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Barriers and enablers to providing community-based occupational therapy to people with functional neurological disorder: An interview study with occupational therapists in the United Kingdom

Nicholson, C., Francis, J. ORCID: 0000-0001-5784-8895, Nielsen, G. and Lorencatto, F. (2021). Barriers and enablers to providing community-based occupational therapy to people with functional neurological disorder: An interview study with occupational therapists in the United Kingdom. British Journal of Occupational Therapy, doi: 10.1177/03080226211020658

Abstract

Introduction
Occupational therapists have an integral role in the treatment of people with functional neurological disorder, yet there is evidence of variable implementation of occupational therapy in community settings. This study explored the barriers and enablers to delivering community-based occupational therapy to people with functional neurological disorder in the United Kingdom.

Methods
Community-based neurological occupational therapists (n = 10) with experience in functional neurological disorder were invited to complete semi-structured qualitative interviews. The interview schedule and analysis were based on the Theoretical Domains Framework, a behavioural science tool for investigating barriers and enablers to clinical practice. Data were analysed using a combined content and framework analysis approach.

Findings
Important barriers to treatment included limited published information to guide practice, lack of professional role clarity and restricted multidisciplinary team working. Enablers included occupational therapists’ dual training in physical and mental health and focus on activity engagement. Service provision, quality and access varied across geographical locations.

Conclusion
Occupational therapists are uniquely placed to help people with functional neurological disorder; however, findings suggest that existing community service structures in many regions in the United Kingdom are inadequate and limit the quality of treatment that can be provided. Additional resources are required to support occupational therapy service provision in community settings.

Publication Type: Article
Additional Information: This article has been published in British Journal of Occupational Therapy , SAGE Publications. DOI: https://doi.org/10.1177/03080226211020658. Reuse is restricted to non-commercial and no derivative uses.
Publisher Keywords: Functional neurological disorder, occupational therapy, rehabilitation, barriers and enablers
Subjects: H Social Sciences > HT Communities. Classes. Races
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health Sciences
Date available in CRO: 03 Aug 2021 14:46
Date deposited: 3 August 2021
Date of acceptance: 28 April 2021
Date of first online publication: 27 May 2021
URI: https://openaccess.city.ac.uk/id/eprint/26545
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