Occupational therapists are increasingly urged to carry out evidenced-based practice; however, little is known regarding their present practice and perceptions of evidence-based practice. To explore this phenomenon, a qualitative study was completed using a grounded theory approach. Semi-structured interviews were carried out with eight occupational therapists who worked in diverse practice settings. Participants were asked to reflect on their own views of evidence-based practice and their use of evidence in therapy. Data were analyzed inductively using constant comparison analysis. Participants' perceptions of evidence-based practice were described in three broad categories. To these occupational therapists, evidence-based practice is: (a) a process of looking for understanding; (b) associated with research, and; (c) a potential threat to the occupational therapist. These findings produce a basis from which recommendations are made to increase the use of evidence-based practice by occupational therapists.

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Evidence-based practice has its roots in evidence-based medicine. This term refers to the formulation of treatment decision using the best available research evidence. While the concept has gained increased attention among health care workers in the recent past, practice based on scientific evidence has been recommended for over 300 years. However, all health-related professions continue to report difficulties adopting evidence-based practice. Notably, practitioners are often concerned that results of population-based research may not be relevant for their specific patients. This may be of particular concern for occupational therapists who aim to provide client-centred intervention, taking into consideration individual characteristics of the client, the environment and the occupation. As well, those wishing to practice evidence-based occupational therapy must determine which decisions are made during the course of therapy and what evidence may impact on these decisions. The Occupational Performance Process Model (Fearing, Law & Clark, 1997) outlines the occupational therapy problem solving process and assists therapists to integrate knowledge from both client and therapist. A framework for evidence-based occupational therapy is presented, based on this model.

A global survey of individuals involved in the delivery of occupational therapy was conducted by the World Federation of Occupational Therapists (WFOT) to determine the impact of the COVID-19 pandemic and identify needs and recommendations for future resources and support. The online survey was circulated in five languages through member organisations and other WFOT communications networks. The 30-item survey collected primarily quantitative data, although some comments and recommendations were requested. A total of 2750 individual responses were received from 100 countries. Findings indicated that the Covid-19 pandemic had a wide-ranging impact on occupational therapy as a result of several factors, including a lack of preparedness, restrictions in service access, new demands during redeployment, frequently changing work conditions, use of new technology and limitations in resources such as additional space for physical distancing and personal protective equipment. Working during the pandemic also had a personal impact on the health of most respondents, with some reporting reduced morale and concerns for their safety. Access to Covid-19 specific training and living in a high-income country were found to have a significant positive impact on a number of outcomes, including the respondent's sense of competence, effectiveness and safety. Those working in a clinical role were less likely to report higher levels of safety, effectiveness and positive impacts associated with the pandemic. Important recommendations emerged from the findings to inform the future work of WFOT and other professional organisations, including the need for: collaborative efforts to provide information and training resources; development of standards and supports to promote quality service provision; and advocacy to promote access to occupational therapy and address occupational injustice.

BACKGROUND: An analysis of data from an international survey was undertaken to determine the impact of the COVID-19 pandemic on telehealth practice in occupational therapy worldwide, in addition to facilitators and barriers in utilising this form of service delivery. METHOD: The global online survey was circulated in the occupational therapy community by the World Federation of Occupational Therapists (WFOT) between April and July 2020, collecting responses to closed-ended questions, in addition to free-text comments. Descriptive statistics and bivariate analyses were used to assess relationships between respondent characteristics and the utilisation of telehealth. Thematic statement analysis provided further insight regarding factors impacting telehealth use. RESULTS: Findings revealed a significant increase in the use of telehealth strategies with the onset of the pandemic among survey respondents, with many reported benefits. Bivariate analyses indicated telehealth users were more likely to score higher feelings of safety and positive work morale, as well as perceive employer expectations to be reasonable. Restricted access to technology, limitations of remote practice, funding issues and slow pace of change were identified as barriers for some respondents to utilising telehealth. Facilitators included availability of supportive policy, guidelines and strategies, in addition to education and training. CONCLUSION: This study advances the understanding of the current scope of occupational therapy telehealth practice in the context of the ongoing COVID-19 pandemic. Although results suggest long-term potential for telehealth use as an adjunct to traditional service provision, important considerations were identified regarding factors influencing integration of such strategies.