Year of Publication


Date of Thesis


Document Type


Degree Name

Master of Science


Occupational Therapy


The purpose of this study was to comparatively analyze the perceptual involvement of clients and occupational therapists in the shared decision-making process in healthcare facilities in the United States. This study also investigated whether there is a difference in perception in the shared decision-making process in different adult/geriatric healthcare facilities. Participants (11 occupational therapists, 30 clients) in adult/geriatric healthcare facilities were each engaged in a semi-structured interview to determine their perceptions of client-centered practice, specifically in relation to the goal setting process. Descriptive statistics were used to analyze the item data. In addition, one-way analysis of variance was computed to identify perceptual differences of opinions in clients and therapists among the four facility variables from where the participants originated from, i.e., longterm care/rehabilitation, hospital outpatient, hospital inpatient, nursing homes. The occupational therapists in this study indicated use of the principles of client­ centered practice in their delivery of occupational therapy services. Their clients however, had displayed mixed perceptions about their role as an active participant in client-centered practice and all responded negative to being aware of the approach. Perceptual differences did appear between the therapists and their clients in relation to the use of client-centered practice, as their responses to similar questions varied. Lastly, facility type significantly influenced clients' knowledge of certain aspects of their treatment in four areas. Results suggest that a perceptual gap exists between occupational therapists and their clients in relation to their stated use of and participation in client-centered practice. In light of the results, development of a systematic strategy by therapists to elicit the roles that their clients desire to play in the therapeutic process may be an effective intervention to ensure that therapists and their clients are able to fulfill their roles in client-centered practice.



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