(experts and peers). Data collection involved cognitive interviewing,
iterative email correspondence, face-to-face discussions, and member
checking. Final adjustments to questionnaire wording were made through
consensus discussion between the first and second authors. Results: Four
therapists participated. Seventy-nine questionnaire items were retained,
with three items being removed as they were unclear, or did not measure
constructs appropriately for context. The final survey instrument had
face and content validity and consisted of 63 KAP items and 16
demographic questions. Conclusion: This is believed to be the first
instrument designed to capture valid information on KAP in OBP in hand
therapy in South Africa. It will assist in identifying gaps in practice
quality, and underpin design of effective strategies for education
about, and implementation of, OBP within hand therapy. The instrument is
suitable for adaptation to other fields of occupational therapy practice
in South Africa, and internationally.