Introducing purposeful activity kits in a hand rehabilitation practice: Effects on clinical practice patterns and job satisfaction among occupational therapy practitioners

Abstract

Introduction: Facilitating function through occupation and purposeful activity is the basic tenet of occupational therapy. However, the majority of research in hand rehabilitation clinics continues to focus on biomechanical interventions. The purpose of this research was to study practice patterns and personal opinions of occupational therapy practitioners before and after providing purposeful activity kits to an outpatient occupational therapy hand clinic. Methods: Mixed-method design to evaluate an 8-week intervention of providing purposeful activity kits to a busy, military outpatient hand clinic. A paper survey was administered to nine occupational therapy practitioners before and after the intervention. Qualitative data were gathered through semi-structured interviews. Results: A descriptive analysis indicated an increase in the use of activities, crafts, and occupation after the introduction of the purposeful activity kits. Practitioners consistently reported time as the top factor in their inability to incorporate more purposeful activities. Qualitative results support use of the new activities during both intervention and evaluation due to the focus on function and ease of use of the kits. Conclusion: Purposeful activities can enhance any rehabilitation clinic in an organized, cost-effective manner. Practitioners responded positively toward the added equipment; however, it will take time and effort to adjust the theoretical decision making of practitioners. Additional participants and length of intervention is needed.

Developing occupation kits in a Hand Therapy Student Experiential Learning Clinic

“…However, there is often a disconnection between the theoretical underpinnings of occupational therapy (OT) and typical hand therapy clinical practice. 6 Hand therapy is traditionally based on the biomechanical model, 7 which focuses on isolated aspects of human functioning, such as body functions and structures alone. 8 Research suggests that a more comprehensive and occupation-based approach to hand therapy will produce better outcomes when compared to this isolated biomechanical approach.…”

“…21 Research identified four primary reasons hand therapists do not deliver occupation-based care: insufficient time, lack of equipment, productivity and reimbursement demands, and reliance on protocols and treatment prescriptions. 6,10,19,21 Hand therapists affirm the value of using occupation-based assessments and interventions and would like to incorporate them more systematically into their practice, but they do not have the tools to do so. 19,21 Bridging the gap to provide skilled, holistic, client-centered care is a challenge that many practicing therapists face.…”

“…Occupation kits address the barriers hand therapists report when integrating occupation-based assessments and interventions because of their low cost, ease of transport, and focus on performance of occupations. 6 These kits can be used as an accessible and easily replicated assessment and intervention tool to promote occupation-based hand therapy. Kits are constructed from a variety of everyday items used while engaging in meaningful activities 6 to facilitate the participation in occupations relevant to the patient.…”

“…6 These kits can be used as an accessible and easily replicated assessment and intervention tool to promote occupation-based hand therapy. Kits are constructed from a variety of everyday items used while engaging in meaningful activities 6 to facilitate the participation in occupations relevant to the patient. The items are placed in containers for ease of access, storage, organization, and transport.…”

“…Occupation kits are used in a variety of clinical settings, including nursing homes and acute rehabilitation settings, 23 but are not commonly used in hand therapy settings. Previous projects or studies in hand therapy have developed purposeful activity kits 6 or gathered materials to simulate activities in clinic; 9 however, these addressed only a portion of occupations, addressed performance at the biomechanical skill level, or the development process lacked scientific rigor. 6,9,15…”