Introduction
In the Model of Human Occupation, role refers to a set of behaviors and responsibilities related to an individual’s social position, and is described as habitual behavior in the performance environment (Kielhofner, 2008). Additionally, the Occupational Therapy Practice Framework: Domain and Process, fourth edition defines a role as having important meaning for the formation of individuals’ sense of self as well as for confirming themselves as social beings through the activities and environments in which they participate in life. However, as this role regulates an individual’s position, it forms the foundation for performing meaningful activities (Taylor, 2017).
Occupation is defined as an activity performed to achieve important goals and give meaning to human life, and it is a factor in maintaining the quality of life related to an individual’s health, well-being, and life in general (American Occupational Therapy Association, 2020). The provision of interventions through occupational therapy is a crucial factor in preventing the decline of social roles and quality of life due to the loss of occupations, while also promoting individual health and well-being (Estrany-Munar et al., 2021). However, role loss negatively affects an individual’s position and identity, leading to a decrease in social participation (Kang, 2020; Seo & Lee, 2024). A lack of social participation contributes to the deterioration of mental and physical health (Jung & Ahn, 2023) and ultimately reduces an individual’s quality of life (Feng et al., 2020; Gweon, 2009).
Thus, roles, excluding simple activities, are important for maintaining a healthy and meaningful life (Jung & Ahn, 2023). A local community is a key environment in which individuals can form social relationships, share their roles, and feel a sense of belonging (Park, Lee et al., 2022). Role performance as a member of the community has a positive effect on physical and emotional health (Ju & Bang, 2021) and is a key factor in strengthening social integration and reducing feelings of isolation (Kang & Lee, 2022; Lee, 2021). This trend is also commonly reported internationally, and research on the relationship between performing social roles within the community and mental health is actively being conducted, mainly in Europe and North America (Courtin & Knapp, 2017; Ettman et al., 2024). Role performance has a significant impact on individuals’ mental health, especially their resistance to depression and anxiety (Kim, 2020; Lee et al., 2022). Community-based occupations can enhance these functions and encourage individual well-being and responsiveness through meaningful activity participation (Han, 2022). This has a positive impact on promoting healthy aging and social integration (An et al., 2023).
Previous studies have explored the role performance of community members and highlighted the importance of occupational therapy from various perspectives. However, most of these studies have focused on specific age groups (e.g., older adults) or diagnostic populations (e.g., individuals with mental disorders such as depression) (Choi et al., 2022; Choi et al., 2023). In particular, studies that quantitatively evaluate the effectiveness of occupational therapy or apply quantitative methodologies have been relatively limited (Choi et al., 2023; Han, 2022). Furthermore, few studies have comprehensively analyzed occupational therapy research trends and visualized the community role performance of community members (Shin et al., 2023).
Understanding the evolving trends in a specific field requires the systematic analysis and visualization of research patterns. Bibliometric analysis has recently been utilized for this purpose, using bibliographic data to examine patterns of co-authorship, keyword co-occurrence, and thematic clusters (Kim et al., 2021). VOSviewer (ver. 1.6.19) is one of the most widely used tools for such analysis (van Eck & Waltman, 2014).
Against this background, the present study aimed to identify the structural and thematic trends in research on occupational therapycentered role performance among community members. By visualizing keyword co-occurrence patterns and thematic clusters, and analyzing research collaboration networks, this study is expected to serve as a foundational reference for future research and clinical practice.
Methods
1.Literature Search
To identify research trends in occupational therapy for community members’ role performance, this study used Web of Science (WoS), an international academic database that provides reliable bibliometric analysis research, including paper information (Maseda et al., 2022). Using the search terms (“community” OR “community member”*) AND “role” AND “occupational therapy” AND (“participation” OR “redesign” OR “activity” OR “intervention”)*, we targeted the literature published until December 16, 2024. The keywords were selected based on theoretical concepts from MOHO and OTPF-4, where “role,” “participation,” and “occupational performance” are considered core components in defining individuals’ engagement in meaningful occupations. The term “community” was included to reflect the environmental and contextual emphasis found in community-based occupational therapy literature. A total of 565 documents were initially retrieved, and the bibliographic information of 553 documents was used after excluding duplicates and records not meeting the selection criteria. Only peer-reviewed journal articles and review articles were included, while conference proceedings, editorials, and book chapters were excluded. Titles and abstracts were screened to ensure that the studies addressed occupational therapy-centered role performance within community contexts. Inclusion criteria required explicit mention of both “occupational therapy” and role-related concepts. Only articles published in English were included in the final analysis. In this study, “role performance” was operationalized based on its conceptual definition in MOHO and OTPF-4. Articles were considered relevant when they included terms such as “role participation,” “occupational roles,” or “social role performance” in their titles, abstracts, or keywords.
2.Bibliometric Analysis
The Korean Library Association defines bibliometrics as a field of study that uses quantitative analysis methods to examine various forms expressed through literature based on bibliographic information (Korean Library Association, n.d.). Bibliometric analysis includes various techniques such as citation analysis, co-occurrence analysis, co-authorship analysis, and co-citation analysis (Park, Lim et al., 2022). For the bibliometric analysis, VOSviewer (ver. 1.6.19) was used. VOSviewer is a program that visualizes the network between bibliographic information, where the size of the circles indicates the frequency of occurrences (Xie et al., 2020). The thickness and distance of the lines connecting the circles show the strength of the connections among bibliographic data (van Eck & Waltman, 2014). Additionally, VOSviewer is a software that can cluster bibliographic information based on publication year, country and region, field, and keywords (Agarwal et al., 2016; Jeong & Ban, 2020; Son et al., 2022). Circles that are positioned closely together indicate that the research topics are closely related, and the thicker and shorter the lines, the stronger the connection (van Eck & Waltman, 2014). Each color represents a cluster of keywords that are related to each other, and through this clustering, subfields can be identified.
Results
1.Number of Publications and Research Fields
An analysis of publications until 2024 confirmed the research trends (Figure 1). The number of publications on occupational therapy for community member role performance tripled in 2009 compared to 2008 and steadily increased, rising continuously after 2020. Among the 553 studies analyzed, rehabilitation was the most researched field (298 studies), followed by public environmental and occupational health (56), healthcare science services (34), psychiatry (26), and health policy services (22) (Figure 2).
2.Country of Analysis of the Target Literature
Up to 2024, research on occupational therapy in community member roles had been published in 62 countries and regions. The top ten contributing countries were analyzed (Table 1). The United States had 159 publications and 2,466 citations, with a total connection strength of 86, which was the second highest among major institutions. These results highlight USA’s central role in advancing this research field. Among the top 10 countries, five were in Europe (Sweden, the Netherlands, Scotland, and Germany), reflecting active research in this region. South Korea ranked among the top 25 countries (Figure 3).
Table 1.
Top 10 Countries and Regions in the Analyzed Literature
3.Keywords in the Analyzed Literature
The co-occurrence analysis identified 2,333 keywords, of which 199 appeared in at least five articles. The search keywords were excluded from the analysis. The top ten most frequent keywords were categorized into eight clusters (Table 2, Table 3, Figure 4). The most common keyword was rehabilitation (82 times), followed by health (80 times). In Figure 5, the extracted keywords are displayed by year; a brighter yellow color indicates more recent occurrences, whereas darker purple indicates older words. Before 2018, keywords related to stroke, disability, disease, and cerebral palsy dominated, whereas after 2020, topics such as occupational balance, anxiety, community participation, environment, and social inclusion became prominent.
Table 2.
Top 10 Keywords in the Analyzed Literature
Table 3.
Eight Clusters in the Analyzed Literature
| Rank of cluster according to frequency (Color shown in Figure 4) | Top 10 keywords by cluster |
|---|---|
| 1 (Red) | Rehabilitation, Stroke, Outcomes, Adults, Disability, Program management, Impact, Risk, Predictors |
| 2 (Green) | People, Recovery, Experiences, Individuals, Work, Schizophrenia, Employment, Occupational engagement, Perspectives, Perceptions |
| 3 (Navy Blue) | Quality of life, Therapy, Older adults, Randomized controlled trial, Depression, Validity, Performance, Reliability, Impairment, Physical activity |
| 4 (Yellow) | Children, Adolescents, Quality of life, Quality, Youth, Parents, Environment, Autism, Disabilities, Early intervention |
| 5 (Purple) | Health, Life, Barriers, Occupation, Mental health, Community participation, Challenges, Facilitators, Skills, Integration |
| 6 (Sky Blue) | Care, Education, Activities of daily living, Model, Follow-up, Prevention, Risk factors, Experience, Mortality, Epidemiology |
| 7 (Orange) | Dementia, Caregivers, Support, Implementation, Physiotherapy, Family caregivers, Physical therapy, Alzheimer’s disease, Behaviors, Cost effectiveness |
| 8 (Brown) | Qualitative research, Services, Health promotion, Home, Transition, Needs, Palliative care, Healthcare, Traumatic brain injury, Aging |
Discussion
For community members, social networks affect physical, mental, and social health and play an important role in healthy aging (An et al., 2023). Thus, participation in community-based activities enhances one’s role and subjective well-being through a sense of belonging to the community (Park, Lee et al., 2022). Accordingly, this study extracted and visualized publication trends, research countries and fields, and keywords through citation analysis based on bibliographic information and analyzed them.
The published literature has been on a continuous upward trend since 2020. This is because many people experienced social isolation and mental health deterioration as social distancing and quarantine measures were strengthened due to the COVID-19 pandemic (Han & Choi, 2021). In particular, because of the reduction in external activities and social networks, the importance of participation in community activities and wellbeing has been emphasized (Han, 2023; Han & Choi, 2021). Therefore, with the emergence of occupational therapy and community activity participation as important issues in the recovery of mental health and well-being after the COVID-19 pandemic, related research has increased. This is the result of various studies conducted by governments and academia worldwide to resolve mental health issues and social isolation in communities (WHO, 2020).
Participation in community activities is an important factor in establishing one’s role by strengthening social support and restoring the quality of life, as well as promoting mental and physical health beyond simple leisure activities (Lee, 2020). However, intervention studies are required to confirm these findings. According to previous studies, occupational therapy using a role-centered approach has been effective in increasing social connectivity and psychological stability after the pandemic (Lannigan & Tyminski, 2021). Such studies have important implications for future research.
The research fields in the published literature are rehabilitation, public environment, occupational health, and health sciences and services. This suggests that research has been conducted primarily in relevant fields of study such as well-being in terms of public health (Burton et al., 2011), subjective life (Stones & Gullifer, 2016), and social participation (Han & Choi, 2021). Additionally, many studies have been conducted in fields such as psychiatry. The research area has expanded as social participation and mental health have emerged as important social issues (Courtin & Knapp, 2017; Loades et al., 2020) due to the increase in social isolation caused by the COVID-19 pandemic. Follow-up studies that consider various academic perspectives and approaches should be conducted.
The results of this study show that occupational therapy research related to the role performance of community members is being conducted in various countries worldwide and is particularly prominent in European countries. This is related to the fact that major European countries have high levels of social trust, perception of fairness, social participation indicators, and strong social cohesion, while Asian countries have good objective conditions (such as low crime rate and rate of difficulties in daily life due to health problems). However, the instability of subjective perception leads to social isolation, which, in turn, leads to a lack of research (Woo, 2017). South Korea is ranked among the top 25 of the 62 countries, and research has been conducted since 2018. This is considered to have occurred due to the increasing awareness of social well-being in South Korean society (Shin, 2016). Nevertheless, because the current occupational therapy aspect of community role performance is inadequate, further development and research are needed, both quantitatively and qualitatively. Therefore, evidence-based research is needed to develop customized programs that reflect the unique characteristics of local communities. Through this method it may be possible to resolve modern issues related to social isolation, well-being, and social participation and to utilize occupational therapy more effectively within the community.
Cluster 1 (red) includes keywords related to rehabilitation, effectiveness, and program management, focusing on rehabilitation effects, risk factors, and prediction. Cluster 2 (green) includes employment, occupational participation, perspective, and awareness, emphasizing the perspectives of occupational participation and employment. Cluster 3 (blue) includes depression, trust, activity, and aging, exploring the correlation between aging and depression and improving the psychological well-being of the elderly. Cluster 4 (yellow) includes autism, disability, and early intervention, with a focus on children's disabilities and early intervention programs. Cluster 5 (purple) includes health, barriers, mental health, and community participation, analyzing the factors that influence community participation and mental health. Cluster 6 (sky blue) includes activities of daily living, models, and prevention, focusing on daily activities, prevention, and epidemiological factors. Cluster 7 (orange) includes dementia, caregivers, psychology, and behavior, examining dementia, caregiver support, and behavioral approaches. Cluster 8 (brown) includes qualitative research, service, and aging, addressing healthcare service needs and processes related to aging.
Taken together, these eight clusters can be interpreted as representing four core domains of role performance in community settings: (1) functional roles, associated with physical and cognitive recovery (e.g., Clusters 1 and 6); (2) vocational roles, related to employment and productivity (e.g., Cluster 2); (3) social and participatory roles, reflecting community integration and mental health support (e.g., Clusters 3 and 5); and (4) health-related and caregiving roles, encompassing early intervention, aging, and caregiver needs (e.g., Clusters 4, 7, and 8). This synthesis demonstrates how occupational therapy research has addressed various aspects of role performance, yet also reveals underrepresented areas—such as caregiving roles, youth role transitions, and informal civic participation— that merit further exploration to promote a more inclusive understanding of roles in community life.
Among the eight extracted clusters, Clusters 2 (green) and 5 (purple) are located at the center of the network and play a hub role through strong connectivity with other clusters (see Table 3). These two clusters are closely related, suggesting that they are important research topics centered on personal well-being and social participation. Occupational participation and mental health are thought to interact and serve as key factors in personal productivity, stability, quality of life, and social roles in modern society.
Cluster 2 is linked to Cluster 1, suggesting the importance of restoring social roles through rehabilitation. The inclusion of keywords such as “elderly” indicates that customized programs for older adults are essential. The connection with Cluster 3 suggests how mental health and depression interact with community participation. The connection with Cluster 6 highlights occupational participation as a key factor in well-being.
Cluster 5 shows how depression and aging impact participation. Cluster 4 suggests early interventions affect adult mental health. Cluster 6 emphasizes practical interventions for daily life. Cluster 8 reflects mental health needs in a pandemic society and the importance of services.
Moreover, mental health has become a crucial factor in determining an individual’s quality of life and community integration. Mental health issues such as depression, anxiety, and stress hinder occupational ability and social role performance, weakening the sense of belonging and community participation (Cloutier-Fisher et al., 2011; Ettman et al., 2020). Conversely, community participation and proactive role performance promote mental health recovery and well-being (Choi et al., 2022). During the pandemic, worsening mental health problems and social isolation weakened individuals’ social roles and increased service demands (Jung, 2023). This situation highlights the need for interventions to address mental health issues and re-establish individuals’ roles within the community. A mental health-centered approach should solve problems and help individuals strengthen their roles, as well as find purpose and belonging through meaningful community activities (Hong, 2020). Therefore, a systematic multidisciplinary intervention program is necessary from a preventive perspective, and customized community-based programs and services should be established. These interventions are expected to enhance occupational participation, social role fulfillment, and community integration, extending beyond the prevention and recovery of mental health issues.
Even though this study made significant findings, it had certain limitations. First, the analysis was limited to the Web of Science (WoS), which may have excluded relevant studies indexed in other databases. Second, only English-language literature was included, which may have introduced language bias and limited the representation of non-English research. Third, this bibliometric study did not involve a quality appraisal of the included articles, and therefore cannot speak to the methodological rigor or validity of the studies cited. In addition, bibliometric analysis inherently focuses on patterns, frequencies, and cooccurrences, which makes it difficult to evaluate clinical outcomes or the real-world effectiveness of interventions. Lastly, the analysis is based on author-supplied keywords and indexing terms, which may not always reflect the actual content or intent of the study. Despite these limitations, this study remains meaningful as it clarifies research trends, visualizes thematic relationships, and provides a structural overview of occupational therapy-centered role performance in community contexts. In the future, bibliometric analyses should be conducted to continuously identify trends in the role performance of community members, and it will be necessary to establish evidence-based intervention plans. In addition, future research should explore how role performance is represented across specific populations, such as older adults, caregivers, or youth, and examine whether differences emerge based on diagnostic groups or health conditions. A systematic review is also needed to examine the effectiveness of occupational therapy interventions targeting various role domains and to derive evidence-based strategies for community practice.
Conclusions
This study analyzed the research trends in community members’ role-performing occupational therapy using bibliometric analysis. Results show that, particularly after the COVID-19 pandemic, social distancing and isolation led to a decline in community activity participation and highlighted the importance of mental health, resulting in an increase in related research. The literature suggests that community-based activities support well-being and social participation. The interaction between mental health and community participation significantly impacts the quality of life and social roles. Therefore, customized programs and systematic interventions are required to help individuals establish their roles and identify ways of belonging through meaningful activities. Future studies should use diverse databases and multidisciplinary approaches to develop evidencebased interventions.