A Qualitative Study Exploring How Occupational Therapists Embed Spirituality Into Their Practice

Introduction
Spirituality is a concept central to healthcare practice, and in particular to occupational therapy.
As a profession, influenced from early Judeo-Christian religious beginnings, occupational
therapy has retained yet translated this as a commitment to holistic, person-centred practice.
Occupational therapy holds the uniqueness of the individual, and meaningful and purposeful
expressions of health and well-being through occupation, as central to professional practice.
Set in the context of 21st century healthcare, this thesis explored how occupational therapists
(n=4) working in the English National Health Service (NHS) embedded spirituality into daily
practice.
Methods
Two studies were undertaken, first a structured literature review and concept analysis,
applying the method outlined by Walker & Avant (2011), to conceptualise spirituality as
described in occupational therapy practice. Second, a qualitative study was undertaken,
underpinned by an ethnographic approach, using participant-as-observer observation and
follow up interviews to explore how occupational therapists embedded spirituality into
everyday practice. Framework approach was used to guide analysis and interpret the large
volume of unstructured textual data.
Findings
Despite the difficulties defining spirituality occupational therapists appeared able to apply the
underpinning core values and philosophy of the profession and embed spirituality in their
practice. Practitioners found it more meaningful to describe spirituality in terms of how they
applied the concept in, and through, practice by comprehending the values, needs and
concerns of the individual as opposed to a consistent definition. Occupational therapists
engaged with spirituality by concerning themselves with supporting patients experiencing
vulnerability due to disruption in their health and well-being. This support was achieved by the
occupational therapist uncovering the individual needs of the patient and through delivering
person-centred care by explicitly addressing spirituality. The scope to embed spirituality was
on occasion limited by organisational and contextual factors that restricted the potential to
practice fully. Achieving organisational targets by adopting time constrained interventions was
perceived as having a particularly limiting impact on embedding spirituality in practice.
Conclusion
The Embedding Spirituality into Occupational Therapy (ESpiOT) model which emerged from
the findings of this study is offered as a tool to guide practice, education and research into
how spirituality is, and could be, embedded into occupational therapy practice.