Sansonetti Danielle, Hoffmann Tammy
Occupational Therapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia; Eastern Health, Melbourne, Victoria, Australia.
Aust Occup Ther J. 2013 Oct;60(5):334-42. doi: 10.1111/1440-1630.12069. Epub 2013 Sep 1.
BACKGROUND/AIM: When working with individuals following stroke or traumatic brain injury, an important role of the occupational therapist is to assess the impact of cognitive impairment on their ability to engage in occupations and resume important life roles. The aim of this study was to survey therapists' reasons for selection of and challenges with using various cognitive assessment approaches, across the continuum of care, when working with individuals following stroke and traumatic brain injury.
A cross-sectional survey, completed via post or online, with responses from 209 Australian occupational therapists was conducted. Participants included clinicians working in acute, inpatient rehabilitation and community settings.
Occupational performance-based assessments were ranked as the most important assessment method, with 69% of participants reporting using these assessments for more than 75% of their clients with cognitive impairment. Participants identified the lack of quantitative data provided by these assessments as a frequent challenge. The identification of cognitive deficits was the highest ranked reason for using cognitive screens and batteries. Challenges identified with using cognitive screens and batteries included difficulty linking assessment results to occupational performance, and difficulty using results to generate intervention strategies. The majority of participants reported using a combined approach to assessment, and used screens and batteries to support findings of occupational performance-based assessments.
Targeted efforts to further incorporate standardised occupational performance-based methods into clinical practice, research, and ongoing professional development is required to enhance occupational therapy services when working with individuals with cognitive impairment.
背景/目的:在为中风或创伤性脑损伤患者提供服务时,职业治疗师的一项重要职责是评估认知障碍对他们参与日常活动及恢复重要生活角色能力的影响。本研究的目的是调查治疗师在为中风和创伤性脑损伤患者提供服务时,在整个护理过程中选择各种认知评估方法的原因以及使用这些方法时所面临的挑战。
通过邮寄或在线方式进行了一项横断面调查,收集了209名澳大利亚职业治疗师的回复。参与者包括在急性、住院康复和社区环境中工作的临床医生。
基于职业表现的评估被列为最重要的评估方法,69%的参与者报告称,他们为超过75%的认知障碍患者使用了这些评估方法。参与者认为这些评估缺乏定量数据是一个常见的挑战。识别认知缺陷是使用认知筛查工具和成套测验的首要原因。使用认知筛查工具和成套测验所面临的挑战包括难以将评估结果与职业表现联系起来,以及难以利用结果制定干预策略。大多数参与者报告采用综合评估方法,并使用筛查工具和成套测验来支持基于职业表现的评估结果。
需要有针对性地努力将标准化的基于职业表现的方法进一步纳入临床实践、研究和持续的专业发展中,以在为认知障碍患者提供服务时加强职业治疗服务。