The role of occupational therapy in providing vocational rehabilitation for people living with inflammatory arthritis: A scoping review

Introduction: Inflammatory arthritis significantly impacts work participation resulting in cost to individuals, employers, and society. Vocational rehabilitation seeks to address this need, but its pathways, interventions, and efficacy continue to be under investigation. Contributing variables are complex, identifying the need for a conceptual framework to guide practice. Occupational therapy addresses this complexity, providing theoretical frameworks such as the Person-Environment-Occupation-Performance (PEOP) model to understand the occupation of work supporting well-being and design interventions. The aim of this scoping review is to map the role of occupational therapy in providing vocational rehabilitation for people living with inflammatory arthritis. Methods: A scoping review following Arksey and O'Malley's (2005) stages was completed. Major databases and grey literature were systematically searched, and hand-searches completed. Descriptive and thematic analysis mapped the findings to the PEOP model framework. Consumer and Community Involvement: There was no consumer or community involvement in this review. Results: Fourteen studies were included. Major themes aligned to the PEOP model with further analysis synthesised in subthemes. A majority of person-related interventions to support work performance was observed. This framework identifies the domains of focus in vocational rehabilitation and current gaps. Work instability, employment retention, and self-efficacy were used to measure effectiveness. Conclusion: This scoping review presents the evidence regarding vocational rehabilitation for the inflammatory arthritis population in the context of occupational therapy theory to provide a framework for clinical practice. A current focus on person-focused interventions was identified. The PEOP model provides a clear framework to understand the complexity and nuances of vocational rehabilitation across the domains. Outcome measures for vocational rehabilitation are heterogenous and require further exploration as capturing the intricacy of achieving balance with work participation remains unclear. Further research into vocational rehabilitation programs incorporating all domains of the PEOP model is needed. Consideration of work performance measurements to inform effectiveness and the resulting impact on a person's well-being is required.