School of Allied Health, Curtin University, Perth, Western Australia, Australia.
Telethon Kids Institute, Nedlands, Western Australia, Australia.
Aust Occup Ther J. 2023 Feb;70(1):43-60. doi: 10.1111/1440-1630.12834. Epub 2022 Aug 7.
In the disability sector globally, and specifically in Australia, assessments of functioning have become key to diagnostic processes, and accessing therapy and funding. Over half of all individuals accessing support through Australia's National Disability Insurance Scheme have a neurodevelopmental condition diagnosis. Little is known about assessments of functioning for this population.
A mixed methods online survey was designed to understand the current assessment of functioning practices (including clinical contexts, concepts being assessed, and assessment methods) and barriers and facilitators to clinicians using best practice. Results were analysed descriptively, and differences between professions calculated where possible. Content analysis was used to explore qualitative comments.
Clinicians from various medical and allied health backgrounds completed the survey (n = 93), with varying ranges of age, experience, and education. Clinicians reported that they assessed functioning across age, setting, sector, funding body, and individuals with a wide variety of diagnoses. Missing from current practice is a clear transdisciplinary conceptualisation of functioning. The largest barriers to best practice were limited time, large caseloads, availability of appropriate tools, and lack of clarity from funding bodies.
Missing from current practice is a clear transdisciplinary conceptualisation of functioning.These results will help inform steps forward to improve assessment of functioning practices to ensure that all individuals receive appropriate and sufficient support.
在全球的残疾领域,特别是在澳大利亚,功能评估已成为诊断过程、获得治疗和资金的关键。在通过澳大利亚国家残疾保险计划获得支持的所有人中,有一半以上的人患有神经发育状况诊断。对于这一人群的功能评估知之甚少。
设计了一项混合方法的在线调查,以了解当前功能评估的实践情况(包括临床背景、评估的概念和评估方法),以及临床医生使用最佳实践的障碍和促进因素。结果进行了描述性分析,并在可能的情况下计算了不同专业之间的差异。内容分析用于探索定性意见。
来自不同医学和联合健康背景的临床医生完成了调查(n=93),年龄、经验和教育程度各不相同。临床医生报告说,他们在不同的年龄、环境、部门、资金来源和具有广泛诊断的个体中评估功能。目前的实践中缺乏明确的跨学科功能概念化。最佳实践的最大障碍是时间有限、工作量大、缺乏合适的工具以及资金来源不明确。
目前的实践中缺乏明确的跨学科功能概念化。这些结果将有助于为改善功能评估实践提供信息,以确保所有个体都能获得适当和充分的支持。