No abstract

No abstract

Importance: When providing services, occupational therapists encounter social inequities that affect the health and well-being of their clients and create ethical tensions. Objective: To develop an understanding of the ethical tensions encountered by occupational therapists working with clients experiencing social inequity and how such tensions are navigated. Design: This qualitative study used an interpretive description methodology. Setting: Community and tertiary health settings. Participants: Fifteen occupational therapists who identified as working with clients experiencing social inequity. Outcomes and Measures: Semistructured interviews were used to explore participants’ practice experiences. Data were analyzed using thematic analysis. Results: Two themes were identified in relation to participants’ experiences of ethical tensions: (a) perpetuating inequities and (b) experiencing conflicting values. A further three themes were identified in relation to how participants identified and navigated these tensions: (a) taking action, (b) seeking support, and (c) ensuring integrity and accountability. Conclusions and Relevance: Ethical tensions frequently emerged when systemic health contexts were not responsive to social inequities or created barriers to health care access. Occupational therapists felt a sense of responsibility to take action to address inequity, which led them to stretch boundaries and roles. Having informal and formal supports, and confidence in the scope of their practice, helped the occupational therapists to navigate ethical tensions with integrity and accountability. Increased avenues for support that incorporate reflexivity offer an opportunity for occupational therapists to engage in dialogue about social inequities and ethical practice. What This Article Adds: This article explores the types of ethical tensions occupational therapists experience when addressing social inequities and provides insights into how such tensions are managed.

No abstract

Service-learning programs can provide clinical assistance in low-resourced settings while providing students with intercultural learning opportunities in diverse health contexts; local partners’ perspectives on international service-learning (ISL) programs are integral to ethical, effective and sustainable university-community partnerships; yet the perspectives of local partners remain under-represented in research. Interpretive description methods guided data collection and thematic analysis of qualitative responses from written questionnaires. Four local partners from Vietnam and Timor-Leste responded to questionnaires in this pilot project. Three themes were identified regarding benefits, underpinning factors for program effectiveness, and a further three themes related to desired improvements. According to local partners, benefits of ISL include skill and knowledge exchange, enhanced assessment and intervention strategies, and increased service quality. Communication and relationships were seen as underpinning factors of effective partnerships. Areas for further improvement included drawing more strongly on local partner strengths and perspectives, further collaborative preparation for the placements, and more regular communication. These preliminary findings align with existing research regarding benefits to local partners. Modelling effective practices, formal training and meetings, and ongoing case discussions may be some useful methods for achieving knowledge and skill exchange in ISL.