Highlights
- •Despite being trained in more holistic treatment approaches, occupational therapists who are certified hand therapists (CHTs) report that a biomechanical intervention approach is their primary approach to treating clients with upper extremity injuries.
- •While many occupational therapist CHTs will integrate occupation-based assessment and interventions into their therapy sessions, most do not formally assess for psychosocial dysfunction, and they do so even less with worker's compensation clients.
- •There is a need for better standardized tools to assess psychosocial factors for hand injured clients.
Abstract
Background
Occupational therapists address occupations, performance skills, and client factors
that interfere with the successful occupational engagement in everyday activities,
including psychosocial factors. However, due to the biomechanical model focus within
hand therapy clinics, provision of a holistic care plan remains challenging for occupational
therapists. If a client's psychosocial functioning is not addressed, progress toward
a full recovery may be limited.
Purpose
The purpose of this study was to identify how occupational therapists who are certified
hand therapists (CHTs), address and provide interventions to clients with psychosocial
factors that negatively impact function.
Study Design
Mixed-Method.
Methods
CHTs completed an electronic survey (n = 117) followed by a virtual focus group (n = 9). Survey data analysis included descriptive and correlational statistics to highlight
frequencies, ranges, and relationships between the participant demographics and the
selection of assessment and the intervention approaches. Thematic analysis guided
the qualitative coding of the focus group transcripts.
Results
Of the 117 survey respondents, 79% reported frequent use of the biomechanical approach.
The most frequently administered assessment included the Quick-Disabilities of the
Arm, Shoulder, and Hand (n = 45; 40.9%). Five themes emerged from the focus groups: hand dysfunction impacts roles
and routines; client rapport building takes time; CHT hesitation to address psychosocial
factors; standardized assessments need to evaluate psychosocial factors that impact
client function; and education and communication are critical intervention approaches.
Conclusions
Occupational therapy practitioners primarily utilize the biomechanical approach and
are less likely to assess or treat psychosocial factors that impact a client's function.
However, participants reported a need for a standardized assessment to identify the
psychosocial factors that impact their clients’ functional performance. Further research
is warranted to increase the measurement and the use of holistic theoretical models
of practice, assessments, and intervention approaches.
Keywords
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Article info
Publication history
Published online: September 18, 2022
Accepted:
July 3,
2022
Received in revised form:
June 22,
2022
Received:
August 20,
2021
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: All named authors hereby declare that they have no conflicts of interest to disclose.
Identification
Copyright
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