Creating opportunities for cultural awareness in occupational therapy: An example from Latin America

Abstract

Aim: to explore how awareness of cultural issues is being applied within occupational therapy to address some of the challenges relating to professional education and practice. Methods: In Study I an integrative literature review was conducted, exploring occupational therapy and culture in the articles published be-tween 2006 and 2011. Thirty-nine articles matched the inclusion criteria. Study II used a content analysis to identify the experiences on culture in personal and professional terms among Chilean occupational therapists (n=10). In-situ and distance interviews were conducted. Study III comprised the development and content validity of an instrument to assess cultural awareness in occupational therapy students in Latin America. Experts (heads of programs and faculty members) from four countries in the region participated in the successive rounds of consultation. Study IV was oriented to evaluate the test-retest reliability of Escala de Conciencia Cultural para Estudiantes de Terapia Ocupacional en América Latina (ECCETO) - Cultural Awareness Scale for Occupational Therapy Students in Latin America. New graduates (n=10) and students from four countries (n=26) participated in the two phases in the study. Results: the literature demonstrated in occupational therapy, there are two dimensions and a group of forces which impact the usage of culture within the profession. Culture is a dynamic and permanent change phenomenon. The notion of occupational therapy as a culture was identified (study I). Ongoing negotiations in personal and professional terms are necessary to be implemented across therapeutic encounters as practitioners are being challenged in terms of their values, beliefs and strategies. Relevant features for practice are highly context dependent in socio-historical and political terms (study II). The development of the Escala de Conciencia Cultural para Estu-diantes de Terapia Ocupacional en América Latina (ECCETO) [Cultural Awareness Scale for Occupational Therapy Students in Latin America], considered item construction, content validity and evaluation of test-retest reliability. The scale considers 30 items distributed in three categories, considering personal, professional and clients’ cultures. The scale has showed promising psychometric characteristics (study III & IV). Conclusions: the studies included in this thesis enlighten some of the current challenges in developing cultural awareness within the occupational therapy community, both in individual and collective terms. Students, practitioners, educators and scholars are being challenged to address an increasingly complex practice worldwide and in local contexts. Practice is being shaped by ongoing social changes, considering issues of globalization, technology development and migration. Regardless of the implications of these universal phenomena, local conditions for practice must be addressed. Local conditions may influence the understanding and experience of professional values and performance. Cultural awareness therefore needs to be developed in the early stages of professional education in order to maintain and increase the social relevance within the occupational therapy discipline.