"Being Holistic Is a Lot to Ask": A Qualitative, Cross-National Exploration of Occupational Therapists' Perceptions and Experiences of Holistic Practice.
Mona Asbjørnslett, Lisebet S Skarpaas, Linda Stigen
PMID 37885963WHAT IT FOUND
Occupational therapists across 13 countries struggle to define and deliver "holistic" care, citing time pressures, resource limits, and conflicting expectations.
They view holism as central to their identity but find it often unrealistic in practice, particularly in hospital settings with high caseloads.
Key findings
01Participants described holism as a core part of occupational therapy identity but struggled to define it, noting it could be an "illusion" when theory conflicted with practice constraints.
02The meaning of "holistic" varied significantly by context; in some countries it meant intensive physical training for independence, while in others it involved adapting to family needs or broader social participation.
03Therapists reported that institutional pressures, such as short hospital stays and large caseloads, made it difficult to balance holistic, client-centered goals with administrative demands.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
All interviews were conducted by undergraduate students with limited research experience, which may affect the depth and consistency of data collection. Translation issues: Some interviews were conducted in native languages and translated by the students themselves, risking loss of nuance or accuracy. The authors did not conduct the primary data collection, relying on secondary analysis of student theses, which may distance them from the raw data context. The sample size (33) across 13 countries is small for cross-national comparison, potentially limiting the generalizability of findings to specific national contexts.
Declared interests
The paper does not explicitly state funding sources or conflicts of interest in the provided text, though it notes the study was approved by the Norwegian Center for Research Data.
The easy way to misread this
Do not interpret the variation in definitions as a lack of professional clarity; rather, it reflects adaptive responses to different health systems and cultural values. Do not assume that therapists who cannot deliver broad holistic care are failing; the study suggests this is often a structural limitation of their workplace.