Pidgeon, F

Occupational therapy in very remote, predominantly Indigenous, settings requires therapists to modify traditional models of practice to make practice applicable, culturally relevant and culturally safe. This article describes some of the author's observations of similarities and differences in what occupational therapy 'does' and 'is' in four different, but in many ways similar, very remote contexts. A Churchill Fellowship allowed the author to travel to visit teams in three very remote regions of Canada and the USA, allowing comparison to practice in the Top End of the Northern Territory in Australia. These very remote settings are unable to support onsite therapy services resulting in fly/drive-in visits from hub towns, influencing service models and extending professional tasks and roles. In many of these remote contexts populations are predominantly Indigenous, which requires therapists to work cross-culturally. This requires occupational therapists to adapt therapy assessments and interventions to make these appropriate to the contexts. Therapists perceived a range of therapeutic adaptations and resources as useful in their practice and some barriers to implementing these. These included supports to practice such as cultural liaisons or interpreters; being open and respectful to differences in beliefs around health, wellbeing, desired occupational pursuits and function; using a client/family-directed approach in care planning, goal setting and development of therapeutic strategies; being selective around use of standardised assessment tools; and taking time and developing relationships with family and clients. Therapists in these areas also reported their scope of practice as being broader in remote settings, requiring skills in a greater range of areas. Therapists also reported the increased use of technology to supplement and support remote practice.

Rural and remote health 2015 Apr-Jun; 15(2): 3002

https://pubmed.ncbi.nlm.nih.gov/25912169/?otool=iaurydwlib

https://hdl.handle.net/10137/5490

Allied Health

Cross-cultural Safety

Occupational Health

Practice Tips

Canada

Clinical Competence

Community Health Workers

Diffusion of Innovation

Family Practice

Female

Health Knowledge, Attitudes, Practice

Health Services, Indigenous

Humans

Male

Northern Territory

Occupational Therapy

Oceanic Ancestry Group

Outcome and Process Assessment (Health Care)

Patient-Centered Care

Physician-Patient Relations

Rural Population

Social Class

Social Support

Transportation

United States

Cross-Cultural Comparison

Cultural Competency

Rural Health Services

Occupational therapy: what does this look like practised in very remote Indigenous areas?

Comparative Study

Journal Article

Multicenter Study

Publication