Table 3.
Environmental Factors that Influence Occupational Therapists’ Actions as SCAs
| Theme | Factor (n = 11) | Synthesis | ||
|---|---|---|---|---|
| Facilitator | Both | Obstacle | ||
| Development of the profession | Emergence of the role of SCA | The role of SCA is becoming more important in professional practice compared to a few years ago and is now part of entry-level and continuing education. | ||
| Lack of knowledge about occupational therapy | Occupational therapy is still an under-recognized health profession and the public knows little about it, which makes it more difficult to promote SCAs’ projects within society. | |||
| Macrosystem | Advantageous macrosystem* | Laws, rules, or procedures are levers to be exploited. The change project may benefit from social and political circumstances, which makes it easier to sell. The geographic location of the project and the SCA can also help. | ||
| Resistance to change | Stakeholders may not wish to support change, possibly due to low receptivity or resistance to it, which may result in minimal commitment, a lack of energy and/or actions to slow the project or even derail it completely. | |||
| Mesosystem | Proactive group of patients | People are showing a growing interest in prevention and health promotion due to their increasing knowledge on the subject. They are now more critical of government services and programs aimed at ensuring better health and are involved with SCAs to help with their projects and ensure their success. | ||
| Accommodating mesosystem* | The values of the organization for which the SCA works are consistent with the SCA’s values. The organization offers a flexible schedule and understands that the SCA must invest time outside of clinical work. | |||
| Microsystem | Collaborative microsystem* | The members of their direct work team (colleagues, immediate superior) encourage SCAs, are positive about the upcoming change and show understanding and flexibility. SCAs may also have the help of a non-therapeutic helper or intern. | ||
| Organizational culture | Facilitating organizational culture* | In the public system, change is facilitated in a decentralized management context and in small institutions. There are fewer hierarchical levels to convince and the decision-making process is quicker. | ||
| Resources | Accessible expertise | SCAs have access to many sources of knowledge, evidence, ongoing training, and/or mentors and thus feel better equipped and confident in carrying out their project. | ||
| Diversified means of communication | The myriad of existing communication channels such as mass media and social networks enables SCAs to spread their message widely and promote the project. | |||
| Available resources* | When resources (financial funds, physical space, equipment, and human resources) are available, SCAs have the elements needed to complete the project. Resources can come from within the organization or from external sources. | |||
Note: *For the sake of clarity, when environmental factors can be both facilitators for and obstacles to SCAs’ actions, only the facilitating factors are shown under Both and described in the table. The negative aspects of these factors are considered to be obstacles to SCAs’ actions.