Occupational Justice Research Articles

(Des)Connections between occupational justice and social justice: an interview with Gail Whitefordand Lilian Magalhães

(Des)Connections between occupational justice and social justice: an interview with Gail Whitefordand Lilian Magalhães

Bridging critical gaps in occupational justice and social justice in occupational therapy practices

Bridging critical gaps in occupational justice and social justice in occupational therapy practices

Desenvolvimento de uma proposta de educação informada por evidências para terapeutas ocupacionais para cuidados paliativos e cuidado no fim de vida: promovendo a justiça ocupacional

Abstract Introduction Death is inevitable, yet hospitals and health services continue to focus on life-sustaining practices despite clients presenting with clear decline related to life-limiting illness. Social and occupational injustice is common for clients receiving palliative or end-of-life care, as they experience increased occupational disengagement and disempowerment. A gap was identified in the Occupational Therapy department of a metropolitan Australian hospital regarding clinician skills, knowledge and confidence in working with these clients. Objective To describe the development of an evidence informed education package designed to support occupational therapists to provide the best possible quality of care and promote occupational justice for clients receiving palliative or end-of-life care. Method Consultation with key stakeholders and a review of existing resources including a skills audit, was conducted to identify current practice. A review of professional and grey literature was completed, and benchmarking with similar organisations provided a wider perspective on current Australian practice. Review of widely available educational resources were evaluated. Results Baseline data collection confirmed that promoting occupational and social justice for people requiring palliative or end-of-life care was under-recognised across the health service. Benchmarking identified significant variation in educational practices across similar Australian health services. The structure and content of a face-to-face clinical education session was formulated using evidence from the literature review and relevant available resources. There are plans to transfer this education package to an e-learning platform with evaluation built into the package to allow content to remain up to date. Conclusion Occupational Therapy clinicians are well placed to promote occupational and social justice for people requiring palliative or end-of-life care but require additional occupationally focused education to optimise their practice in this area.

Pedagogias dentro do currículo de terapia ocupacional: centrando uma práxis decolonial na prática de desenvolvimento comunitário

Abstract Introduction Critical occupational therapy aims to promote occupational justice through addressing the social determinants of health and the socio-political structures that affect peoples’ occupational engagement. Objective This paper reports on two objectives from a case study, namely: To describe the teaching and learning practices in South Africa, University of Cape Town Occupational Therapy, Community Development Practice curriculum, and the pedagogy informing it. Method Multiple methods were used as data in the construction of the case. These included the review of curriculum documents and a focus group discussion with academics who teach on the programme. These academics also wrote reflective journal entries which were included in our analysis. Data was analysed using a critical interpretive synthesis. Results An overarching theme emerged, namely “Modelling a development processes in a teaching and learning alliance”. This theme identified our key pedagogical approach, illustrating how a decolonial praxis that involves consciously resisting coloniality in the design and implementation of the curriculum occurred. This was made possible through pedagogical actions embedded in the approach and reflected in three categories: “Partnering to bring our critically reflexive and authentic selves”; “The labour of working with individual and systemic processes of struggle” and “Being committed to facing uncertainty together”. Conclusion Our interpretation of our pedagogical approach within the curriculum demonstrates how decolonial pedagogies open up pathways that promote the kind of dialogic and transformative learning that is important for critical occupational therapy. These decolonial pedagogies hold significance for addressing health inequities and developing a justice-oriented profession.

Alienação ocupacional e a saúde mental de estudantes universitários

Abstract Mental health, especially in the youth, has been a prevailing concern in recent years. University students are a particularly high-risk population for mental health problems. Changing perspectives in the field of mental health present the opportunity to explore this concept through an occupational justice lens – specifically that of occupational alienation. Through a brief review of relevant literature, this critical essay will explore the relationship among the concepts of alienation from both a sociology and occupational science perspective, and consider the insights that may be obtained through application of this concept to understanding the mental health of university students. The use of an occupational justice lens provides an opportunity for an alternative perspective when considering factors potentially contributing to the mental health problems in this population.

A new two-stage nurse scheduling approach based on occupational justice considering assurance attendance in works shifts by using Z-number method: A real case study

In this paper, a new binary integer programming mathematical model for scheduling nurses’ problems in the emergency department of Kamkar Hospital in Qom province is developed. The manual arrangement of nurses by the head nurse and its time-consuming, occasional absences during the period and protests against injustices in the arrangement of nurses’ work shifts were among the emergency department’s challenges before implementing the model. Most relevant studies aimed to enhance nurses’ satisfaction by creating a general balance considering occupational preferences. Thus, the present study pursued justice through considering preferences based on the results from periodical evaluations of each nurse’s performance with the ultimate goal of improving nurses’ satisfaction. Moreover, the lack of clarity in selecting shifts, which may cause irregular attendance, was improved using the Z-number method. After the run of the model, the rate of nurses’ absences decreased by 40%, the rate of complaints about the performance of the nursing unit decreased by 50%. Also, nurses’ satisfaction increased by 30% after the implementation of the model.

Occupational Participation of Latinx Cancer Survivors and Family Caregivers Living in Long-Term Survivorship

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Latinx cancer survivors experience worse physical and mental health during survivorship. This group's occupational participation during survivorship is a product of cultural values, environmental influences, and occupational gains and losses. To promote occupational justice, the OT profession is called to deliver culturally tailored care to capitalize on this group's strengths and prepare them for daily participation. Primary Author and Speaker: Ricardo Daniel Ramirez Additional Authors and Speakers: Susan Magasi

Occupational Therapists as Social Change Agents: Exploring Factors that Influence Their Actions.

Background.When acting effectively in their social change agent (SCA) role, occupational therapists can impact population health and occupational justice. However, empirical evidence of the influence of personal and environmental factors on their ability to act as SCAs is scarce.Purpose.To explore personal and environmental factors that influence the ability of occupational therapists to act as effective SCAs.Method.We conducted a descriptive interpretive qualitative study with 18 Québec occupational therapists recognized as successful SCAs. We collected data through semi-structured interviews with three focus groups and analyzed them thematically using a lexicon.Findings.We identified nine cross-cutting personal factors, including discovery, effective communication, and planning, that enable occupational therapists to act as successful SCAs. Six thematic groups of environmental factors facilitated or hindered their actions.Implications.To act effectively as SCAs, occupational therapists need to consider personal and environmental factors involved in their change project.

Occupational justice in direct-funded attendant services: Possibilities and constraints

ABSTRACT In direct-funded attendant services, public funds are transferred to service users to recruit, hire, train, and manage support staff. An outcome of activist efforts to deinstitutionalize support services, direct funding models are often said to increase the choice and control that disabled people have in their attendant services and in everyday life. Focusing on one direct funding program in Ontario, Canada, the overarching reflexive ethnographic study explored the work that physically disabled adults contribute to organize and manage their own attendant services. In this paper we present a secondary analysis of qualitative interview data, examining the impact of participation in direct funding on service users’ occupational engagement. The results of this analysis suggest that direct funding promotes occupational rights by providing supports needed to participate in a range of meaningful occupations. At the same time, occupational engagement was found to be constrained at individual and group levels. In this paper we apply occupational justice concepts to analyze systemic constraints on occupational engagement and occupational choice, including program eligibility criteria and societal factors that condition access to and use of public resources. The discussion highlights how direct funding can support occupational engagement and constrain occupational choice, illuminating the complexity of occupational justice as a dynamic concept that may be promoted and obstructed simultaneously within a given context. We situate direct funding within an ongoing history of institutionalized supports for disabled people and identify specific factors that may promote or inhibit the occupational rights of disabled people who use direct-funded attendant services.

Supporting Occupational Justice for Transgender and Gender-Nonconforming People Through Narrative-Informed Theater: A Mixed-Methods Feasibility Study.

Societal stigma gravely impedes occupational justice for transgender and gender-nonconforming (TGNC) people, producing vast health disparities for this population. To test the feasibility of an intervention to reduce stigma and improve the well-being of TGNC people. A parallel, mixed-methods design was used to test feasibility in the areas of acceptability, demand, and limited efficacy. Community. Forty-two audience members and 5 TGNC interviewees. Virtual, narrative-informed play reading and moderated discussion about gender diversity and affirmative care. Outcomes and Measures: The valid and reliable Acceptance and Action Questionnaire-Stigma was used to assess stigma beliefs. An open-ended, qualitative question assessed TGNC interviewees' experiences. Recruitment and participant responses to the intervention indicated feasibility in the areas of acceptability, demand, and limited efficacy. However, future efforts at obtaining a diverse TGNC sample are needed. The intervention decreased stigma beliefs in audience members and offered a positive experience for TGNC participants. Feasibility outcomes warrant future efficacy testing. What This Article Adds: This article adds an innovative intervention for promoting occupational justice to support the health and well-being of TGNC people. The community-based intervention facilitates change in societal attitudes and stigmatizing beliefs.

World Federation of Occupational Therapists position statement: Occupational Therapy and Human Rights (Revised 2019) – the backstory and future challenges

ABSTRACT The World Federation of Occupational Therapists’ (WFOT) adoption of the Position Statement, Occupational Therapy and Human Rights (2006) was a global milestone for the profession. The revised 2019 Position Statement marks the next milestone towards becoming a socially and ethically responsive profession; playing a vital role to advance human rights, justice, and social inclusion globally. To inform progress towards embracing a human rights perspective, this paper documents that history and unpacks the reasoning behind the revisions. We start with a brief history of the 13-year journey from 2006 to 2019, marked by extensive discussion, consultation, and scholarship on occupational justice, social inclusion, and human rights. We end with notes on opportunities and challenges for occupational therapists in any situation, from clinical practice to policy leadership, to speak out, write, and otherwise take a strong stand on occupational therapy and human rights, occupational justice and social inclusion.

Occupational Justice-Colonial Business as Usual? Indigenous Observations From Aotearoa New Zealand: La justice occupationnelle : sous régime colonial comme d'habitude? Observations d'autochtones d'Aotearoa en Nouvelle-Zélande.

Western ideologies and systems of occupation and justice are implicated in the colonization of indigenous peoples worldwide. Yet, colonialism, racism, and privilege are minimally acknowledged and examined within occupational therapy and occupational science literature, as evidenced in uncritical development of notions of "occupational justice." First, to open a discussion of how and why theories and approaches to justice have developed as they have in Aotearoa New Zealand. Second, to further a burgeoning field of Indigenous perspectives and critiques of colonial theorizing within the profession, while highlighting local Indigenous justice frameworks including Te Tiriti o Waitangi and Matike Mai Aotearoa. Colonialism is minimally examined in occupational justice approaches and promotion. Honest examination of colonialism alongside Indigenous justice frameworks can advance critical praxes of decolonising occupation and re-connect occupation with justice and equity.

The Occupational Participation of Latinx Cancer Survivors and Their Family Caregivers Living in Survivorship: A Qualitative Exploration Informed by Multiple Stakeholders

The purpose of this study was to examine the lived experiences of Latinx cancer survivors and their family caregivers during survivorship. Eighteen semi-structured interviews were conducted with a variety of stakeholders including Latinx cancer survivors (n = 8), their family caregivers (n = 5), and cancer care providers (n = 5). Data were analyzed thematically to describe occupational participation. Latinx families lived in political, economic, language, and social contexts that facilitated and hindered their well-being. Survivors simultaneously experienced occupational deprivation and posttraumatic growth. To promote occupational justice, occupational therapy practitioners and researchers are called to partner with Latinx survivors and their families to facilitate skills needed for everyday participation.

A Critical Reflexion on Two Conceptual Tools From a Global South Perspective: Réflexion critique sur deux outils conceptuels selon la perspective des pays du sud.

Occupational therapy's conceptual tools need to be considered from Global South perspectives to make them more culturally relevant and safe. This paper uses an empirical example, and the author's professional and academic experiences, to analyze the strengths, limitations, and potential refinement of the Critical Thinking Tool (CTT) and the Participatory Occupational Justice Framework (POJF). The paper describes processes of critical reflexivity and intercultural translation to compare concepts used in the CTT and POJF with the findings of a study about olive growing in Palestine to consider the applicability of these tools in Global South settings. The CTT should be amended to address collective occupations, and global and historical contexts, and the POJF should embed intercultural translations and solidarity into its philosophy and processes. These refinements would enhance the cultural safety of the CTT and the POJF. Tools in occupational therapy will benefit from more evidence to enhance their global utility in an increasingly interconnected world, in which occupational therapists share the duty to tackle social and occupational injustices.

The Lived Experience of Mothers Who Are Homeless and Participated in an Occupational Therapy Leisure Craft Group

This phenomenological, qualitative, pilot investigation gained insight into the lived experience of mothers, living in an emergency homeless shelter, who participated in a twice weekly occupational therapy leisure craft group. This research applied the constructs of the Person-Environment-Occupation theoretical model along with concepts from occupational justice to provide occupational therapy services to an underserved population. Information was obtained using semi-structured interviews to explore what meaning was derived from participating in these occupational therapy group craft sessions. Informants verified content from existing literature regarding benefits of leisure participation and added the importance of creating an opportunity for self-care when faced with homelessness.

Developing understandings of occupational (in)justice with occupational therapy students in a transnational project

ABSTRACT This article describes an innovative transnational education project involving three European universities, funded through ERASMUS+. One of its aims was to develop and provide a curriculum to facilitate students’ understanding and identification of occupational (in)justice by exposing them to marginalised people living in three European communities with differing cultural, social, and political systems. Occupational injustice is an ongoing deprivation or patterns of disruption that creates health burdens, barriers to educational and social opportunities, and risk to the individual’s lifespan. We describe how a transnational educational collaboration offered a new way of facilitating learning of occupational (in)justice in a practical way to stimulate the application of concepts to discipline specific thinking and engage students in debate about new areas of potential practice which are transformational. The educational theory underpinning the project is discussed, together with a description of how authentic learning experiences supported the development of occupational justice knowledge and justice-focused practice.

An occupational justice perspective on playing football and living with mental distress

ABSTRACT Physical inactivity is a global public health priority, yet people living with a disability or long-term health condition, such as those who experience mental distress, continue to face inequalities and barriers to participation in sport and physical activity. These inequalities are considered an occupational injustice, in terms of participation in health enhancing occupations being restricted for these groups of people, despite them wanting to be more active. This study aimed to gain an in-depth understanding of the nature and value of participating in a UK based community football project, for people with experience of mental distress. Twenty-three people took part in this first strand of a larger participatory action research study, which used the World Café as a method for structuring and recording conversations. Data from the three World Café events were analysed collectively and thematically. The study’s findings reveal tensions, nuances, and subtleties that exist in relation to the reciprocal relationship between playing football and people’s health and well-being. The complexity of enabling participation in sport and physical activity amongst marginalised groups, such as people with experience of mental distress, is highlighted.

Occupational justice health questionnaire: reflections on its application

ABSTRACT Introduction Occupational justice concept is defined as the equal access and participation in all occupations, including the resources required for participation and opportunities for social inclusion. Occupational justice not only remains conceptually ambiguous for occupational therapy practice but also lacks critical examination of its applicability to non-Western cultures. Objective This article describes the reflexive process exercised by the researchers during and after using the Occupational Justice Health Questionnaire (OJHQ) as an occupational therapy tool in a substance addiction rehabilitation setting in the Philippines. Method This qualitative study gathered transcriptions from field notes and focus group discussions of the authors. These transcriptions were characterized by the authors’ reflections on their experiences using the OJHQ on four distinct periods: 1) OJHQ translation, 2) pilot testing, 3) OJHQ-Filipino version administration, and 4) project conclusion. Data were analyzed through thematic analysis. Results Qualitative data revealed four themes: tool usefulness; administration guidelines; contextualized use of the tool; and nuances of occupational injustices in substance addiction and rehabilitation setting. Conclusion Findings expanded OJHQ’s purpose to enhance clinical reasoning, promote justice-oriented health care, activate reflective practice, and recognize the interweaving and evolving nature of injustices. This article offers an understanding of how reflections can facilitate cultural adaptation of practice tools used in occupational therapy and justice practice.

A Commentary of Occupational Justice and Occupation-based Community Development Frameworks for Social Transformation: The Marikana Event

Background: The Occupational justice framework is significant in enabling communities to collaborate with occupational therapists to strengthen social vision and to enhance the occupational potential. It has been highlighted that the occupational justice framework could be used in conjunction with Occupation-based Community Development programmes to enrich social transformation through engagement in community-led occupations. However, little is known about the applicability of both occupational justice and Occupation-based Community Development frameworks in designing programmes for communities that experienced collective trauma after the Marikana event. Purpose : This commentary explores and describes the Marikana event in terms of the occupational justice framework and its outcomes of occupational injustice. It further unpacks the occupation of protest and the factors predicting protest using the Marikana event. Key Issues : Critical reflections of mineworkers' movements are used to enhance an understanding of the occupational lens of the protest in addressing conditions of social reproduction in communities. Conclusion: The applicability of the occupational justice and Occupation-based Community Development frameworks can help occupational therapy clinicians, educators, and students to collaborate with communities through a cycle of critical consciousness to achieve social vision, social transformation, and healing. Recommendations are provided in relation to community-centred occupational therapy practice, education, and future research within a South African context.

Re-orienting occupational therapy: Embracing generative disruption and revisiting a posture that acknowledges human dignity

ABSTRACT BACKGROUND: Amidst the Covid-19 lockdown that commenced in March 2020, while the profession and service-users were coming to terms with its vast implications, the Occupational Therapy Association of South Africa initiated a Webinar series that stimulated provocative discussions and difficult dialogues. The authors of this paper deliver a commentary, critically engaging with the challenges of cogently articulating the contribution of occupational therapy services across various sectors of service delivery during the first wave of the Covid-19 pandemic in South Africa. The challenges of on the one hand, negotiating the abrupt cessation of rehabilitation services, especially in the public sector and, on the other, advancing the reasoning for accessible, community-based services, are considered AIM: The commentary draws from presentations at and reflections on the webinar hosted on 24 June 2020 titled 'Ethical and Moral Challenges for Occupational Therapy'. In this paper, the competing ethical and moral issues arising from being urged to adopt different ways of thinking and doing occupational therapy during the Covid-19 lockdown are outlined PROPOSITION: It is suggested that experiences emerging from this pandemic are urging the profession to rethink its positionality in the health sector. Two main considerations deserve attention: The first is rethinking how we use occupational therapy knowledge to act from and in relation to local contexts, viewing people who are marginalised as knowledge and action partners through generative disruption. The second is to revisit what it entails to foster a posture that acknowledges human dignity CONCLUSION: Generative disruption includes a continuous and unabashed critical reflection of and on the limits of our practice and knowledge at hand. It means that we need to include service users and community partners in taking necessary steps to render services in local contexts most needed in recalibration toward social and occupational justice. In our knowledge-making partnerships, it is also imperative to revisit the posture of acknowledging human dignity Keywords: Covid-19; occupational therapy; occupational justice; human dignity; generative disruption