作业治疗专业思维在中国的发展历程(1986-2006)——历史文献研究(上)

Professional Reasoning of Occupational Therapy in China 1986-2006: A Documentary Analysis(Ⅰ)

目的梳理出1986年至2006年作业治疗专业思维在中国的发展历程。方法采用作业治疗历史文献研究方法,共搜集1986年至2006年公开发表的与作业治疗有关的历史文献1308篇,筛选得到52篇,进行深入分析。每一篇文献由3名研究员分别进行分析和审阅,并应用定性研究的主题分析提取文献的专业思维轴心。结果得出两条主线。第一条是有关思维改变的三个主题:早期作业治疗作为一门治疗技术而不是专业被引入中国后,历经作业治疗从业者由康复相关者(并不一定是作业治疗)逐渐演变成专职从事作业治疗的治疗师;由简单和粗浅的思考,演变为深入和周密的思维;从向国外学习到逐渐本土化。第二条是维持不变而足以影响专业思维发展的状况,包括三个主题:作业治疗专业人才数量严重不足;大众对作业治疗服务有误解,专业人员对作业治疗专业思维理解不准确;作业治疗服务范围局限于肢体康复和医院服务。结论梳理出1986年至2006年的21年时间里作业治疗专业思维在中国的发展历程。虽然作业治疗思维渐趋专业化,但早期影响专业发展的问题仍然存在,专业思维还需优化。

Objective To understand the development of professional reasoning of occupational therapy (OT) in China from 1986 to 2006. Methods A search of all OT papers published from 1986 to 2006 in the Chinese Academic Journals database yielded 1, 308 papers.Among them,52 papers were selected for further analysis of professional reasoning.Each was reviewed by three researchers.Thematic analysis was conducted using an interpretive approach. Results Two themes were identified:ongoing changes and sustaining contexts.Theme one consisted of three changes: from OT being an approach used by various healthcare providers to becoming a separate profession;from simple and superficial (e.g.,upper limb exercise) to in-depth and complex professional reasoning (e.g.,occupation-based models);and from relying on overseas experience to building on local practice experience.Theme two covered three sustaining practice contexts:insufficient supply of qualified OT,misconceptions of the roles and functions of OT and scope confined to hospital-based rehabilitation for people with physical disability. Conclusion This paper reported the historical development of professional reasoning in China from 1986 to 2006.Professional issues in early days have continued to influence current practice.We need to work together to sustain the spirit of OT and improve OT professional reasoning in China.