Doing what's right: A grounded theory of ethical decision-making in occupational therapy.

Background: Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated.Objective: The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice.Method: A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience. Initially, participants nominated as key informants who were able to reflect on their decision-making processes were recruited. Theoretical sampling informed subsequent stages of data collection. Participants were asked to describe their process of ethical decision-making using scenarios from clinical practice. Interview transcripts were analyzed using a systematic process of initial then focused coding, and theoretical categorization to construct a theory regarding the process of ethical decision-making.Findings: An ethical decision-making prism was developed to capture three main processes: Considering the Fundamental Checklist, Consulting Others, and Doing What's Right. Ethical decision-making appeared to be an inductive and dialectical process with the occupational therapist at its core.Conclusion: Study findings advance our understanding of ethical decision-making in day-to-day clinical practice.

Continuing competency in ethical decision making: An interpretive description of occupational therapists' perspectives.

BACKGROUND.: Competency in ethical decision making is a criterion for ethical practice, and it is expected to advance with ongoing professional development. However, research exploring continuing competency needs of occupational therapists regarding ethical decision making is limited. PURPOSE.: The purpose of this study was to explore potential gaps and directions for development related to continuing competency in ethical decision making from the perspective of practicing occupational therapists. METHOD.: Interpretive description informed secondary data analysis of professional narratives from a grounded theory study regarding ethical decision making. In-depth interviews were conducted with a purposive sample of 18 occupational therapists. Data analyses focused on identifying gaps and future directions regarding continuing competency. FINDINGS.: Two main themes regarding gaps were identified: "I didn't have the knowledge" and "I don't have anybody." Education, tool development, and ethics mentorship were identified directions for development. IMPLICATIONS.: Findings advance understanding of continuing competency needs of occupational therapists regarding ethical decision making.

[Values related to the occupational therapy profession: Identifying them to better define them]. / Valeurs liées à la profession d'ergothérapeute : les répertorier pour les définir.

BACKGROUND.: Inaccuracies and conceptual confusion characterize the literature on the values associated with occupational therapy. PURPOSE.: The purpose of this study was to identify values related to occupational therapy, propose definitions for those values, and validate the content of the definitions. METHOD.: A review of the literature ( n = 52) and consultation of occupational therapists ( n = 26) were used to document and define a series of values. The resulting list of values was tested for functionality by occupational therapists ( n = 5) and presented to occupational therapists with ethics expertise ( n = 6) to assess content validity of the value definitions. FINDINGS.: The proposed list presents 33 values with their definitions that the experts considered to be clear and representative of the realities they describe. The results show that the list is considered exhaustive. IMPLICATIONS.: This study identified values that are ideals that can guide occupational therapy practice and support the claims and cultural and ethical competencies of occupational therapists.

DESCRIPTION.: Des imprécisions et des confusions conceptuelles caractérisent les écrits sur les valeurs liées à l'ergothérapie. BUT.: Répertorier des valeurs liées à l'ergothérapie, proposer des énoncés qui les définissent et procéder à leur validation de contenu. MÉTHODOLOGIE.: Une recension des écrits ( n = 52) et la consultation d'ergothérapeutes ( n = 26) ont permis de documenter et de définir une série de valeurs. Le répertoire issu de ces démarches a été soumis à un test de fonctionnalité auprès d'ergothérapeutes ( n = 5), puis présenté à des ergothérapeutes détenant une expertise en éthique ( n = 6) pour en évaluer la validité de contenu des définitions des valeurs. RÉSULTATS.: Le répertoire proposé comprend 33 valeurs suivies de leur définition que les experts ont jugées claires et représentatives des réalités qu'elles désignent. Les résultats montrent que le répertoire est considéré comme exhaustif. CONSÉQUENCES.: Cette étude a permis de répertorier et de définir des valeurs qui constituent des idéaux susceptibles de guider la pratique ergothérapique et de soutenir les revendications ainsi que les compétences culturelles et éthiques des ergothérapeutes.

The values of occupational therapy: Perceptions of occupational therapists in Quebec.

OBJECTIVE: Recently, there has been increasing interest in the values of occupational therapy and the values held by occupational therapists. A wide range of values has been reported in the literature. Furthermore, despite the fact that values are an important part of professional identity, empirical studies have demonstrated that several occupational therapists possess an ambiguous professional identity. This study was undertaken to explore the values of Canadian occupational therapists, specifically French-speaking occupational therapists in Quebec. METHODS: Semi-structured interviews were conducted with 26 occupational therapists. Their narratives were subject to hermeneutic analysis, a method of textual analysis common in philosophical research. RESULTS: A total of 16 values were identified in the discourses of the occupational therapists interviewed: autonomy; human dignity; occupational participation; social justice and equity; professionalism; holism; partnership, environment, or ecological approach; quality of life; solicitude; honesty; integrity; health; creativity; professional autonomy; effectiveness; and spirituality. CONCLUSIONS: The results of this study are, in general, consistent with those reported in the few other empirical studies that have documented the values perceptions of occupational therapists. Finally, the explanation of the values of occupational therapists may reinforce their professional identity and favour best, or at least desirable, professional practices related to ethics and culture.

Developing professional values: perceptions of francophone occupational therapists in Quebec, Canada.

Objective Recent literature shows growing interest in the values displayed by occupational therapists. Yet, none of these writings has so far examined the factors that contribute to the development of occupational therapists' professional values. These factors are important, since values play a pivotal role in forging professional identity, which in the case of some occupational therapists remains somewhat ambiguous. This article proposes possible answers to the following question: What do Quebec Francophone occupational therapists perceive as the building blocks of their professional values? Methods Using a phenomenological qualitative method, the subjective experience of occupational therapists in Quebec, Canada was examined. Twenty-six occupational therapists took part in the study. Results As intended, their professional experience was varied. According to the participants, four factors contributed significantly to their professional values: professional experience, university training, personal experience, and professional development. However, fewer than 50% of the participants cited six other factors (workplace, family upbringing, personal development, personality and abilities, professional normative framework, and sociocultural background). Conclusions Most of these results are consistent with those documented in existing works. They point to the relevance of discussing professional values during university training and continuing professional development, as well as encouraging occupational therapists to become exemplars for their colleagues and interns. This study constitutes an initial step in understanding how occupational therapists' axiological identity is formed.