Critical perspectives on implementation of evidence-based practice in occupational therapy – Exemplified by Lifestyle Redesign® in a Danish context

Abstract

Introduction Evidence-based practice is an increasing demand in occupational therapy (OT), although multiple barriers can hinder the translation of research knowledge into practice. The article illuminates the transformation of results from a randomised controlled trial into a practice development project with future practice implementation in mind. Method A case study was carried out, consisting of a comparison of the US randomised controlled trials (RCTs) Lifestyle Redesign® and the derived Danish practice development project. Results The study showed how results from RCTs of Lifestyle Redesign® were transformed into a practice development project with intentions to implement the programme in a Danish context. The modifications of the US RCT into a practice development project in Denmark compromised the study’s scientific execution. The practice development project was used to legitimise the intervention within OT locally by testing an evidence-based intervention, without using associated scientific tools and without considering barriers and facilitators for implementing the project in clinical practice. Conclusion Research design compromises in practice development projects may have implications for the internal and external dynamics of professionalisation processes regarding OT and the recognition of OT as a scientific discipline and an autonomous profession, nationally and internationally.

The European Standard EN 17398:2020 on Patient Involvement in Health Care – a Fairclough-Inspired Critical Discourse Analysis

“…Also, the academisation of other health professions than medicine, e.g., nursing and occupational therapy, has been closely associated with the medical academic tradition of randomised clinical trials as a research method par excellence ( Glasdam, 2007 ). There has been a long-standing struggle in non-medically oriented healthcare professions in terms of being academic professions with/without (partial) detachment from the medical paradigm, and also in terms of belonging to a humanistic scientific position or a medical scientific position ( Beedholm & Frederiksen, 2015 ; Glasdam and Sudmann, 2021 ; Glasdam et al, 2021 ; Heyman, 1995 ).…”

A call for theory‐inspired analysis in qualitative research: Ways to construct different truths in and about healthcare

“…Since the 1980s, there has been significant development in qualitative research and related method development within healthcare (Morse, 2015; Norlyk et al, 2023). This development is an extension of the academisation efforts within nursing, occupational therapy, physiotherapy, among others, where researchers have sought to define their research areas within healthcare (Glasdam et al, 2022). Martinsen (1993) argues for being ‘faithful and unfaithful’ at the same time when conducting qualitative research.…”