Factors affecting clinical reasoning of occupational therapists: a qualitative study

Background: Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical prac-tice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occu-pational therapists. Methods: Twelve occupational therapy practitioners working in mental and physical dysfunction fields partic-ipated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method. Results: There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1- client beliefs; 2- therapist values and beliefs; 3- social attitude to disability. The second theme: individual at-tributions included two subthemes 1- client attributions; 2- therapist attributions. The final theme was the work-place environment with the three subthemes: 1- knowledge of the managers of rehabilitation services, 2- work-ing in an inter-professional team; 3- limited clinical facilities and resources. Conclusion: In this study, the influence of the attitudes and beliefs of client, therapist and society about ill-ness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational ther-apy services. Accurate understanding of these influential factors requires more extensive qualitative and quan-titative studies.