Occupational Therapy Department, Gannon University, Ruskin, FL, USA.
Hand Therapy Canada, London, Ontario, Canada.
J Hand Ther. 2019 Jul-Sep;32(3):361-367. doi: 10.1016/j.jht.2017.12.001. Epub 2018 Jul 4.
Productive outcomes for the hand therapy patient involve many components. Understanding whether therapists agree with the recommendations they receive, or find these informative, is a first step into understanding how shared decision-making on a treatment plan can be optimized.
The purposes of this study include (1) the extent which therapists see variable presentations of primary surgical/management in some indicator exemplars where practices vary from accepted/evidence-based practice; (2) hand therapists' level of agreement with the interventions prescribed on referrals, (3) describe the undocumented complications observed by hand therapists, and (4) report the therapists' perceptions as to the reasons for these complications METHODS: A survey was designed and pilot tested. Multiple-choice questions and free text allowed further explanation. The survey was administered through an electronic mailing to all American Society of Hand Therapy members with available e-mail addresses. Raw survey data were extracted and processed. Descriptive statistics were used to analyze therapists' demographic information. Frequencies of therapists' responses were calculated.
Ninety percent of all who responded have been in practice 10 years or more. The mean of the "often and always" ordered interventions was 20%. The mean of therapist perceptions as to whether these ordered interventions are best practice was 14%. Sixty percent reported that they had found an undocumented condition, and 60% reported to have found a postoperative complication. Perceived reasons for complications included the lack of communication and therapy intervention.
Hand therapists can play an important role in improving patient outcomes. Therapists can provide the health care team information regarding best practice. Additionally, the hand therapist may be who first identifies a postsurgical complication or an undocumented issue. Communication between the hand therapist and referral source is vital in optimizing patient outcomes.
Hand therapists can play an important role in improving overall outcomes for patients. The inter-professional working relationship between the referral source, hand therapist, and the patient is a complex phenomenon and communication between the hand therapist and referral source is vital.
手部治疗患者的生产成果涉及许多因素。了解治疗师是否同意他们收到的建议，或者发现这些建议是否具有信息性，是了解如何优化治疗计划的共同决策的第一步。
本研究的目的包括（1）治疗师在一些实践与公认/循证实践不同的指标示例中看到主要手术/管理的各种表现的程度；（2）手部治疗师对转介中规定的干预措施的认同程度，（3）描述手部治疗师观察到的未记录的并发症，以及（4）报告治疗师对这些并发症的原因的看法。
设计并进行了一项调查。多项选择问题和自由文本允许进一步解释。通过电子邮件向所有有可用电子邮件地址的美国手部治疗协会会员发送了调查。提取并处理原始调查数据。使用描述性统计来分析治疗师的人口统计学信息。计算了治疗师回答的频率。
90%的回应者已经从事该行业 10 年或更长时间。“经常和总是”排序干预措施的平均值为 20%。治疗师认为这些排序干预措施是否为最佳实践的平均值为 14%。60%的人报告说他们发现了一种未记录的情况，60%的人报告发现了术后并发症。并发症的潜在原因包括沟通和治疗干预不足。
手部治疗师可以在改善患者预后方面发挥重要作用。治疗师可以为医疗团队提供有关最佳实践的信息。此外，手部治疗师可能是第一个发现术后并发症或未记录问题的人。手部治疗师与转介来源之间的沟通对于优化患者预后至关重要。
手部治疗师可以在改善患者整体预后方面发挥重要作用。转介来源、手部治疗师和患者之间的专业间合作关系是一个复杂的现象，手部治疗师和转介来源之间的沟通至关重要。
