Spirituality in practice : exploring the knowledge, attitudes, and practices of occupational therapists on the role of spirituality in physical rehabilitation inpatient settings

Abstract

Background: Spirituality is recognised as a core component of holistic and person-centred care within healthcare and is deeply embedded in the philosophy of occupational therapy. It contributes to individuals’ sense of meaning, purpose, and engagement in occupation. Despite its acknowledged importance, spirituality is often inconsistently addressed in practice, particularly within physical rehabilitation settings. Limited research has explored how occupational therapists integrate spirituality into practice, especially within the Maltese context. Aims: This study aimed to explore occupational therapists’ understanding and experiences of spirituality in physical rehabilitation settings in Malta. It also sought to identify the barriers and facilitators influencing the integration of spirituality into occupational therapy practice. Method: A qualitative research design was adopted. Data were collected through semi-structured interviews to gain in-depth insight into participants’ perspectives and experiences. Participants were recruited using purposive sampling based on predefined inclusion criteria. A total of 5 occupational therapists working in physical rehabilitation settings in Malta participated in the study. Data were analysed using thematic analysis. Findings: Thematic analysis generated several key themes. These included Understanding and conceptualisation of spirituality, The Role of Spirituality in the rehabilitation process Integration into practice, barriers to addressing spirituality. Barriers identified included lack of training, time constraints, organisational limitations, and uncertainty regarding professional boundaries. Facilitators included the use of self, strong therapeutic relationships, and alignment with client-centred and holistic care principles. Discussion: The findings highlight a gap between the theoretical importance of spirituality and its practical application in occupational therapy. While participants valued spirituality, its integration was often implicit rather than explicitly addressed. The study also identified context-specific influences within Malta, including organisational and cultural factors shaping practice. Recommendations for education, practice, and future research are proposed to support occupational therapists in integrating spirituality more confidently into rehabilitation settings.