Outpatient OT Perceptions, Attitudes, & Motivations Surrounding the Treatment of the Neurological Upper Extremity

Stroke survivors are having difficulty participating in everyday tasks, reintegrating into the community, and there is also a growing demand for rehabilitation that addresses the needs of those in the chronic phase of stroke (Benjamin et al., 2019, Doyle et al., 2014, Mawase et al., 2020, Sullivan et al, 2019, Xu et al., 2017). More research is needed to explore the role of occupational therapists in outpatient neurological care. The research question for this study is what are the perceptions, attitudes, and motivations of outpatient occupational therapists around treating the neurological upper extremity? Participants were recruited using convenience and snowball sampling. A phenomenological approach was utilized with 11 outpatient occupational therapists using semi-structured interviews. An iterative approach was used when examining the data to allow for flexibility with subsequent interview research questions based on the emerging data. Co-investigators discussed and refined until a consensus was reached on the final themes. Member-checking was completed by participants and triangulation was completed by investigators to reveal any missed areas in data interpretation. Four themes were extracted from the data including: (i) neurology requires more time, (ii) neurology requires a specialized setting, (iii) therapists’ perceived potential for progress, (iv) certified hand therapists (CHTs) and occupational therapists specializing in neurology could learn from each other. The results suggest that occupational therapists can be successful treating the neurological upper extremity in an outpatient setting. Continued education is recommended for therapists who do not frequently work with these clients and therapists should also consider organizational support when working with this population. If OTs use occupation as a guide in combination with practical hand therapy skills, they have an opportunity to provide the highest level of outpatient care to this population.

References

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Doyle, S. D., Bennett, S., & Dudgeon, B. (2014). Upper limb post-stroke sensory impairments: The survivor’s experience. Disability and Rehabilitation, 36(12), 993-1000. https://doi.org/10.3109/09638288.2013.825649

Mawase, F. Cherry-Allen, K., Xu, J., Anaya, M, Uehara, S., & Celnik, P. (2020). Pushing the rehabilitation boundaries: Hand motor impairment can be reduced in chronic stroke. Neurorehabilitation and Neural Repair, 34(8), 733-745. https://doi.org/10.1177/15459683209563

Sullivan, J. E., Drogos, J., Carmona, C., & Yao, J. (2019). The post-stroke upper limb improvement effort survey (IMPETUS): A survey of individuals with chronic stroke. Topics in Stroke Rehabilitation, 26(8), 608-620. https://doi.org/10.1080/10749357.2019.1647649