Exploring Practice and Taking Action to Enable Human Rights and Occupational Justice in an Australian Hospital Context: An Action Research Study

Danika Galvin

    Research output: ThesisDoctoral Thesis

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    Abstract

    It may be argued that human rights have become an
    increasingly important moral discourse in contemporary society and
    that Australian occupational therapists have a legal and ethical
    obligation to address matters of human rights. The emerging theory
    of occupational justice has potential to assist therapists to identify
    and address issues of occupational inequity or absence of
    occupational rights in practice. However, there is need for research
    about how occupational justice can be applied in occupational
    therapy practice, to overcome long-standing patterns of hegemony.

    An action research study was therefore undertaken at a
    metropolitan hospital in Melbourne, Australia to explore the primary
    question: How do occupational therapists reflect upon and act to
    enable human rights and occupational justice in their practice? Over
    the course of 10 months, nine occupational therapists engaged in
    monthly focus groups and in three rounds of individual interviews. Data was collected through audio recording and transcribing focus groups and interviews. The transcribed data was formally analysed using thematic analysis within a framework of hermeneutic phenomenology.

    A finding of this qualitative research was that initially the coresearchers
    tended not to see and address the full range of occupational injustices that impacted on their clients, due to their cultural heritage as Australians and a lack of an agreed set of professional beliefs about human rights and occupational justice. The influence of medical and fiscal hegemony in the hospital precluded
    co-researchers from thinking about clients from an occupationally just
    perspective; co-researchers were initially unaware of how their
    loyalty to the hospital contributed to their discriminatory practices and
    their gate-keeping of services. Moreover, a dominant technical risk
    discourse contributed to a lack of occupational rights in the hospital,
    and to a climate of solicitousness that was a barrier to enabling
    occupational justice.

    Through the research, the co-researchers engaged in local,
    contextualised discussions about people’s lived realities and
    experiences of injustice. This was found to be effective for cultivating
    a human rights culture within this group of practice scholars. Through
    the process of learning and critique, the co-researchers developed
    their sense of agency and became more likely to implement
    enabling, emancipatory practices.

    The co-researchers made three kinds of change to enable
    occupational justice. They used stories as a means to highlight their
    clients’ humanity. They facilitated permeability between the hospital
    and community, thereby enriching the ward with opportunities for people’s active participation. They used advocacy to engage their
    colleagues in public reasoning about matters of occupational rights.

    A three-step model for the process of creating occupationally
    just practice was created. The first step entailed assisting the coresearchers
    to better understand the contextual influences that
    shaped and constrained their practice of human rights and
    occupational justice. The second step was to create a human rights
    culture and thus inspire the co-researchers to make a commitment to
    change. In the third step, the co-researchers acted for human rights
    and occupational justice by creating spaces for participation and
    partnership with clients, colleagues and community members.

    This action research illustrated that applying the occupational
    science concept of occupational justice and using continual
    discursive practices may enhance occupational therapy practice and
    praxis. Furthermore, the co-researchers (and I) constructed new
    practice-based meanings about occupational justice which
    foreground the concepts of participatory occupational spaces. Thus,
    demonstrating there is potential for taking a context-specific
    approach to shaping of occupational science epistemology.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • Charles Sturt University
    Supervisors/Advisors
    • Whiteford, Gail, Co-Supervisor
    • Wilding, Clare, Principal Supervisor
    Award date01 Oct 2013
    Place of PublicationAustralia
    Publisher
    Publication statusPublished - 2014

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