Workers with musculoskeletal disorders undertaking Malaysia's return to work (RTW) programmes may experience challenges in occupational competence (OC) and negative emotional states (NES). This study aimed to measure and examines the OC and NES of the workers by comparing specific comparison groups and groups of different phases. A total of 76 participants were recruited from a national RTW programme and categorized into three groups based on different RTW phases: off-work (n = 22), re-entry (n = 31), and maintenance (n = 23). Self-report questionnaires consisted of the Occupational Self Assessment version 2.2 and the Depression, Anxiety and Stress Scale-21. Results showed that injured workers exhibited significantly lower OC in comparison with an international group with various disabilities. In contrast, there was significantly higher NES when compared with Malaysia's general population. Significant differences in OC and NES were also found between workers in the three RTW phases. In particular, OC and NES in the off-work and re-entry phases were significantly lower (OC) and higher (NES) than in the maintenance phase. Furthermore, there was a moderate, negative correlation between OC and NES in the off-work and re-entry phase groups. This indicated that low levels of perceived OC were associated with higher levels of NES.
INTRODUCTION: In a previous study consensus was sought from Malaysian occupational therapists of occupation-based intervention (OBI) that was perceived as a means and an end. Occupation as a means refers to occupational and purposeful tasks as a therapeutic agent while occupation as an end refers to occupation as an outcome of intervention. The purpose of this follow-up study was to describe the occupational therapists' experiences of providing OBI in hand injury rehabilitation in Malaysia.
METHODS: Sixteen occupational therapists with more than five years of experience in hand rehabilitation were individually interviewed on their experiences of using OBI in practice. Data were thematically analysed using interpretative phenomenological analysis.
RESULTS: Definition of "Occupation as a means", and "Occupation as an end" was broadened after data analysis of interviews to include two new themes: "Rewarding yet challenging" and "Making OBI a reality". Occupational therapists had positive experiences with OBI and perceived that occupation as a means and an end can be merged into a single therapy session when the occupational therapists use an occupation that is therapeutic.
CONCLUSION: Although occupation as a means and as an end have different purposes, when the ultimate goal is to enhance the clients' maximum level of functioning both can be used for successful rehabilitation of hand injuries.
KEYWORDS: Activities of daily living; hand injuries; occupational therapy; occupations; qualitative research