Occupation-based practice in a tertiary hospital setting: occupational therapists' perceptions and experiences.

Occupation-based practice is an important feature of occupational therapy. There is however limited research regarding occupational therapists' experiences with occupation-based practice. This study aimed to explore occupational therapists' perceptions and experiences regarding occupation-based practice in a tertiary hospital setting in the Western Cape, South Africa. An explorative and descriptive research design within a qualitative research approach was utilised. Purposive sampling allowed the selection of fourt participants with a minimum of 2 years practice experience. Semi-structured interviews were conducted to gain an understanding of how they perceived and implemented occupation-based practice. Data were analysed using thematic analysis. Four themes emerged: occupation-based practice expresses professional identity; occupation-based practice necessitates relevance; constraints to occupation-based practice; and facilitators of occupation-based practice. The findings revealed that the participants' perceived the implementation of occupation-based practice as an expression of their professional identity and that in adopting an occupation-based approach they perceived their roles as diverse and transformational. It was however highlighted that the nature of the service context posed several constraints that influenced the implementation of occupation-based practice. Thus, occupational therapists may need to generate practice-based evidence to advocate for the service conditions necessary to implement occupation-based practice and deliver relevant occupational therapy services.  Key words: Occupation; occupation-based practice; tertiary hospitals; qualitative research