Independence: An Analysis of a Complex and Core Construct in Occupational Therapy

Abstract

Introduction: Independence is a core concept in occupational therapy, but there is little consensus within the profession upon a universal definition. The present study employed a critical interpretive synthesis to examine two fundamental research questions: ‘How is independence conceptualised in quantitative and qualitative research within occupational therapy?’ and ‘How does the term “independence”, in its present use, critically impact occupational therapy policy and practice?’ Method: Articles pertaining to occupational therapy and contributing to the definition of independence within the profession were examined. Three successive levels of coding — open, axial and selective — were used to analyse 19 final articles. Findings: From the literature, nine definition themes emerged: function, autonomy and competence, control, context, culture, environment, personal attributes and safety. These themes were then organised into three categories: personal factors, environmental factors and continuum, which were synthesised together to create a model that addresses all factors critical to the composition of independence. In addition, four clinical themes developed: goal of occupational therapy, client-therapist relationship, variable definitions in occupational therapy practice and limitations of present practice. Conclusion: Through the formalisation of the integral components of independence, this study enables a standardised foundation for the examination of this core concept across the profession.

Development and Validation of the Celiac Disease-Children’s Activities Report (CD-Chart) for Promoting Self-Management among Children and Adolescents

“…However, as they develop, they need sophistication and refinement of daily activities, such as managing and preserving a healthy lifestyle [ 32 , 50 ]. During the critical transition to adolescence, several main developmental experiences occur such as: striving for independence, gaining of control, development of identity, acquisition of skills needed to carry out adult relationships and roles, and the capacity for abstract reasoning [ 51 , 52 ]. The distinction in preference of participation that was recognized in the CD-Chart as the children grow into adolescence might reflect the complexity of this transitional stage.…”

Experiences of international students from Asian backgrounds studying occupational therapy in Australia

“…Our participants identified some aspects of occupational therapy theory and practice that corresponded with Western rather than Asian worldviews, and these are reflected in previous literature. Independence for example, while often considered the ‘cornerstone’ of occupational therapy in Western cultures, is seen as less important in non‐Western cultures which often favour ‘interdependence’ as a concept (Bonikowsky, Musto, Suteu, Mackenzie & Dennis, ). However, participants did not find this problematic as the differences in specific cultural values could be over‐ridden by client‐centredness.…”

Towards environmentally responsible nursing: a critical interpretive synthesis

“…Bonikowsky et al . ). This CIS follows the iterative, reflexive approach, comprising the following phases: formulating the review question, searching for the literature, sampling, determining the quality, extracting data and conducting an interpretive synthesis (Dixon‐Woods et al .…”

“…The ultimate purpose of this CIS was to produce a synthesis that would bring together the many different elements of environmental issues in nursing in a useful and explanatory way (see e.g. Bonikowsky et al 2012). This CIS follows the iterative, reflexive approach, comprising the following phases: formulating the review question, searching for the literature, sampling, determining the quality, extracting data and conducting an interpretive synthesis (Dixon-Woods et al 2006, Talseth & Gilje 2011.…”