Date Presented 03/22/24

This poster describes qualitative research indicating that OTs value knowledge, observation, and interdisciplinary care for assessing and treating functional cognition after stroke. Results highlight opportunities to improve cognitive rehabilitation.

Primary Author and Speaker: Emma R Gregg

Contributing Authors: Renee Causey-Upton, Cassandra C Ginn

Impaired cognition is a key predictor of poor functional outcomes after stroke (Malik et al., 2020). Evidence regarding assessment and treatment of functional cognition in occupational therapy (OT) is limited (O’Donoghue et al., 2022). Understanding the perceptions of OTs assessing and treating functional cognition in people after stroke can identify gaps in knowledge and highlight opportunities to improve evidence-based cognitive rehabilitation. This study utilized a qualitative descriptive approach. Recruitment fliers were distributed virtually through various methods (e.g., alumni and employer email lists, social media). Purposive sampling was used for maximum variation, considering work setting, years of experience, and location. Inclusion criteria were 1) licensed OT working full-time, 2) treat individuals following stroke as at least 1/3 of their typical caseload, 3) able to access Zoom, and 4) able to read interview questions and participate in an interview in English. One-on-one interviews were conducted via Zoom with 8 OT participants from multiple states who had a variety of experience in practice settings. An inductive approach to thematic analysis was used to analyze the data (Nowell et al., 2017), and three main themes emerged from the data. Knowledge, observation, and interdisciplinary care were found to matter most for OTs addressing functional cognition. Occupational analysis and occupation-based interventions were described as beneficial tools in assessing and treating functional cognition, and objective methods to address functional cognition were limited. OTs also described lacking confidence in addressing functional cognition due to lack of training in professional and continuing education. OTs emphasized the value of interdisciplinary care in stroke rehabilitation across settings. Findings indicate the value of OTs in cognitive rehabilitation after stroke, and highlight the need for further clinician support and research in this area.

References

Malik, F. N., Zubair, U. B., Alamgir, W., Hashmat, A., Arif, S., & Nawaz, K. H. (2020). Prevalence of cognitive decline in patients with stroke. Pakistan Armed Forces Medical Journal, 70(6), 1604–1608. https://doi.org/10.51253/pafmj.v70i6.5860

Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16, 1–13. https://doi.org/10.1177/1609406917733847

O’Donoghue, M., Leahy, S., Boland, P. Galvin, R., McManus, J., & Hayes S. (2022). Rehabilitation of cognitive deficits poststroke: Systematic review and meta-analysis of randomized controlled trials. Stroke, 53(2). https://doi.org/10.1161/STROKEAHA.121.034218