Date Presented 04/04/19 Secondary effects of burn injury, such as scarring and contractures, impair occupational performance. Home programs (HP), which may include exercises, splint or garment wear, and functional activities, are used by OT practitioners to extend care postdischarge. This study utilized a descriptive survey to gather information from OT practitioners across the US. This poster will describe OT practice patterns for this population. Primary Author and Speaker: Ann Cook Additional Authors and Speakers: Elena Donoso-Brown, Margaret Hyland

The rigor of occupation-based standardized assessments that rely on observational scoring procedures depends on proven reliability among test administrators. This study measured interrater reliability of the Cognitive Performance Test (CPT), a standardized, occupation-based assessment that measures cognitive–functional capacity in older adults with neurocognitive disorders. To capture a range of experience among test administrators, two sets of raters—four expert and three novice—scored video recordings of 10 patients administered the CPT. Interrater reliability results were strong among all raters (intraclass correlation coefficient [ICC] = .93), with expert raters (ICC = .97) yielding higher coefficients than novice raters (ICC = .93). Spearman’s ρ correlation coefficients were high among all raters (rs = .92–1.00). Practitioners can be confident that results of the CPT give accurate and consistent information to the health care team, family members, and patients when administered with fidelity using standardized protocols.

Objective. This study provides a descriptive analysis of the factors affecting pressure garment adherence from the perspective of adult patients with burn injuries and occupational therapy clinicians. Method. Questionnaires were administered to 23 adult patients with burn injuries and 10 occupational therapy clinicians selected from six provincial hospitals in a large metropolitan area in South Africa. Adherence behavior was evaluated from the perspective of both sample groups in terms of four variables: garment type, garment comfort, garment cosmesis, and garment instructions. Results. Adherence behavior was negatively influenced by differences in both patient and clinician perceptions across several variables, including the types and consequences of skin problems arising from pressure garment use, levels of satisfaction with garment construction and color, and the issuing and understanding of garment instructions. Other factors compromising adherence behavior included the negative effects of visible burn disfigurement, the issuing of pressure garments after hypertrophic scarring had developed, a lack of patient choice in the selection of scar management techniques, and a lack of social support in the wearing of pressure garments. Conclusion. Much of what is traditionally understood as “patient nonadherence” appeared to be largely because of rational choices made by patients in the face of several difficulties they experienced with the current form and nature of their pressure garment therapy. On the basis of these findings, a range of patient-centered interventions are indicated to enhance treatment efficacy and consumer satisfaction with this treatment regimen, including horizontal rather than vertical therapist–patient communication, closer interaction among members of the health care team, the facilitation of family and social support, and interactive health education interventions.

Objective. This study was designed to compare measures of pain when children with burn injuries were engaged in a purposeful activity, specifically a play activity, versus rote exercise. Method. Two 6-year-old children participated in a study using a single-subject, randomized multiple treatment design to compare two conditions: purposeful activity and rote exercise. Data were gathered for each session on four dependent measures: number of repetitions of therapeutic exercise completed, number and type of overt distress behaviors displayed, scores on self-report scales of pain intensity, and overall enjoyment of the activity. Results. Visual inspection of the graphed data suggested that, early in the rehabilitation process, the use of a play activity in comparison to rote exercise yielded better outcomes in terms of all four dependent measures. Additionally, the data implied that there may be a point later in the rehabilitation of a child with a burn injury when rote exercise may be as effective as play activities in meeting therapeutic goals. Conclusion. This study supports the belief that purposeful activity can yield results equal to or better than those achieved using rote exercise. Replication of this study is warranted, and the development is indicated of a measure of overt behavioral distress that is more appropriate than those currently available for children with burn injuries.