A realist synthesis and evaluation of the role and impact of occupational therapists in reablement services

• Main Author: Dibsdall, L.
• Published: University of the West of England, Bristol 2019
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.767166

Reablement services aim to improve the ability of people experiencing poor health or disability to complete daily living tasks. Existing studies of reablement have identified the primary role of occupational therapists as providers of equipment. This study proposed that occupational therapists have a broader role working with both service users and carers, and reablement support workers. The study aimed to evaluate the role of occupational therapists in reablement from the perspective of occupational therapists in practice and managers and reablement support workers who work with them. A realist approach was taken, commencing with a realist synthesis review of the literature that identified four programme theories concerning occupational therapists in reablement services. These included: the recognition of occupational therapists by others; holistic approaches to assessment and goal setting; the provision of equipment; and working with support workers. The programme theories were tested, refined and expanded using a qualitative case study design. Each of the three case studies consisted of a reablement service that comprised two organisations. Methods of the study included observations and interviews with occupational therapists in practice, interviews with managers and focus groups with reablement support workers. This study contributes to knowledge of occupational therapists in reablement services with the presentation of a conceptual framework for practice, incorporating the original programme theories and two new theories identified in the case study phase, concerning a team approach to reablement. Findings conclude that occupational therapists make a positive contribution to reablement services. Advanced clinical reasoning skills support occupational therapists to undertake assessments, person centred goal setting and select from their toolbox of interventions to support service users. Occupational therapists' informal and formal training with support workers encourages a reabling ethos. Effective policies, good communication and co-location were identified as factors supporting team working and a shared purpose of reablement.