Current trends in the practice of home health care of occupational therapists treating patients who have had a stroke

Moulton, Christina

doi:10.1002/oti.46

Cited by 11 publications

(12 citation statements)

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“…In addition, living at home independently is also economically beneficial for society since home care treatment is less expensive than institutional care (Anderson et al, 2000). Söder and Rogers' views on autonomy are in agreement with occupational therapy principles, suggesting that rehabilitation should be more sensitive to the individual's experienced values of certain activities (Chiou and Burnett, 1985;Law, 1993;Jongbloed, 1994;Moulton, 1997;Gray, 1998).…”

Section: Introductionmentioning

confidence: 60%

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Therapeutic strategies used by occupational therapists in self‐care training: a qualitative study

Guidetti

Tham

2002

Occupation Therapy Intl

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Self-care training is one of the most frequently used interventions in rehabilitation. However, there is a need for clear descriptions of what occupational therapists do during self-care training with clients. The aim of this qualitative study was to describe what characterizes the therapeutic strategies used by occupational therapists during self-care training. Twelve occupational therapists working with clients who had had a stroke (n = 6) or spinal cord injury (n = 6) were interviewed and asked to tell a therapeutic story focusing on the self-care training process of one client. Data were transcribed and analysed using the Empirical, Phenomenological, Psychological (EPP) method, a qualitative method that aims to describe the essence, structure and character of the studied phenomenon (that is, therapeutic strategies). The characteristics of eight intervention strategies, used by all participants during self-care training, were identified. Findings showed that the occupational therapists' strategies focused primarily on how to create a relationship built on trust with their clients, how to find the right way to motivate clients, how to support the setting of goals, and how to provide enabling occupational experience and adjust training to the needs of the client, rather than focusing on teaching clients how to use technical and compensatory strategies. The general aim for using the strategies was to support the clients in taking control of their lives again. One conclusion from this study is that occupational therapists could, through understanding the individual's unique situation, vary their strategies and adapt themselves, like a chameleon, to meeting clients' experiences and needs during self-care training. However, the therapeutic outcome of using these strategies needs to be verified in future studies focusing on clients' experiences from self-care training.

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Section: Introductionmentioning

confidence: 60%

“…Moulton (1997), in a study of common trends in occupational therapy concerning stroke rehabilitation in home health care, reported that 98% of the interventions conducted by occupational therapists were training in ADL.…”

Section: Introductionmentioning

confidence: 98%

Therapeutic strategies used by occupational therapists in self‐care training: a qualitative study

Guidetti

Tham

2002

Occupation Therapy Intl

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“…Case-Smith (2005)] is based on theories of a child's healthy development through a series of motor skill 'milestones'. Ayres's approach, although primarily aimed at paediatric neurorehabilitation, has also been used in adult neurorehabilitation (Moulton, 1997). In the sensorimotor approach, therapists selected tasks and activities which enabled them to modulate the amount of stimulation and were 'of interest'.…”

Section: Task-specifi C Training: How Does It Relate To Current Intermentioning

confidence: 99%

Task‐specific training: evidence for and translation to clinical practice

Hubbard

Neilson²

2009

Occupation Therapy Intl

372

279

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“…From a survey of the literature available at the time of this study, it appears that therapists are utilising some interventions for the management of ULPSSI, though no details of interventions used have been provided other than in one small study (Moulton, 1997). That study indicated therapists appeared to focus predominantly on compensatory approaches to address ULPSSI.…”

Section: Use Of Interventions For Ulpssi In Clinical Practicementioning

confidence: 97%

“…The most recent survey about the use of sensory assessments with stroke patients was undertaken eight years prior to this current study and was based in Canada (Dannebaum et al, 2002 physiotherapists but no details of the interventions observed were given, the category sensory training activities included sensory, perceptual and cognitive interventions, and the overall frequency of therapists' use of sensory training activities was low compared to other intervention categories (De Wit et al, 2006). No further studies were identified at the time of this study which described the interventions therapists were using when addressing ULPSSI.From a survey of the literature available at the time of this study, it appears that therapists are utilising some interventions for the management of ULPSSI, though no 186 details of interventions used have been provided other than in one small study (Moulton, 1997). That study indicated therapists appeared to focus predominantly on compensatory approaches to address ULPSSI.…”

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confidence: 88%

Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

Doyle¹

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BackgroundStroke survivors form the largest client group seen by occupational therapists and a large proportion of these stroke survivors experience upper limb post-stroke sensory impairments (ULPSSI) which impact upper limb function and participation. This thesis addresses the clinical decision-making (CDM) of occupational therapists when managing ULPSSI. No appraised and synthesised summary of the research evidence related to the effectiveness of interventions for ULPSSI is available to support therapists' CDM.Information on occupational therapists' practice choices and decisions about managing ULPSSI and the survivors' perspective on ULPSSI is scant. This information could support occupational therapists CDM when addressing ULPSSI and potentially improve stroke survivors' outcomes. Thesis AimsThis thesis aims to:1. Synthesise the effectiveness of interventions for ULPSSI; 2. Explore how occupational therapists make and manage decisions regarding ULPSSI management; 3. Describe practice choices occupational therapists commonly make when managing ULPSSI and the sources of information they use to make these decisions; 4. Compare current assessment choices and intervention practices with recommendations from the research evidence and clinical practice guidelines; 5. Describe the stroke survivors' perspective with regard to ULPSSI; and 6. Design and pilot an evidence-based, theory-driven educational intervention to support occupational therapists' CDM when addressing ULPSSI. Thesis MethodsFive distinct studies addressed the above aims. A Cochrane systematic review evaluated the evidence for the effectiveness of ULPSSI interventions.iii  Twelve occupational therapists participated in a qualitative descriptive study exploring therapists' practice choices and CDM related to ULPSSI. Based on the qualitative study, a survey of 187 occupational therapists described therapists' current practice choices regarding ULPSSI management and factors impacting CDM. A qualitative descriptive study using semi-structured interviews with 15 stroke survivors explored their experience of ULPSSI and the associated rehabilitation encounter. Finally, based on the need for training expressed by the survey participants, a one group pre-and post-test design, feasibility study evaluated the effect of a one day, theory-based educational intervention on 19 occupational therapists' knowledge, perceived behavioural control, attitudes and intended behaviour regarding ULPSSI management, research utilisation, and shared decision-making. Workshop content incorporated information from the prior research studies forming this thesis. ResultsA Cochrane systematic review located 13 randomised controlled trials (RCTs) addressing ULPSSI interventions, with benefit shown from individual RCTs evaluating mirror therapy, a graded thermal stimulation, and intermittent pneumatic compression. Other single RCTs reporting statistically significant results for repetitive peripheral magnetic stimulation, early intensive task-orientated training and graded...

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Current trends in the practice of home health care of occupational therapists treating patients who have had a stroke

Abstract: The present study was designed to examine current practices in home health care among occupational therapists in the United

Cited by 11 publications

References 13 publications

Therapeutic strategies used by occupational therapists in self‐care training: a qualitative study

Therapeutic strategies used by occupational therapists in self‐care training: a qualitative study

Task‐specific training: evidence for and translation to clinical practice

Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

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