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. 2026 Jun 30;52(3):e70068. doi: 10.1111/jorc.70068

Occupational Therapy Services Provided to Adults Diagnosed With Kidney Disease: A Scoping Review

Jane Levison 1, Susan Brandis 1,✉
PMCID: PMC13317469  PMID: 42376957

ABSTRACT

Background

Chronic kidney disease and treatment have a severe and detrimental impact on life participation, reducing independence, autonomy, physical and cognitive function requiring a multidisciplinary approach. Occupational therapists have comprehensive skills in enabling independence and quality of life, yet the role in a kidney team is poorly understood.

Objectives

To identify occupational therapy services for adults diagnosed with kidney disease which will inform future practice, service planning and role definition.

Methods

Following Joanna Briggs Institute methodology for scoping reviews and the PRISMA‐ScR guidelines, PubMed, Scopus, PsycINFO‐OVID, ProQuest, and CINAHL were searched from inception to 15 December 2025. The population of interest was adults at any grade of kidney disease, the concept being occupational therapy services/models of care, and the context of any service setting. Results were transferred from Endnote to Covidence, duplicates removed and the title and abstract of articles screened. The full text of the remaining articles was assessed by two researchers, and themes were identified in alignment with the research questions.

Results

The search provided 1603 results, with 434 duplicates removed leaving 1169 articles. Following title and abstract screening, 40 papers remained for full text review, resulting in 23 studies for data extraction and analysis. Themes identified included types of occupational therapy interventions, grade of disease progression when interventions were undertaken, models of care and service location. The most reported occupational therapy roles related to activities of daily living, equipment prescription and mental health interventions.

Conclusions

While the occupational therapy role for patients with kidney disease is evolving worldwide, notably over the past 5 years, it is still underutilised. Further research is required to inform the development of clinical practice guidelines for clear role delineation.

Keywords: chronic kidney disease, end‐grade renal failure, occupational therapy, scoping literature review

1. Introduction and Literature Review

Chronic kidney disease (CKD) prevalence is increasing due to several complex factors, including an aging population and its comorbidity with other well‐known chronic diseases such as heart disease, hypertension, diabetes and obesity (Ozdemir et al. 2021). Previously ranked as the 12th leading cause of death worldwide, affecting over 10 percent of the global population (Hill et al. 2016; Jadoul et al. 2024), it rose to the ninth leading cause of death in 2023. The World Health Organisation has allocated CKD the status of ‘a non‐communicable disease of global priority’ (Abdulkader et al. 2025). In Australia, kidney disease contributed to approximately 11 percent of deaths in 2017–2018 (Australian Institute of Health & Welfare 2020), and related deaths have more than doubled since 2000 (Australian Institute of Health and Welfare 2024). The progression of kidney disease has in the past been referred to as stages on a continuum. More recent consensus recommends the use of the term ‘grade’ (Levey et al. 2020). This current paper uses the term as published in the source papers, while recognising the more recent nomenclature in the remaining analysis.

Kidney disease is a five‐grade continuum, with many individuals experiencing early‐grade disease whilst being asymptomatic. Commonly, patients with grade I & II kidney disease may not experience any symptoms, with signs and symptoms only appearing in grades III & IV (Australian Institute of Health and Welfare 2020). Kidney failure (KF) is the fifth and final grade of CKD where patients have very limited treatment options, including dialysis, transplant, conservative kidney management or palliative care (Kidney Health Australia 2019).

CKD and treatment have a systemic detrimental effect on the patient, with profound fatigue (Davis et al. 2025; Farragher et al. 2025), declining physical and mental abilities, poorer psychological well‐being and reduced quality of life. CKD causes many debilitating symptoms, including cognitive decline that influences the patient's ability to self‐care in activities of daily living, increased hospital stays and reduced quality of life and independence (Farragher et al. 2020). Patients with kidney failure experience considerable disability and symptoms that are life‐changing personally and their families. Treatment is arduous and difficult and limits occupations that are meaningful (Bezerra et al. 2008).

Kidney disease service settings span the continuum of care throughout the grades of the disease. These include acute hospital settings, renal wards, outpatients, rehabilitation and the community. Historically, the medical model is commonly implemented using a multidisciplinary approach comprised of specialist doctors and nurses, social workers and physiotherapists with occupational therapy less featured (Strand and Parker 2010). Occupational therapists can enable patients to access the best level of client‐centred care, including early intervention strategies, lifestyle modification and education that could reduce the health and economic burden of CKD (Australian Institute of Health and Welfare 2024).

Research currently describes the occupational therapy role as symptom management alongside other multidisciplinary team health professionals (Farragher et al. 2020), assessment pre‐ or post‐dialysis (Saby and Miller 2016), interventions to maximise functional capacity through adaptation and task modification (Saby and Miller 2016), optimising quality of life through psychosocial interventions/support and fostering independence and self‐management (Boudreau and Dubé 2014). The enhanced and expanded use of occupational therapy in the team management of patients with kidney disease warrants further investigation due to the discipline's comprehensive, client‐centred, holistic approach which enable the patient to participate in life despite illness‐created barriers and functional capacity limitations (American Occupational Therapy Association 2020).

Currently, the significance of kidney disease and the potential role of occupational therapy are not well researched, providing little guidance for occupational therapists working in this area.

The objective of this review is to inform future occupational therapy practice when working with patients diagnosed with kidney disease to enable the best outcome for clients. The overarching aim is to ensure occupational therapists understand the potential of the role, and to explore opportunities for the full scope of practice as valuable team members. This leads to the following research question and sub‐questions:

  • 1.
    What has been reported in the literature regarding services/interventions and recommendations for occupational therapy practice for adult patients with kidney disease?
    • a.
      In what settings are these occupational therapy services/interventions delivered?
    • b.
      At what grade of the kidney disease process has occupational therapy been utilised?
    • c.
      What models of care and multidisciplinary/interdisciplinary approaches to patient care have occupational therapists participated in?

2. Methods

A scoping literature review was undertaken to explore the above questions (Arksey and O'Malley 2005) using the population, concept, and context structure (Peters et al. 2020). The aim was to identify occupational therapy services and recommendations for occupational therapy for adults diagnosed with kidney disease to inform future practice and planning of services as the volume of kidney patients rapidly increases. The population of interest was adults at any grade of kidney disease, the concept being occupational therapy services and models of care, and the context of any service setting (Peters et al. 2020). This approach maps all literature to ensure details are gathered about service provision and highlights knowledge shortfalls, which can be used as a basis for further research and to guide clinical decision‐making (Tricco et al. 2016). The PRISMA Extension for Scoping reviews (PRISMA‐ScR) checklist (Tricco 2018) structured the review process. The titles and abstracts of articles were screened, and the Johanna Briggs Institute Framework (JBI) was used for data extraction (Jordan et al. 2019).

2.1. Inclusion and Exclusion Criteria

Studies were included if they were level 4 research evidence or above (Hoffmann et al. 2017), quantitative, qualitative and mixed methods, published in English. Grey literature was excluded. Studies needed to include interventions provided by registered occupational therapists or recommendations for occupational therapy with participants over the age of 18 years, with kidney disease as a primary diagnosis, in hospital or community settings.

2.2. Data Collection and Analysis

The search scoped the electronic databases PubMed, Scopus, PsycINFO‐OVID, ProQuest and CINAHL from inception to 30th November 2021, with an updated search rerun up till 15th December 2025. MESH terms, truncation and Boolean logic were used in PubMed as indicated (see Appendix 1). The primary researcher (JL), conducted the searches, with the key search terms used for PubMed presented in Appendix 1. The search terms were translated in Polyglot for use in each database with the assistance of the university librarian. The search results were then uploaded into Endnote and transferred to Covidence for screening. Following removal of duplicates (JL) screened titles and abstracts of articles. A quality audit was conducted by a second researcher (SB) where a sample of excluded and included papers was independently screened to ensure accuracy of the screening terms. The remaining articles were full‐text screened by both researchers (JL and SB) against the inclusion/exclusion criteria independently.

2.3. Data Extraction

The primary researcher (JL) extracted data which included author, service setting, study design, intervention, key learnings, model of care, grade of disease and results. Results were compiled into tables, then thematic and bibliometric analysis was undertaken to better understand the interrelationship of factors in response to the research questions. A series of diagrams and charts was created to examine and identify the frequency of terms and key themes. Papers were mapped against the occupational domains and occupational therapy process as outlined in the occupational therapy practice framework (American Occupational Therapy Association 2020). Service settings were examined from the most acute health setting to the community. The team met regularly to discuss the findings and a conceptual framework developed to help synthesis the findings (Jabareen 2009). As this was an exploration of what had been reported in the literature in relation to occupational therapy practice, a critical appraisal of the literature and grading of evidence was not conducted. The scoping methodology was selected to provide a picture of the status and representation of occupational therapy practice to patients with kidney disease.

3. Results

3.1. Search Results

The search strategy found 1603 titles and abstracts. Of these 40 articles were full‐text reviewed, with 23 studies meeting the inclusion criteria. The PRISMA flow chart (Figure 1) summarises the search and selection of studies process. Additional details regarding each of the included papers are available in the supplementary Table.

Figure 1.

Figure 1

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PRISMA flowchart.

3.2. Characteristics of the Included Studies

While we searched from inception, the studies included were published from 2004 to 2025, used multiple designs and emanated from USA (6), Brazil (4), Canada (4), Australia (2), UK (2), Chile (1), Korea (1), Taiwan (1), and Turkey (1). There was one practice guideline based on systematic reviews, one systematic review, one scoping review, three randomised controlled trials, eight quantitative studies and three qualitative studies. The topic of the practice guideline included multiple chronic diseases, although contained a moderate level of evidence specific to occupational therapy interventions for patients with kidney disease (Fields and Smallfield 2022). Some of the included papers were of a lower level of research due to the scoping review approach (Hoffmann et al. 2017). While we searched from inception, interest in the area of the provision of occupational therapy services to patients with kidney disease has accelerated since 2000 as shown in Figure 2.

Figure 2.

Figure 2

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Number of included papers from inception.

3.3. Occupational Therapy Services and Interventions Provided

A variety of occupational therapy services and interventions were identified, some quite specific (such as bed mobility) and other more generally referred to as ‘occupational therapy’ without defining what this involved. Since 2020, there has been an increase in holistic, client‐centred and educational interventions, enabling the patient's occupational performance (Correa et al. 2025; Farragher et al. 2025; İnal Özün et al. 2021) often through collaborative goal setting (Chotivatanapong et al. 2024) and role adaptations (Cárdenas‐Cárdenas et al. 2022). Please see Table 1.

Table 1.

Occupational therapy interventions presented in the literature.

Occupational therapy services/intervention Reference
Cognitive screening, symptom management (pacing strategies, sleep advice), relaxation sessions (art therapy, mindfulness, chair‐based yoga, games), facilitation of meaningful activity, occupational therapy access visits, discharge planning and supports Ancliffe et al. (2024)
Early identification of reduction in independent activities of daily living abilities through assessment, interventions to enable occupational adaptation Arenas‐Jimenez et al. (2019)
Surveys/questionnaires about: quality of life & occupational functioning Bezerra et al. (2008)
Restructuring of routines, support to enable occupational adaptation, symptom management Cárdenas‐Cárdenas et al. (2022)
Measurement of functional capacity Chen et al. (2018)
Holistic supports including shared decision making, symptom management, and psychosocial support Chotivatanapong et al. (2024)
Interventions with a holistic approach, targeting cognitive changes, psychological anxiety and distress, also understanding the impact of the caregivers' support, prescription of home modifications and assistive devices Correa et al. (2025)
Home assessment/modifications, prescription of assistive equipment Crews et al. (2019)
Energy management programmes utilising metacognitive strategy training Davis et al. (2025)
Occupation‐based interventions that optimise occupational performance and participation Farragher et al. (2025)
Energy management technique education in self‐identified areas Farragher et al. (2020)
The Personal Energy Planning (PEP) programme
Multimodal self‐management programme including education, goal setting and problem solving Fields and Smallfield (2022)
Use standardised assessments and qualitative patient data
Telehealth services can be utilised
Rehabilitation Forrest (2004)
Client‐centred education programmes provided by occupational therapists on fatigue and pain management, sleep regulation, physical and leisure activities İnal Özün et al. (2021)
Fatigue management & depression Lee et al. (2015)
Self‐care, anxiety & depression Lowney et al. (2015)
Arts & crafts/leisure activities during haemodialysis, prescription of adaptive equipment Mariotti and Rocha de Carvalho (2011)
Bed mobility, transferring/mobility education & assistance Mayer et al. (2020)
Needs assessment during haemodialysis, promoting independence and mobilising support services Pereira et al. (2020)
Occupational therapy assessments to inform treatment choice of peritoneal dialysis instead of haemodialysis Pinto et al. (2021)
Recommendations for occupational therapy to slow/prevent disease progression. Strand and Parker (2010)
Semi‐structured interviews to understand occupational performance barriers and occupational deprivation Wells (2015)
Referral to occupational therapy White and Grenyer (2006)
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Reported and recommended roles for occupational therapy were further mapped against the occupational therapy practice framework to integrate findings (American Occupational Therapy Association 2020). As can be seen in Figure 3, health symptom management (mainly fatigue) and education were most reported while leisure and play received less attention. As play is predominantly a child's occupation, this can be explained by our exclusion of age under 18.

Figure 3.

Figure 3

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Number of papers by occupational domain.

Data extracted from the included studies identified that 65% of service provision was in the hospital or renal unit, and 35% related to community or mixed settings. A flow chart of service settings with associated publications is depicted in Figure 4.

Figure 4.

Figure 4

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Analysis of service setting.

3.4. Grade of Kidney Disease

Analysis showed that 78% of the included research papers referenced patients in kidney failure (grade 5) who had commenced treatment, the remaining 28% were patients with grades 3–5, pre‐dialysis, acute kidney injury or across the continuum.

3.5. Models of Care and Team Structure Reported

The data was further explored to identify what service delivery model was in place. Six authors used the medical model (Chen et al. 2018; Forrest 2004; Mayer et al. 2020; Strand and Parker 2010; White and Grenyer 2006). The biopsychosocial model was used by the remaining seven authors (Bezerra et al. 2008; Crews et al. 2019; Lee et al. 2015; Lowney et al. 2015; Mariotti and Rocha de Carvalho 2011; Pereira et al. 2020; Wells 2015). The first author disciplines included fourteen occupational therapists, four medical practitioners, three nurses one physiotherapist, and one researcher. Interestingly, the models of care utilised appeared related to the author's discipline in that doctors or nurses often favoured the medical model, while occupational therapists were more likely to use the biopsychosocial model.

The members of the multidisciplinary/interdisciplinary teams varied across countries, lead author's discipline and models of care. The teams included specialist doctors and nurses, physiotherapists and occupational therapists (Mayer et al. 2020), with Forrest (2004) including speech pathologists and psychologists. The systematic review by Strand and Parker (2010) included exercise physiologists, dieticians, social workers, pharmacists, diabetic educators, and podiatrists. One paper utilising the medical model recommended referring to occupational therapists and physiotherapists but was unsure of the result of their referral (White and Grenyer 2006).

The final analysis considered the occupational therapy process to understand how occupational therapy was reported along the continuum from evaluation, intervention and outcome measurement, including the implications for practice. These have been summarised in Table 2.

Table 2.

Occupational therapy process of evaluation, intervention and outcome.

Paper E I O Implications for OT practice
Ancliffe et al. (2024) X X X Occupational therapy as part of physiotherapy clinical exercise physiology multidisciplinary team to provide assessment & rehab interventions to enable living well with chronic kidney disease
Arenas‐Jimenez et al. (2019) X X X Evaluation of independent activities of daily living's as part of dialysis care, before loss of function progresses, early interventions of programmes to prevent, slow or reverse health‐related disability
Bezerra et al. (2008) X X X Assessment and identification of barriers
Support from occupational therapist to restructure routines to enable participation in meaningful occupations
Cárdenas‐Cárdenas et al. (2022) X X X Occupational therapy as part of the multidisciplinary team to enable occupational adaptation in early grades of diagnosis to prevent reduction in quality of life
Chen et al. (2018) X Taiwan performance‐based independent activities of daily living may detect functional limits before other independent activities of daily living self‐reporting scales. Functional fitness declines as independent activities of daily living deficits increase.
Chotivatanapong et al. (2024) X X Opportunities for nephrology providers to optimise holistic, patient‐centred comprehensive conservative kidney management care for patients who refuse renal replacement therapy, outcome to increase health related quality of life
Correa et al. (2025) X X Lack of research and prioritisation of life participation as a primary outcome. Research does not address the multiple, complex challenges that this pt population faces
Crews et al. (2019) X X X A home‐based intervention addressing physical and social functioning of low socio‐economic older adults on haemodialysis was feasible & acceptable
Davis et al. (2025) X X X Fatigue has a detrimental effect on a patient on haemodialysis ability to engage in occupational roles and routines
Energy management programmes using metacognitive strategy training may positively enable occupational engagement
Farragher et al. (2020) X X X Personal Energy management programme (PEP) using problem solving and three education modules on energy mgmt. was acceptable to stakeholders
Farragher et al. (2025) X X X Overwhelming fatigue causes significant impairment to the occupational performance of patients on haemodialysis. Novel interventions are needed to enable participation in meaningful occupations
Fields and Smallfield (2022) X X X Moderate evidence to provide individual education sessions, follow‐up phone calls to include action plans, goal setting & diagnosis education to improve self‐management. skills & self‐efficacy & knowledge base for people with kidney disease
Forrest (2004) X X X Patients on haemodialysis can benefit from rehabilitation services including physiotherapy, occupational therapy & psychology
Inal et al. (2021) X X X Occupational therapy interventions are an important part of the treatment process & can improve occupational performance & quality of life in patients with kidney failure on haemodialysis
Lee et al. (2015) X X X Patients with end grade renal disease need interventions including education programmes to assess & manage depression, fatigue; and a suitable environment for occupational rehabilitation or late‐night haemodialysis to maintain occupational performance and engagement
Lowney et al. (2015) X X X Patients on haemodialysis have high symptom burden & poor health‐related quality of life. Interventions to improve quality of life include pain assessment/mgmt., mobility assessment and occupational therapy/physiotherapy
Mariotti and Rocha de Carvalho (2011) X X X Occupational therapy should be included in patient's haemodialysis treatment programmes to improve quality of life
Mayer et al. (2020) X X X Early rehabilitation in critically ill pts with kidney failure is safe and feasible. Occupational therapy interventions as part of multidisciplinary team.
Early rehabilitation interventions with a focus on mobility may improve patient outcomes
Pereira et al. (2020) X X X Assessment of needs
Stimulation of functional capacity
Reorganisation of routines
Link to support networks
Pinto et al. (2021) X X X Relationship between occupational performance and type of dialysis treatment, haemodialysis leads to have higher levels of occupational performance
Strand and Parker (2010) X X Use of clinics with occupational therapy included, to educate can delay the time to onset of kidney failure
Wells (2015) X Patients with kidney failure on haemodialysis experience reduced occupational participation in meaningful activities, including social interactions, and required occupational adaptations
White and Grenyer (2006) X 50% of Renal Units in Australia refer to occupational and physiotherapy services, but the outcome of these referrals is unknown
Education is a part of the treatment offered
Exercise recognised as treatment
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4. Discussion

This scoping review aimed to understand the interplay between the setting of occupational therapy services, the grade of disease that occupational therapy interventions were proposed or applied, and the model of care utilised for adults diagnosed with kidney disease. Further, the recognition and inclusion of occupational therapy in the multidisciplinary/interdisciplinary team approach, and the development of this role in the past 10 years.

This review identified three distinct types of papers: interventional, qualitative and those that recommended occupational therapy services to be included as part of the treatment plan (Strand and Parker 2010; White and Grenyer 2006). Occupational therapy services currently utilised include; assessments (Arenas‐Jimenez et al. 2019; Chen et al. 2018; Crews et al. 2019; Lee et al. 2015; Lowney et al. 2015; Pereira et al. 2020), collaborative goal setting (Fields and Smallfield 2022; Mariotti and Rocha de Carvalho 2011), recommendations (Ancliffe et al. 2024; Correa et al. 2025; Forrest 2004; Pinto et al. 2021; Strand and Parker 2010; White and Grenyer 2006), interventions (Bezerra et al. 2008; Cárdenas‐Cárdenas et al. 2022; Crews et al. 2019; Davis et al. 2025; Farragher et al. 2025; Farragher et al. 2020; Mayer et al. 2020), support (Chotivatanapong et al. 2024; Pereira et al. 2020), education (Crews et al. 2019; İnal Özün et al. 2021; Wells 2015) and referrals to other specialties. These recommendations are consistent with the occupational therapy practice framework (American Occupational Therapy Association 2020), 2020). Only recently has there been some delineation of the occupational therapy role and guidance for service provision to patients diagnosed with kidney disease.

In the United Kingdom Multiprofessional Renal Workforce Plan for Adults and Children with Kidney Disease, the occupational therapy role included assessments of cognition, participation in occupations, seating and posture; equipment recommendations; home modifications; support for end‐of‐life care; referrals for rehabilitation and support audits and research. Recommendations were also made specifically for outpatient care, including vocational rehabilitation; interventions including energy management and fatigue education, anxiety, relaxation; baseline cognitive and functional assessments; support for symptom management from kidney disease and treatment; support for peritoneal dialysis in the home including environmental assessments and task analysis; promotion of meaningful occupations; upper limb rehabilitation and education and group therapy.

Occupational therapists can use advanced communication techniques including active listening, and comprehensive, holistic, client‐centred assessment to adapt tasks and enable occupational participation in meaningful activities, increasing health‐related quality of life for patients (Cárdenas‐Cárdenas et al. 2022). Kidney patients report a minimal understanding of their disease process and treatment options and lack the confidence or rapport with the treating medical team to ask important questions (Chotivatanapong et al. 2024; Correa et al. 2025; Pereira et al. 2020). Patients report comfort in the professional relationship with occupational therapists which can be leveraged to empower patients' voice in the complex treatment choice process (Pereira et al. 2020).

The high symptom burden of kidney disease was highlighted across all settings, indicative of the importance of maintaining function (Cárdenas‐Cárdenas et al. 2022). Patients report a life‐altering difficulty living with treatments such as haemodialysis (Lowney et al. 2015). Depression from heavy symptom burden including pain severity comparable to advanced cancer intensity (Lowney et al. 2015) and the chronic incurable nature of kidney failure are large determining factors in health‐related quality of life, alongside anxiety and fatigue (Lee et al. 2015). Kidney failure affects patients by reducing their physical fitness, strength, mobility and functional capacity for activities of daily living (Bezerra et al. 2008; Forrest 2004). Reported symptoms of kidney failure patients on haemodialysis include fatigue, loss of functional capacity for activities of daily living, depression and anxiety (Lee et al. 2015). Kidney disease causes impairment in social, emotional and physical areas of a patient's life (Bezerra et al. 2008) and also affects the ability to perform meaningful occupational roles and self‐care, hence highlighting the value of access to occupational therapy. The individual prescription of dosage and frequency of haemodialysis necessitates a client‐centred approach when understanding the patient's experience of treatment, caused fatigue, the most commonly reported symptom of chronic illness and in particular kidney disease (Lee et al. 2015).

The occupational therapy scope of practice includes assessment, recommendations, intervention and education in the areas of ADLs and IADLs, health management, rest and sleep, work, play, leisure and social participation (American Occupational Therapy Association 2020). This review has illustrated that occupational therapy is not utilising the breadth and depth of the professional role to maximise the quality of care for adults with renal disease. The Australian Government's National Strategic Action Plan for Kidney Disease (2019) second priority is the provision of optimal care and support through high‐quality care. The expansion of the occupational therapy role into novel or emerging areas of practice could become a pathway due to comfort in the professional relationship with occupational therapists that can be leveraged to empower patients' voice in the complex treatment choice process.

4.1. Service Settings and Models of Care

Occupational therapists were reported as providing services across the continuum of health care from the intensive care unit, hospital inpatient and outpatient clinics, rehabilitation and community settings. Most services were provided in the hospital environment, with 61% of the included studies set in an acute or ward setting. The medical multidisciplinary model was utilised by several lead authors who were doctors and nurses, while the biopsychosocial model was the approach that occupational therapists favoured (Mariotti and Rocha de Carvalho 2011; Pereira et al. 2020). This could be due to the occupational therapist's comprehensive assessment approach that considers the person, environment, and occupational factors in the context of social and cultural influences, to best enable occupational participation in meaningful activities, which increases health‐related quality of life (American Occupational Therapy Association 2020).

There appears to be a link between the use of a medical model (focus on treatment for disease) (Chotivatanapong et al. 2024) and a limited use of the occupational therapy role (Pereira et al. 2020). Interestingly, in Chotivatanapong's 2024 research, a knowledge void was identified in the conservative kidney management (CKM) pathway that approximately 10% of kidney failure patients choose. She reported that Nephrologists did not feel that CKM was within their scope of treatment provision. Lack of recognition for the breadth and scope of the occupational therapy domain to provide services and value add to patients with renal disease is a barrier to the expansion of the ability of occupational therapists to enable an increase in health‐related quality of life. In 2006, the medical model was widely utilised in Australian kidney care, however a shift of emphasis from treatment to living with chronic disease‐related disability is evident (White and Grenyer 2006). The medical professionals' expectations influence whether patients are offered early rehabilitation during haemodialysis (White and Grenyer 2006) or CKM (Chotivatanapong et al. 2024), and nurses were identified as a key influential stakeholder group. The perceptions of patients and their families also affected the treatment patients received and their long‐term prognosis (Wells 2015). Occupational therapy, utilising a holistic approach that assesses and understands the impact of kidney disease on the whole person and their family, is crucial to provision of the best care for patients.

4.2. Multidisciplinary or Interdisciplinary Approaches

The highest level of evidence found in this search, a recent Practice Guideline of Occupational Therapy for Adults with Chronic Conditions (Fields and Smallfield 2022) found a moderate level of evidence to support the use of a preventative, collaborative multimodal approach by occupational therapists that includes education, goal setting and problem‐solving to enable a patient's self‐management of the occupational adaptations necessitated by kidney disease. Occupational therapy collaboration in the interprofessional team was valued due to the ability to comprehensively understand the patient's challenges, including intrinsic factors and extrinsic influences and positively affect the trajectory of kidney disease disability (Fields and Smallfield 2022). In addition, an Australian systematic review stated that multidisciplinary care was effective in slowing disease progression to kidney failure requiring haemodialysis (Strand and Parker 2010). Kidney replacement therapy is life‐altering due to added symptom management, strict dietary and fluid regimes, the hours spent having treatment, high cost and health‐reduced quality of life (Wells 2015). As a result, delays in disease progression through early intervention with health promotion strategies including education on lifestyle adaptations are a positive outcome for the patient (Arenas‐Jimenez et al. 2019; Davis et al. 2025; Farragher et al. 2025; Farragher et al. 2020), and a reduced cost for the government from an institutional perspective (Strand and Parker 2010).

Occupational therapists were included in part of a multidisciplinary/interdisciplinary approach in many of the included articles (Ancliffe et al. 2024; Arenas‐Jimenez et al. 2019; Bezerra et al. 2008; Cárdenas‐Cárdenas et al. 2022; Chotivatanapong et al. 2024; Crews et al. 2019; Farragher et al. 2020; Fields and Smallfield 2022; Forrest 2004; Mariotti and Rocha de Carvalho 2011; Mayer et al. 2020; Pereira et al. 2020; Strand and Parker 2010). The interdisciplinary team approach, including occupational therapy, is recognised and utilised in the most acute care of patients with kidney disease, and is directed by a protocol in the recent research by (Mayer et al. 2020).

4.3. Occupational Therapy Role Changing Over Time

The changing role of occupational therapy over time is demonstrated by the evolving models of care presented. The medical model with a multidisciplinary approach was applied by Forrest (2004), while the same model was utilised by White and Grenyer (2006) but included recommendations for a more comprehensive biopsychosocial approach. Similar recommendations were made by Strand and Parker (2010), with the biopsychosocial model used or recommended by the remaining articles reviewed. In 2020, the interdisciplinary approach was described with physiotherapy and occupational therapy working side by side in an acute setting, towards the client‐centred goal of early rehabilitation (Mayer et al. 2020). The interprofessional model where occupational therapists are valued for their skill set and the effects of interventions noted, was researched by Fields and Smallfield (2022). In 2024, Ancliffe et al. (2024) noted in a service evaluation paper based on United Kingdom rehabilitation service provision, over 60% of rehabilitation units had access to occupational therapists working in a multiprofessional model of care, with a greater scope of the occupational therapy role utilised.

While this search was from inception, the appearance of literature pertaining to occupational therapy and kidney disease is quite recent. Occupational therapy was listed towards the end of the list of disciplines that might be included in the multiprofessional kidney team. The biopsychosocial approach was used by multiple occupational therapists lead authors from 2008 to 2020 (Bezerra et al. 2008; Mariotti and Rocha de Carvalho 2011; Pereira et al. 2020). Lead authors from a medical background also used or recommended the biopsychosocial approach (Crews et al. 2019; Lowney et al. 2015), suggesting wider knowledge and recognition of occupational therapy services in the provision of care for kidney patients and the changing of attitudes and experience with occupational therapy in a kidney setting.

The evolution of occupational therapy as an important part of the interdisciplinary approach was expressed by a physiotherapist lead author (Mayer et al. 2020). Taking an interdisciplinary approach where physiotherapy and occupational therapy are working side by side with the medical team towards the common goal of early rehabilitation, illustrates the emerging expansion of occupational therapy in the hospital setting. In the last 5 years of the number of research papers has increased parallel to the increased burden of kidney disease.

4.4. Expanding the Occupational Therapy Role in a Kidney Setting

From the point of diagnosis with kidney failure, the patient without a kidney transplant faces life living with the physical, emotional and social limitations of health‐related disability related to the disease and treatment needed to prolong life (Bezerra et al. 2008). The ability to participate in meaningful, wanted and needed occupations is diminished as functional capacity decreases. This degeneration of functional competency in activities of daily life requires occupational therapy that is client‐centred, holistic and comprehensive to maximise health‐related quality of life (Bezerra et al. 2008). Reimagining a new, different life for kidney patients living with health‐related disability (Bezerra et al. 2008) is the privileged domain of occupational therapy.

Occupational therapy services can assist kidney patients reconfigure their life by enabling occupations, including maximising physical abilities in self‐caring tasks, recommending home modifications, psychosocial symptom management and cognitive decline (Arenas‐Jiménez, et al. 2019, Kellerman, et al. 2010). The broad skill set of an occupational therapist can support the patient's mental health and wellbeing with many experiencing anxiety and depression caused by the severity of their disability associated with CKD (Kellerman, et al. 2010). The individual prescription and frequency of haemodialysis necessitate a client‐centred approach when understanding the patient's experience of treatment caused fatigue, the most commonly reported symptom of chronic illness and in particular kidney disease (Lee et al. 2015).

In conclusion, occupational therapists are providing interventions to adults with kidney disease, including mobility and transfer assistance, functional and environmental assessment, education on health promotion and symptom management, task adaptation and finally advocacy to enable patient autonomy. Occupational therapy interventions are crucial across all health settings from the most acute intensive care wards to the community. The models of care used to provide treatment to kidney disease patients vary, from medical to biopsychosocial, often utilising a multidisciplinary or interdisciplinary team approach. The occupational therapy role within the multidisciplinary/interdisciplinary team is emerging, and recognition of the full scope of the occupational therapy domain is ongoing.

4.5. Limitations and Strengths of This Review

Limitations include the scoping review approach to include all types of evidence, with only seven papers being of a level 1 and 2 evidence (Hoffmann et al. 2017), a practice guideline, two systematic literature reviews, three randomised control trials and a cohort study. Many papers were qualitative to better understand the experience of living with renal disease. CASP analysis was not completed on the included papers, as many would have been excluded on levels of evidence, and the overall picture of occupational therapy service provision would not have been as complete. Articles were only included if they were in English and Grey literature was excluded.

Strengths include the different levels and types of research, including qualitative, quantitative, and mixed methods research, that were included. The inclusion of qualitative studies informs understanding of the patient's perspective and priorities and illustrates the occupational therapy domain for practice. This review provides a framework and basis for further research and development of clinical practice guidelines for occupational therapy across the care continuum.

4.6. Key Findings

Further research by occupational therapists across all service settings, should be undertaken using the mixed method approach to understand the complex experiences of adults diagnosed with kidney disease. Protocols should be developed for each service setting to enable maximum occupational therapy services and interventions, and recognition of the discipline amongst other members of the multidisciplinary/interdisciplinary team in kidney disease.

Author Contributions

J.L. and S.B. conceived the study. Under the direct supervision of S.B., J.L. developed the search strategy and protocol. J.L. conducted the initial abstract screening, with both S.B. and J.L. reviewing full texts and conducting data analysis. J.L. wrote the first draft of the manuscript. Both authors reviewed and edited the manuscript and approved the final version of the manuscript. S.B. refined the manuscript to meet journal guidelines and is the corresponding author.

Funding

The authors did not receive any funding remuneration for this scoping review. This research received no specific grant from any funding agency in the public, commercial, or not‐for‐profit sectors. It was commenced as part of the coursework for Master of Occupational Therapy, Bond University, 2022.

Ethics Statement

The authors have nothing to report.

Consent

Consent was not required as there were no participants involved in this scoping review.

Conflicts of Interest

The authors declare no conflicts of interest.

What the Study Has Added

There has been limited research into occupational therapy interventions by occupational therapists when working with kidney patients. Occupational therapy is needed to maximise health‐related quality of life in adults diagnosed with kidney disease. While the occupational therapy role is broad and diverse, current research illustrates the lack of protocols across service settings to guide therapists new to kidney services.

Supporting information

Appendix 1: Data base and search terms.

JORC-52-0-s002.docx (65.1KB, docx)

Appendix 2: List of acronyms used in Tables.

JORC-52-0-s001.docx (133.4KB, docx)

Supporting File

JORC-52-0-s003.docx (23KB, docx)

Acknowledgements

The authors acknowledge the assistance of the research librarian. The authors acknowledge the assistance of Sarah Bateup, research librarian at Bond University for her invaluable assistance during the initial searching phase of the review. JL (student) would like to also acknowledge the assistance of the Bond University Occupational Therapy academic staff for their invaluable advice when completing this scoping review. Open access publishing facilitated by Bond University, as part of the Wiley ‐ Bond University agreement via the Council of Australasian University Librarians.

Levison, J. , and Brandis S.. 2026. “Occupational Therapy Services Provided to Adults Diagnosed With Kidney Disease: A Scoping Review.” Journal of Renal Care 52: e70068. 10.1111/jorc.70068.

Paper partly completed as a component of the Master of Occupational Therapy by Jane Levison under the supervision of Professor Susan Brandis.

Data Availability Statement

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

References

  1. American Occupational Therapy Association . 2020. Occupational Therapy Practice Framework: Domain and Process, 4th Edition (Vol. 4th edition) [Book]. AOTA Press. https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=2678393&site=ehost-live&scope=site. [Google Scholar]
  2. Ancliffe, L. , Castle E. M., Wilkinson T. J., and Young H. M. L.. 2024. “A National Survey of Current Rehabilitation Service Provisions for People Living With Chronic Kidney Disease in the Uk: Implications for Policy and Practice.” BMC Nephrology 25: 302. 10.1186/s12882-024-03742-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Arenas‐Jimenez, M. D. A. , García M. N., Reina E. S., and Álvarez‐Ude F.. 2019. “Disability in Instrumental Activities of Daily Living in Hemodialysis Patients: Influence on Quality of Life Related to Health.” Nefrologia 39, no. 5: 531–538. 10.1016/j.nefroe.2019.10.007. [DOI] [PubMed] [Google Scholar]
  4. Arksey, H. , and O'Malley L.. 2005. “Scoping Studies: Towards a Methodological Framework.” International Journal of Social Research Methodology 8, no. 1: 19–32. 10.1080/1364557032000119616. [DOI] [Google Scholar]
  5. Australian Institute of Health and Welfare . 2020. Table 2.1 Trends in CKD Hospitalisation Rates as A Principle Diagnosis (Excluding Regular Dialysis) by Sex 2000‐2001 ‐ 2017 ‐ 2018.
  6. Australian Institute of Health and Welfare . 2024. Chronic Kidney Disease: Australian Facts. https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease.
  7. Bezerra, K. V. , and Santos J. L. F.. 2008. “Daily Life of Patients With Chronic Renal Failure Receiving Hemodialysis Treatment.” Revista Latino‐Americana de Enfermagem 16, no. 4: 686–691. 10.1590/S0104-11692008000400006. [DOI] [PubMed] [Google Scholar]
  8. Boudreau, J. E. , and Dubé A.. 2014. “Quality of Life in End Stage Renal Disease: A Concept Analysis.” CANNT Journal = Journal ACITN 24, no. 1: 12–20. [PubMed] [Google Scholar]
  9. Cárdenas‐Cárdenas, N. , Miranda‐Catalan M. I., Obando‐Conejeros C., Rosales‐González J., and Carrasco‐Madariaga J.. 2022. “Occupational Repercussions in People With End‐Stage Chronic Kidney Disease Who Attend Hemodialysis: An Occupational Justice Framework.” Cadernos Brasileiros de Terapia Ocupacional 30: 8–14. 10.1590/2526-8910.ctoAO233230832. [DOI] [Google Scholar]
  10. Chen, H. M. , Hsiao S. M., Kuo M. C., et al. 2018. “Identifying Early Decline of Daily Function and Its Association With Physical Function in Chronic Kidney Disease: Performance‐Based and Self‐Reported Measures.” PeerJ 6, no. 7, Article: e5286. 10.7717/peerj.5286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Chotivatanapong, J. , Prince D. K., Davison S. N., Kestenbaum B. R., Oestreich T., and Wong S. P. Y.. 2024. “A National Survey of Conservative Kidney Management Practices for Patients Who Forgo RRT.” Kidney360 5, no. 3: 363–369. 10.34067/KID.0000000000000367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Correa, M. , Hussam R., and Farragher J.. 2025. “Exploring Interventions to Support Life Participation for Adults With Chronic Kidney Disease: A Scoping Review.” BMC Nephrology 26, no. 1: 251. 10.1186/s12882-025-04162-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Crews, D. C. , Delaney A. M., Walker Taylor J. L., et al. 2019. “Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living With ESRD (SOCIABLE) Study.” Kidney Medicine 1, no. 1: 13–20. 10.1016/j.xkme.2018.12.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Davis, J. A. , Farragher J., Thomas C., Ravani P., Manns B., and Hemmelgarn B. R.. 2025. “A Qualitative Follow‐Up on Perceptions of Energy Management Education and Daily Life by Individuals With Fatigue Undergoing Hemodialysis Treatment.” British Journal of Occupational Therapy 88, no. 8: 517–526. 10.1177/03080226251335228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Farragher, J. , Davis J. A., Thomas C., et al. 2025. “Occupational Priorities of People on Hemodialysis Who Participated in Energy Management Education.” Canadian Journal of Occupational Therapy 92, no. 2: 94–101. 10.1177/00084174241271205. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Farragher, J. F. , Jassal S. V., McEwen S., and Polatajko H. J.. 2020. “Development of an Energy Management Education Program (‘The Pep Program’) for Adults With End‐Stage Renal Disease.” British Journal of Occupational Therapy 83, no. 6: 397–404. 10.1177/0308022619881955. [DOI] [Google Scholar]
  17. Farragher, J. F. , Stewart K. E., Harrison T. G., Engel L., Seaton S. E., and Hemmelgarn B. R.. 2020. “Cognitive Interventions for Adults With Chronic Kidney Disease: Protocol for a Scoping Review.” Systematic Reviews 9, no. 1: 58. 10.1186/s13643-020-01320-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Fields, B. , and Smallfield S.. 2022. “Occupational Therapy Practice Guidelines for Adults With Chronic Conditions.” American Journal of Occupational Therapy 76, no. 2: 1–30. 10.5014/ajot.2022/762001. [DOI] [PubMed] [Google Scholar]
  19. Forrest, G. P. 2004. “Inpatient Rehabilitation of Patients Requiring Hemodialysis.” Archives of Physical Medicine and Rehabilitation 85, no. 1: 51–53. 10.1016/s0003-9993(03)00366-6. [DOI] [PubMed] [Google Scholar]
  20. Hill, N. R. , Fatoba S. T., Oke J. L., et al. 2016. “Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta‐Analysis.” Public Library of Science ONE 11, no. 7: e0158765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Hoffmann, T. , Bennett S., and Mar C. D.. 2017. Evidence‐Based Practice Across the Health Professions. 3rd ed. Elsevier. [Google Scholar]
  22. İnal Özün, Ö. , Kayihan H., Karahan S., and Üstündaǧ S.. 2021. “Effect of Occupational Therapy in Patients Receiving Hemodialysis: A Randomized Controlled Study.” Turkish Journal of Nephrology 30, no. 1: 63–69. 10.5152/TURKJNEPHROL.2021.4677. [DOI] [Google Scholar]
  23. Jabareen, Y. 2009. “Building a Conceptual Framework: Philosophy, Definitions, and Procedure.” International Journal of Qualitative Methods 8, no. 4: 49–62. 10.1177/160940690900800406. [DOI] [Google Scholar]
  24. Jadoul, M. , Aoun M., and Masimango Imani M.. 2024. “The Major Global Burden of Chronic Kidney Disease.” Lancet Global Health 12, no. 3: e342–e343. [DOI] [PubMed] [Google Scholar]
  25. Jordan, Z. , Lockwood C., Munn Z., and Aromataris E.. 2019. “The Updated Joanna Briggs Institute Model of Evidence‐Based Healthcare.” JBI Evidence Implementation 17, no. 1: 61–63. https://journals.lww.com/ijebh/Fulltext/2019/03000/The_updated_Joanna_Briggs_Institute_Model_of.8.aspx. [DOI] [PubMed] [Google Scholar]
  26. Kellerman, Q. D. , Christensen A. J., Baldwin A. S., and Lawton W. J.. 2010. “Association Between Depressive Symptoms and Mortality Risk in Chronic Kidney Disease.” Health Psychology 29, no. 6: 594–600. 10.1037/a0021235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Kidney Health Australia . 2019. The National Strategic Action Plan for Kidney Disease. (ISBN: 978‐0‐6485572‐6‐5). https://www.health.gov.au/sites/default/files/documents/2020/03/national-strategic-action-plan-for-kidney-disease_0.pdf.
  28. Lee, J. , Kim K., and Kim J.. 2015. “Factors Influencing Quality of Life in Adult End‐Stage Renal Disease Patients Undergoing Hemodialysis.” Journal of Nursing Research 23, no. 3: 181–188. 10.1097/jnr.0000000000000087. [DOI] [PubMed] [Google Scholar]
  29. Levey, A. S. , Eckardt K.‐U., Dorman N. M., et al. 2020. “Nomenclature for Kidney Function and Disease: Report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference.” Kidney International 97, no. 6: 1117–1129. 10.1016/j.kint.2020.02.010. [DOI] [PubMed] [Google Scholar]
  30. Lowney, A. C. , Myles H. T., Bristowe K., et al. 2015. “Understanding What Influences the Health‐Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland.” Journal of Pain and Symptom Management 50, no. 6: 778–785. 10.1016/j.jpainsymman.2015.07.010. [DOI] [PubMed] [Google Scholar]
  31. Mariotti, M. C. , and Rocha de Carvalho J. G.. 2011. “Improving Quality of Life in Hemodialysis: Impact of an Occupational Therapy Program.” Scandinavian Journal of Occupational Therapy 18, no. 3: 172–179. 10.3109/11038128.2010.488271. [DOI] [PubMed] [Google Scholar]
  32. Mark, P. B. , Stafford L. K., Grams M. E., et al. 2025. “Global, Regional, and National Burden of Chronic Kidney Disease in Adults, 1990–2023, and Its Attributable Risk Factors: A Systematic Analysis for the Global Burden of Disease Study 2023.” Lancet 406, no. 10518: 2461–2482. 10.1016/S0140-6736(25)01853-7. [DOI] [PubMed] [Google Scholar]
  33. Mayer, K. P. , Hornsby A. R., Soriano V. O., et al. 2020. “Safety, Feasibility, and Efficacy of Early Rehabilitation in Patients Requiring Continuous Renal Replacement: A Quality Improvement Study.” Kidney International Reports 5, no. 1: 39–47. 10.1016/j.ekir.2019.10.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Ozdemir, S. , Choong L. H. L., Gan S. W. S., et al. 2021. “Patient Decision Aid Development for Older Adults With End‐Stage Kidney Disease in Singapore.” Kidney International Reports 6, no. 11: 2885–2896. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Pereira, J. B. , Almeida M. H. M., Batista M. P. P., and Toldrá R. C.. 2020. “Contribuições Da Terapia Ocupacional No Atendimento a Usuários Com Insuficiência Renal Crônica No Contexto De Hospitalização.” Cadernos Brasileiros de Terapia Ocupacional 28, no. 2: 575–599. 10.4322/2526-8910.ctoAO1855. [DOI] [Google Scholar]
  36. Peters, M. D. J. , Marnie C., Tricco A. C., et al. 2020. “Updated Methodological Guidance for the Conduct of Scoping Reviews.” JBI Evidence Synthesis 18, no. 10: 2119–2126. 10.11124/JBIES-20-00167. [DOI] [PubMed] [Google Scholar]
  37. Pinto, S. C. A. , Dos Santos Coelho F., Dos Santos G. K. C., and de Assis Santos Dos Santos A.. 2021. “Comparison of Occupational Performance Between Dialytic Treatment Modalities.” Brazilian Journal of Occupational Therapy 28(4): 1220–1233. 10.4322/2526-8910.ctoAO2012. [DOI] [Google Scholar]
  38. Saby, A. , and Miller L. S.. 2016. “Functional Assessment in End‐Stage Renal Disease: Enhancing Quality of Life.” Seminars in Dialysis 29, no. 2: 170–172. 10.1111/sdi.12466. [DOI] [PubMed] [Google Scholar]
  39. Strand, H. , and Parker D.. 2010. “Effectiveness of Medical Compared to Multidisciplinary Models of Care for Adult Persons With Pre‐Dialysis Chronic Kidney Disease: A Systematic Review.” JBI Library of Systematic Reviews 8, no. 26: 1058–1087. https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=paovftl&AN=01583928-201008260-00001. [DOI] [PubMed] [Google Scholar]
  40. Tricco, A. C. 2018. PRISMA Extension for Scoping Reviews (PRISMA‐ScR): Checklist and Explanation. [DOI] [PubMed]
  41. Tricco, A. C. , Lillie E., Zarin W., et al. 2016. “A Scoping Review on the Conduct and Reporting of Scoping Reviews.” BMC Medical Research Methodology 16: 15. 10.1186/s12874-016-0116-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Wells, S. A. 2015. “Occupational Deprivation or Occupational Adaptation of Mexican Americans on Renal Dialysis.” Occupational Therapy International 22, no. 4: 174–182. 10.1002/oti.1394. [DOI] [PubMed] [Google Scholar]
  43. White, Y. , and Grenyer B. F. S.. 2006. “Do We Encourage Health or Illness? A Survey of Exercise Rehabilitation Practices for Patients in Australian Renal Units.” Renal Society of Australasia Journal 2, no. 1: 5–15. https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106341397&site=ehost-live&scope=site. [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Appendix 1: Data base and search terms.

JORC-52-0-s002.docx (65.1KB, docx)

Appendix 2: List of acronyms used in Tables.

JORC-52-0-s001.docx (133.4KB, docx)

Supporting File

JORC-52-0-s003.docx (23KB, docx)

Data Availability Statement

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

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