Independence: an analysis of a complex and core construct in occupational therapy

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Introduction: Independence is a core concept in occupational therapy, but there is little consensus within the profession upon a universal definition. The present study employed a critical interpretive synthesis to examine two fundamental research questions: 'How is independence conceptualised in quantitative and qualitative research within occupational therapy?' and 'How does the term “independence”, in its present use, critically impact occupational therapy policy and practice?'

Method: Articles pertaining to occupational therapy and contributing to the definition of independence within the profession were examined. Three successive levels of coding – open, axial and selective – were used to analyse 19 final articles.

Findings: From the literature, nine definition themes emerged: function, autonomy and competence, control, context, culture, environment, personal attributes and safety. These themes were then organised into three categories: personal factors, environmental factors and continuum, which were synthesised together to create a model that addresses all factors critical to the composition of independence. In addition, four clinical themes developed: goal of occupational therapy, client-therapist relationship, variable definitions in occupational therapy practice and limitations of present practice.

Conclusion: Through the formalisation of the integral components of independence, this study enables a standardised foundation for the examination of this core concept across the profession.


Document Type: Research Article


Publication date: April 1, 2012

More about this publication?
  • The British Journal of Occupational Therapy (BJOT) is the official journal of the College of Occupational Therapists. Its purpose is to publish articles relevant to theory, practice, research, education and management in occupational therapy internationally.

    BJOT publishes research articles, critical reviews, practice analyses, opinion pieces, editorials, letters to the editor, book reviews and an annual index. Please refer to the author's guide at

    Submissions can be made at

    The 2013 Impact Factor for The British Journal of Occupational Therapy is 0.897.

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