Working with clients of higher weight in Australia: Findings from a national survey exploring occupational therapy practice

Abstract

Introduction: Occupational therapists are key members of the multidisciplinary team and regularly work with people of higher weight across age groups and practice settings. There is limited existing research regarding the occupational therapy role with this client group. The aim of this study was to explore occupational therapy practice and barriers to service provision for Australian occupational therapists working with clients of higher weight.

Methods: A cross-sectional study design using a self-administered online survey was distributed to members of the national occupational therapy professional association. The survey was designed to identify common assessments and interventions used with clients of higher weight and explore occupational therapists' perspectives on their knowledge and confidence and the barriers to service delivery. Descriptive statistics were used to summarise rating scales, and open-ended responses were analysed using thematic analysis.

Results: Eighty Australian occupational therapists working in a range of settings and with varied experience levels participated in the study. Participants described the most common areas of occupational therapy assessment and intervention when working with clients of higher weight to be self-care, equipment prescription, home modifications and pressure care. Respondents were least confident in interventions related to psychosocial, leisure and employment interventions. Barriers to service delivery included accessibility and cost of equipment, lack of training and weight stigma.

Conclusion: Occupational therapy practice promotes and enables participation in everyday occupations with people of higher weight. This study highlights not only the occupational therapy skills and unique approach to the person, their environment and occupations but also the challenges faced by occupational therapists when working with people of higher weight. Occupational therapists could consider utilising the weight-inclusive paradigm to broaden their contribution from self-care to other important aspects of participation and well-being.

Keywords: assessment; bariatric; barriers; higher weight; intervention; obesity; occupational therapy; scope of practice; social stigma; weight-inclusive.