title: Factors affecting clinical reasoning of occupational therapists: a qualitative study.
abstract: BACKGROUND
  Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical practice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occupational therapists.
  
  
  METHODS
  Twelve occupational therapy practitioners working in mental and physical dysfunction fields participated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method.
  
  
  RESULTS
  There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1- client beliefs; 2- therapist values and beliefs; 3- social attitude to disability. The second theme: individual attributions included two subthemes 1- client attributions; 2- therapist attributions. The final theme was the workplace environment with the three subthemes: 1- knowledge of the managers of rehabilitation services, 2- working in an inter-professional team; 3- limited clinical facilities and resources.
  
  
  CONCLUSIONS
  In this study, the influence of the attitudes and beliefs of client, therapist and society about illness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational therapy services. Accurate understanding of these influential factors requires more extensive qualitative and quantitative studies.
authors.affiliation: 1. Lecturer and Occupational Therapy PhD student, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. narges7@yahoo.com.
authors.forename: Narges
authors.initials: N
authors.lastname: Shafaroodi
authors.affiliation: 2. Associate Professor, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. kamali@mkamali.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kamali
authors.affiliation: 3. Associate Professor, Iran Nursing and Midwifery School, Centre for Educational Research in Medical sciences, Iran University of Medical Sciences, Tehran, Iran. s_parvizy@tums.ac.ir.
authors.forename: Soroor
authors.initials: S
authors.lastname: Parvizy
authors.affiliation: 4. Assistant Professor, School of Rehabilitation Sciences, Department of Occupational Therapy, Iran University of Medical Sciences, Tehran, Iran. a-mehraban@tums.ac.ir.
authors.forename: Afsoon Hassani
authors.initials: AH
authors.lastname: Mehraban
authors.affiliation: 5. Lecturer Occupational Therapy, University of Newcastle, Newcastle, Australia. gjyn.otoole@newcastle.edu.au.
authors.forename: Giyn
authors.initials: G
authors.lastname: O'Toole
keywords: Decision- making; Occupational therapy; Qualitative research