Occupation-based Intervention Research Articles

Sew and Tell: A Descriptive Examination of the Occupation of Sewing for Adults

Abstract Date Presented 03/22/24 Sewing as an occupation-based intervention was found to be effective in increasing social participation, occupational performance, and quality of life for adults with conditions affecting fine motor coordination and cognitive deficits. Primary Author and Speaker: Camille Skubik-Peplaski Additional Authors and Speakers: Jose Gonzalez, Susan Skees Hermes, Amanda S Hansford

Early Daily Activity: Development and description of an occupation-based intervention for surgically repaired distal radius Fractures.

To describe the theoretical development and structure of an occupation-based intervention for people with a surgically repaired distal radius fracture. The Early Daily Activity (EDA) intervention uses the performance of strategically selected daily activities as the primary rehabilitative strategy. Occupation-based interventions are recommended for hand injury rehabilitation but are often poorly described and lack explicit theoretical underpinnings. The EDA-intervention was developed from exploratory research that informed the theory and structure. The theoretical principles are that daily activity performance is (i) safe within defined parameters (ii) appropriately self-determined (iii) produces high ranges and amounts of therapeutic movement, and (iv) builds psychosocial competencies. The EDA-intervention is designed to be commenced within 2 weeks of surgery. There are three key components. The first is activity-specific education to emphasise the safety, benefits, and therapeutic actions of activity performance. A set of parameters for defining safe activities is described to support education. The second component is patient-therapist collaboration to select a range of daily activities that provide a 'just-right' challenge. Collaboration occurs at regular intervals throughout the rehabilitation period to incrementally increase the challenge of activities. The third component is performance of activities at-home targeted at improving range of movement and function. The EDA-intervention can be used by hand therapists, but it has not yet undergone effectiveness evaluation. A planned study will explore clinician readiness to adopt the EDA-intervention, inform iterative changes to the protocol and the design of feasibility and effectiveness studies.

Comparing the Effectiveness of Patellar Bracing with Conventional Exercises to Occupation-based Intervention with Conventional Exercises in Managing Patellofemoral Pain Syndrome in Athletes

Introduction: Patellofemoral Pain Syndrome (PFPS) is a prevalent lower extremity condition observed in physically active individuals, characterized by diffuse anterior knee pain without the presence of intra-articular damage or a specific mechanism of injury. The heterogeneity in symptom presentation poses a challenge, with activities like squatting and stair climbing triggering knee pain. Aim & Objectives: To evaluate and compare the efficacy of patellar bracing combined with conventional therapeutic muscle strengthening exercises against occupation-based intervention along with conventional therapeutic muscle strengthening exercises in the management of Patellofemoral Pain Syndrome in athletes. Material and Methodology: Group A received therapeutic muscle strengthening exercises with a Patellar Brace, while Group B received Occupation-Based Intervention (OBI) along with therapeutic muscle strengthening exercises. Both groups underwent a 12-week management program, with evaluations conducted at baseline, 6 weeks, and 12 weeks. Result: The data was tested for normality using the Kolmogorov-Smirnov Z test with p <0.05. Repeated measures ANOVA was used for mean pre and post comparison within group and mean and mean changes between groups. The level of significance was set at p < 0.05. Conclusion: In conclusion, findings indicate that both approaches are effective, but Occupation-Based Intervention (OBI) combined with Therapeutic Muscle Strengthening Exercises proves significantly more effective than Patellar Brace with Therapeutic Muscle Strengthening Exercises.

Occupation-based intervention for instrumental activities of daily living in people with disabilities: a single-blinded randomised controlled trial

Background/Aims Instrumental activities of daily living are meaningful and purposeful activities that contribute meaning to people's lives and reflect their values and cultures in the community. This study investigated the effects of an occupation-based intervention for instrumental activities of daily living on stress levels, quality of life, and participation in instrumental activities of daily living in people with disabilities. Methods A total of 18 people with different types of disabilities (intervention group n=9, control group n=9) were recruited. The occupation-based intervention took place in 45-minute sessions, with a total of 16 sessions held twice a week for 8 weeks. The measurement tools used were the Lawton–Brody Instrumental Activities of Daily Living Scale and the Waisman Activities of Daily Living Scale to evaluate activities of daily living, the Mini-Mental State Examination to examine cognitive status, the 36-item Short Form Survey questionnaire to assess quality of life, the Perceived Stress Scale to examine stress level, and the Community Integration Questionnaire to evaluate participation in the community were used. Results After 8 weeks, there were significant improvements in performance and participation in instrumental activities of daily living, stress and quality of life in the intervention group intervention group had significant increases in instrumental activities of daily living (z=−2.6, P=0.008), vitality (z=−0.5, P=0.041), role emotional (z=−2.7, P=0.008), role physical (z=−2.3, P=0.020), general health (z=−3.3, P=0.001) and participation (z=−1.3, P=0.023). There were also significant reductions in stress (z=−2.8, P=0.005) and bodily pain (z=−3.2, P=0.001) scores compared to the control group Conclusions The occupation-based intervention reduced the stress levels of people with a range of disabilities and increased their ability to perform activities of daily living], participation in activities of daily living and improved their quality of life. Implications for practice Occupational therapists could use occupation-based interventions to reduce the stress levels of people with disabilities and increase their performance and participation in activities of daily living and improve their quality of life.

Concept Mapping to Define Components for an Occupation-Based Intervention for Parkinson's Disease and Anxiety.

Anxiety, a common symptom of Parkinson's disease (PD), results in reduced life quality, reduced participation in meaningful roles and daily activities, and increased health burden. There are no evidence-based interventions to reduce the impact of anxiety in PD on participation. This study aimed to identify the key components required for the co-production of an occupation- and community-based intervention for people with PD-related anxiety. A participatory mixed-methods research study was conducted using online Group Concept Mapping methodology that included five stages: brainstorming, idea synthesis, sorting activity, rating activity, and analysis. A cluster map, pattern match, and 'go-zone' charts were created through multivariate statistical analysis based on participants' responses. The stages were guided by questions generated by the research team working with stakeholders. Eighty-three people participated, with 64 taking part in more than one activity. Participants included people with PD (n = 72), care partners (n = 6), and occupational therapists (n = 5). The final map contained 119 statements with eight clusters (stress value 0.252): exercise, lifestyle changes, self-help, coping, access to information, professional help, peers and groups, support from others. Significant agreement existed between the importance and feasibility rating activities (r = -0.07). 'Go-zone' charts highlighted the priority statements for intervention development. This novel participatory study highlighted priority components that provide starting points for future development of an occupation- and community-based intervention for people with PD-related anxiety.

The Relationship Between Horticulture, Recovery and Occupational Therapy in Mental Health: A Scoping Review

This scoping review aimed to establish if horticulture is an occupation-based intervention in mental health recovery. Horticulture as an occupation was found to aid recovery by facilitating the social aspect of person-driven recovery based on strengths and responsibility. Where occupational therapists were able to use horticultural therapy, they did so in a client-centred and recovery-oriented outcome way. The findings support occupation-based and recovery-oriented occupational therapy practice. Use of recovery-oriented outcome measures and systematic appraisal of evidence are required to enhance applicability of these findings.

A comparison of the effects of occupation-based interventions with and without responsibility feedback and conventional interventions on participation in people with idiopathic Parkinson’s disease: study protocol for a randomized controlled trial

BackgroundParkinson’s disease (PD) is a neurodegenerative disorder with debilitating motor and non-motor symptoms which affect participation in meaningful occupations. Occupation-based interventions can improve participation in people with PD. Evidence for incorporating structured and intensive occupational therapy by considering the concept of responsibility is lacking for this population. This trial will compare the effects of occupation-based interventions with and without responsibility feedback and conventional interventions on participation in people with idiopathic PD.MethodsA total of 45 people with PD, between 35 and 85 years old and Hoehn and Yahr stages between I to III, will be recruited from movement disorder centers for this three-armed study. Participants will be randomized into three groups (occupation-based interventions with responsibility feedback, occupation-based interventions without responsibility feedback, and conventional interventions). All participants will receive intervention for 24 sessions during a period of 12 weeks (2 sessions per week). The primary outcome measure will be participation satisfaction. Participation frequency and restriction, self-perceived performance, performance satisfaction, motivation, volition, sense of agency, responsibility, physical activity, community integration, activities of daily living (ADL), instrumental ADL, upper extremity function, balance, fatigue, and quality of life will be measured as secondary outcome measures. All outcomes will be measured at baseline, session 9, session 17, post-intervention (week 13), and follow-up (week 25).DiscussionThis home-based high-intensity, structured, client-centered, and occupation-based intervention will be conducted by utilizing the concept of responsibility. This proposed trial may result in enhanced participation that would benefit other motor and non-motor symptoms in people living with PD. Findings from this proposed study are expected to expand the knowledge of clinicians and help them in evidence-based decision-making processes.Trial registrationIranian Registry of Clinical Trials IRCT20140304016830N13. Registered on August 19, 2022

Occupation-based Interventions in Patients With Severe Mental Disorders: A Review Study

Background and Aims The importance of participatory health governance has been acknowledged by the World Health Organization. Studies have shown the positive effects of participation in occupation-based intervention in patients with severe mental disorders, including schizophrenia, in outpatient and inpatient wards. The purpose of this article is to review the studies on occupation-based interventions in patients with severe mental disorders. Methods This is a narrative review study. A search for related articles was conducted in PubMed, Google Scholar, Cochrane, ScienceDirect, Scopus, OTseeker, PsycInfo databases using the keywords “severe mental disorder”, “serious mental illness”, “schizophrenia”, “Major depression disorder”, “Bipolar disorder”, “Occupational therapy”, Occupation”, and “Occupation-based intervention” without the time limitation. Titles and abstracts of 480 yielded articles were examined. Results Twelve articles were reviewed; Two were related to occupation-based interventions in psychiatric inpatients, five were related to occupation-based interventions in outpatients, and five were related to occupation-based interventions in both inpatients and outpatients. Among these articles, one studied the challenges of using occupation-based interventions. Conclusion It seems that occupation-based interventions in inpatients and outpatients with mental illness have been used more to reduce symptoms, and less attention has been paid to the effectiveness of these interventions in maintaining and or improving occupational performance in these patients. The Canadian model of occupational performance and the recovery framework have been used in the design of these interventions. To achieve better results in psychosocial rehabilitation where occupation-based interventions lead to an increase in quality of life, the challenges in this area should be solved.

Assessing the Effectiveness of an Occupation-Based Intervention in Promoting OT Student Well-Being

Abstract Date Presented 04/21/2023 Mixed-methods study demonstrating the effectiveness of an occupation-based intervention in promoting OT student well-being. Significant interaction effects were found for well-being, self-compassion, engagement in meaningful occupations, and occupational balance. Primary Author and Speaker: Elena Wong Espiritu

Effect of Occupation-Based Intervention Using the ADOC-H Combined With Physical Function-Based Intervention on Patients With Distal Radius Fractures: A Retrospective Case-Control Study.

Occupation-based intervention (OBI) involves daily and meaningful activities for evaluation and intervention. Recently, the "aid for decision-making in occupation choice for hand" (ADOC-H) was developed to facilitate OBI in patients with hand injuries. We aimed to examine the efficacy of OBI using the ADOC-H combined with physical function-based interventions (PBI) for patients with distal radius fractures (DRF). Patients with DRF were retrospectively allocated to two groups, ADOC-H group (n = 14) and PBI group (n = 14), and compared. Improvements in the Pain Catastrophizing Scale magnification and Hospital Anxiety and Depression Scale and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were significantly higher in the ADOC-H group than in the PBI group (p < .05). The groups showed no differences in measure of physical function, such as range of motion and grip strength. OBI using the ADOC-H combined with PBI is clinically useful for patients with DRF as it promotes use of the injured hand for daily activities in a step-by-step approach, improving psychological difficulties in using the hand.

Cognitive Retraining and Functional Treatment (CRAFT) for adults with cancer related cognitive impairment: a preliminary efficacy study.

To examine the preliminary efficacy of Cognitive Retraining and Functional Treatment (CRAFT) combining remote computerized cognitive training (CCT) and occupation-based treatment in adults with cancer-related cognitive impairment (CRCI). Three-armed randomized controlled trial including 74 individuals with CRCI, randomized into 12weeks of either CRAFT, CCT alone, or treatment-as-usual. Assessments evaluating participation in daily life, perceived cognition, cognitive performance, quality-of-life, and treatment satisfaction were administered at baseline, post-intervention, and 3-month follow-up. Significant time × group interactions in favor of the CRAFT and CCT groups were found for participation in daily life (F2,34 = 5.31, p = .01, eta = .238), perceived cognition (F2,34 = 4.897, p = .014, eta = .224), and cognitive performance on speed of processing test (F = 5.678, p = .009, eta = .289). The CRAFT group demonstrated significantly larger clinically meaningful gains on participation in daily life (chi-square = 6.91, p = .032) and significantly higher treatment satisfaction. All treatment gains were maintained at a 3-month follow-up (n = 32). CCT and CRAFT were found to have a positive impact on participation and cognitive outcomes among individuals with CRCI. The CRAFT showed an additional advantage in improving self-chosen occupation-based goals suggesting that a combination of cognitive training with occupation-based intervention has a positive synergistic effect resulting in "real world" health benefits. A combination of cognitive training with occupation-based intervention has a positive effect resulting in clinically meaningful improvements in participation in daily life, objective cognitive performance, and subjective cognitive impairment. ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered.

Incorporation of occupational based intervention into joint protection education for individuals with thumb carpometacarpal osteoarthritis: A case series

BackgroundTo our knowledge, the use of occupational performance in education on joint protection techniques has not been studied for individuals with thumb carpometacarpal (CMC) osteoarthritis. PurposeThis case series was designed to investigate if occupation-based instruction inside the clinic was useful and found satisfactory as an educational tool for individuals with thumb CMC joint arthritis. MethodsThree participants with thumb CMC joint osteoarthritis performed washing, rinsing, and drying a dish, moving a pot and pan, maneuvering a laundry basket, and pouring from a pitcher during joint protection education in the therapy clinic with a skilled hand therapist in addition to routine treatment. Satisfaction with this intervention was assessed via a 3-question satisfaction survey. Pain with activity and function via the Thumb Disability Examination were assessed at baseline and a 4week follow up. ResultsPatients in this study expressed satisfaction with the inclusion of the performance of occupations in their joint protection education in the clinic. Pain with activity improved by an average of 1.7/10 on a 10-point Numeric Pain Rating Scale and function improved by an average of 10.04 on the Thumb Disability Examination. ConclusionsAlthough no causal relationships can be assumed in this study, hand therapists should consider adding occupation-based intervention as a component of patient education on joint protection for individuals with thumb CMC joint osteoarthritis.

The use of occupation based interventions among certified hand therapists.

The effectiveness of occupation-based hand therapy and the barriers to the use of occupation-based interventions (OBIs) have been established, but the current experience of hand therapists using OBIs and the extent of the use of OBIs in practice is unknown. This study aimed to identify the frequency that occupational therapists who are Certified Hand Therapists (CHTs) utilized OBIs, how occupational therapists who are CHTs described their application of OBIs, and identify the supports and barriers to the application of OBIs. Twenty-nine participants completed a survey that included 27 questions. The questions consisted of close ended, Likert scale, and multiple-choice questions which were analyzed quantitatively, and open-ended questions which were analyzed qualitatively. The majority of the participants, 57.7%, reported implementing OBI at least 75% of the time. Barriers and supports to the use of OBIs reported include a lack of equipment and therapist creativity, and support for the use of OBIs included the therapist's creativity, support from the facility, the availability of equipment, and the intrinsic motivation of therapists. Descriptions of OBI application included activity simulation, adaptive equipment use, and participation in meaningful activity. Although the use of OBIs in hand therapy may be expanding, occupational therapy practitioners and educators have a role to play in overcoming the remaining barriers to occupation-based hand therapy. Additional research is needed to gain further insight into use of occupation-based intervention by occupational therapists who are CHTs and explore the effect of education on promoting the use of OBIs.

613-P: Rural Caregiver Perceptions of an Occupation-Based Coaching Telehealth Intervention to Improve Child Diabetes Management and Quality of Life

Caregiver diabetes training and psychosocial support after a child’s type 1 diabetes diagnosis is critical for successful diabetes management and family quality of life. Disruption to family routines and increased stress are frequently reported after a child’s type 1 diabetes diagnosis. However, limited services exist that blend both caregiver medical training and psychosocial support. After the implementation of a 12-week, novel occupational therapy coaching telehealth intervention designed to promote rural caregiver independence with their child’s type 1 diabetes management and improve caregiver psychosocial well-being, we interviewed rural caregivers to explore their perceived quality of life. Utilizing a phenomenological design, 8 caregivers completed a semi-structured interview. Zoom interviews were recorded, transcribed verbatim, and coded using a phenomenological analysis. Caregiver ages ranged from 34-50 years, 86% were married, and all held a minimum of an associate degree. Their children were diagnosed with type 1 diabetes at 12 months to 9 years and time since diagnosis ranged from months to 8.5 years. Three distinct themes emerged related to caregivers’ experiences after diagnosis: occupational deprivation and decreased well-being; longing for connection with social supports; and desire for knowledgeable, relatable, and accessible providers. Two themes emerged related to after receipt of the telehealth coaching intervention: satisfaction with diabetes management and psychosocial support and hope for childhood normalcy. Overall, the caregivers reported satisfaction with the intervention as it provided validation of their lived experience of raising a child with diabetes in a rural community. The caregivers also reported a sense of hope that their children can successfully participate in important everyday activities, which ultimately improved the caregivers’ quality of life. Disclosure V.D.Jewell: Research Support; Dexcom, Inc. K.J.Funk: None. A.Currie: None. J.Shin: Research Support; Dexcom, Inc. E.Knezevich: Research Support; Dexcom, Inc. A.D.Valdez: None. M.Bunsness: None. Funding Creighton University Health Science Strategic Faculty Investment Fund

The investigation of the effects of occupation-based intervention on anxiety, depression, and sleep quality of subjects with hand and upper extremity burns: A randomized clinical trial

AimThis study aimed to investigate the effects of occupation-based intervention on psychological factors and sleep quality of subjects with hand and upper extremity burns. MethodsIn this randomized controlled intervention trial, a total of 20 patients were randomly assigned to one of the control group or intervention group. The control group only received traditional rehabilitation. However, the intervention group received traditional rehabilitation and Cognitive Orientation to daily Occupational Performance (CO-OP), respectively (during 18 sessions, 45 min/day in both groups). Occupational therapy sessions were held three times a week for a six-week duration. Occupational performance and satisfaction, anxiety, depression, and sleep quality were measured before the intervention and in weeks 2, 6, and 14 (follow-up) using Canadian Occupational Performance Measure, Beck Anxiety Inventory, Self-rating Depression Scale, and Pittsburgh Sleep Quality Index, respectively. FindingsThe results of the present study show that there were significant changes in all the studied variables in the two groups. However, these changes (P ≤ 0.05) were not statistically significant between these two groups. ConclusionThe results of this study show that occupation-based interventions are as effective as traditional therapeutic interventions on improving the anxiety, depression, and sleep quality in patients with hand burn injuries.

Telerehabilitation for Managing Daily Participation among Breast Cancer Survivors during COVID-19: A Feasibility Study

We aimed to examine the feasibility and impact of a short-term occupation-based telerehabilitation intervention (Managing Participation with Breast Cancer (MaP-BC)) on daily participation, health-related quality-of-life, and breast-cancer-related symptoms and understand women’s perspectives regarding strategies to manage daily participation and symptoms during COVID-19 pandemic. A mixed-methods study (single-arm pre–post with a qualitative component) included 14 women after their primary medical treatment for breast cancer. Women received six weeks of occupation-based intervention using a video-communication. Sessions focused on identifying functional goals and training strategies to manage daily participation. The primary outcome was perceived performance and satisfaction with meaningful activities by the Canadian Occupational Performance Measure (COPM). Secondary outcomes were participation in the Activity Card Sort (ACS), upper-extremity functioning of Disability Arm Shoulder Hand, self-reported symptom severity, executive-functioning, health-related quality of life, and a question regarding strategies used to manage daily participation. Women significantly improved their daily participation in meaningful activities in the COPM, most ACS activity domains, self-reported executive functioning, and health-related-quality-of-life. Qualitative findings revealed three main themes: (1) daily life under the threats of breast cancer and COVID-19, (2) women’s own strategies to overcome challenges, and (3) contribution of the MaP-BC. Providing telerehabilitation during the COVID-19 pandemic is feasible and successful in improving women’s daily participation after breast cancer.

The use of occupation-based intervention among Malaysian occupational therapists: A focus group discussion

ABSTRACT Research regarding occupation-based intervention (OBI) has been mainly conducted in developed Western and Asian countries. Therefore, the transferability and generalisability of the published research to the Malaysian context is questionable. The purpose of this study was to examine Malaysian occupational therapists’ perceptions of the developed definition of OBI and how they put it into practice. Three focus group discussions were conducted. Participants were recruited among Malaysian occupation-based practitioners. Data were analysed using a manifest and latent content analysis. The major finding that emerged from the data analysis was the practice of OBI in Malaysia, which was further divided into how OBI is implemented in Malaysia, and the facilitators to practise OBI. This study’s findings suggest that OBI was implemented in various ways by the Malaysian occupational therapists despite agreeing with the developed definition of OBI as occupation as a means and an end.

“It was like a bad dream”: Making sense of violent hand amputation and replantation in South Africa

BackgroundSouth Africa is faced with one of the highest rates of violent crime in the world. Accordingly, therapists treat high numbers of deliberate hand injuries. There is, however, a paucity of literature exploring the lived experiences of these survivors. PurposeThe aim of this study was to describe and interpret the meaning of living through a violent hand amputation and replantation, the impact on occupational adaptation and to reflect on therapeutic intervention, within the context of South Africa. Study DesignAn exploratory embedded single case study using a qualitative approach. MethodsInterpretative phenomenological analysis was used to analyze data from: 8 interviews with the primary participant, over a period of 33 months; an interview with his work colleague; interviews with 5 health professionals; a review of the occupational therapy rehabilitation file and a review of the audio-visuals, recorded over 2-years. ResultsThis narrative reveals a man who understood his terrifying assault to be part of a southern African ritual of spiritual origin - using human body parts for traditional medicine (muti crime) or witchcraft. He perceived his expensive hand replantation and therapy as surreal and violence as normal. Challenges highlighted the importance of being attentive to the psychosocial sequelae of violence; and the most valuable part of therapy was perceived as occupational engagement. ConclusionsThe perception of attempted muti murder situates this extreme and unusual case study as a novel contribution to the medical and rehabilitation literature. South African therapists are urged to be actively involved in changing the culture of violence, and hand therapists are reminded of the importance of applying holistic and occupation-based intervention.

Effects of colour narrative in community-dwelling older adults: A mixed methods study

Background Based on occupational storytelling/story-making, this study developed Colour Narrative, a program to promote the health and well-being of community-dwelling older adults. Objectives To conduct a pilot study to implement Colour Narrative in a heavy snowfall area of Japan and verify the participants’ experiences in the program and its effectiveness. Material and methods An advanced mixed methods design was used. The participants were 22 members of a community-based social group for older adults. Quantitative measurements of life functions and health-related quality of life (HRQOL) were conducted before and after the intervention. Qualitative data were collected from focus group interviews regarding the participants’ experiences during the intervention process. Lastly, both datasets were integrated. Results The harsh living conditions due to heavy snowfall reduced the participants’ overall activity. In this environment, Colour Narrative encouraged them to control their lives more in their own ways and enhanced their HRQOL. The core of their experiences was ‘negotiating occupations’. This negotiation was a highly intellectual task that significantly improved their cognitive function. Conclusions The structure and content of Colour Narrative were found to be useful and feasible for community-dwelling older adults. Significance Colour Narrative offers a new occupation-based intervention strategy for preventive occupational therapy.

Percepção de barreiras para implementar intervenções baseadas em ocupação

Abstract Introduction Occupation-based intervention (OBI) is defined as an intervention using a clients’ occupation and purposeful activities as a treatment medium to achieve the client’s goals. Several barriers to practising OBI have been reported in previous studies. However, limited research has been done to identify these perceived barriers to applying OBI in Malaysia’s various occupational therapy practice areas. Objective This study aimed to identify perceived barriers to applying OBI in Malaysia’s three main occupational therapy practice areas including physical, psychiatry and paediatric. Method A cross-sectional study design was employed, and participants were recruited using a purposive sampling strategy. Data was collected using an online survey from a Delphi study. Results Two hundred ninety-eight Malaysian occupational therapists aged between 22 and 56 years old participated in this study. The study identified several perceived barriers from the client factors, the contextual factors, occupation as treatment modalities and logistical issues. A statistically significant difference was found in the perceived barriers of applying OBI between different areas of occupational therapy practice (p=.013), working experience (p=.003), and position of occupational therapists (p=.001). Conclusion This study suggests that perceived barriers to applying OBI were influenced by the area of practice, working experience and position of the occupational therapists. The results highlight the need to identify potential solutions to applying OBI through research and education.