Koh Chia-Lin, Hoffmann Tammy, Bennett Sally, McKenna Kryss
Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Aust Occup Ther J. 2009 Oct;56(5):324-31. doi: 10.1111/j.1440-1630.2008.00764.x.
BACKGROUND/AIM: Cognitive impairment is a common and often debilitating consequence of stroke. The current practice patterns of Australian occupational therapists who work in this area are not clearly known. The aim of this study was to investigate the theoretical approaches, assessments, interventions and research evidence used by Australian occupational therapists who work with patients who have cognitive impairment poststroke.
A self-administered, purpose-designed online survey was used.
Survey responses were received from 102 occupational therapists. The client-centred approach was the most commonly used theoretical approach, with 81.3% and 72% using it often or all of the time with inpatients and outpatients, respectively. Assessments that were most frequently used were the Mini Mental State Examination (63.7% of participants), the Lowenstein Occupational Therapy Cognitive Assessment (45.1%), the Functional Independence Measure (57.8%, and the Assessment of Living Skills and Resources (10.0%). Interventions involving functional activities were used more frequently than compensatory techniques, such as diaries, alarms, or other electronic devices, and paper and pencil remedial exercises. Few (16%) participants used computer programs specifically designed for cognitive rehabilitation. Although 60.8% of the participants reported using research literature when making decisions about interventions, a higher percentage reported relying on their past experience (88.3%) and colleagues' opinions (77.4%).
This study provides an insight into the current practices of Australian occupational therapists who work with people who have cognitive impairment after stroke. Client-centredness is emphasised in current practice; however, the use of research evidence to inform practice appears to be limited.
背景/目的：认知障碍是中风常见且往往使人衰弱的后果。目前在该领域工作的澳大利亚职业治疗师的实践模式尚不清楚。本研究的目的是调查为中风后认知障碍患者提供服务的澳大利亚职业治疗师所采用的理论方法、评估、干预措施及研究证据。
采用自行设计的在线问卷调查。
共收到102名职业治疗师的调查回复。以患者为中心的方法是最常用的理论方法，分别有81.3%和72%的治疗师在为住院患者和门诊患者提供服务时经常或始终使用该方法。最常使用的评估方法是简易精神状态检查表（63.7%的参与者）、洛温斯坦职业治疗认知评估量表（45.1%）、功能独立性测量（57.8%）以及生活技能与资源评估（10.0%）。涉及功能活动的干预措施比补偿性技术（如日记、闹钟或其他电子设备以及纸笔康复练习）使用得更频繁。很少有参与者（16%）使用专门为认知康复设计的计算机程序。尽管60.8%的参与者报告在做出干预决策时会查阅研究文献，但更多的参与者表示依赖他们过去的经验（88.3%）和同事的意见（77.4%）。
本研究深入了解了为中风后认知障碍患者提供服务的澳大利亚职业治疗师的当前实践。当前实践强调以患者为中心；然而，利用研究证据为实践提供参考的情况似乎有限。
