国际功能、残疾和健康分类视角下桡骨远端骨折 1 年后的职业表现。

Occupational Performance 1 Year After a Distal Radius Fracture From the Perspective of the International Classification of Functioning, Disability and Health.

机构信息

Maryam Farzad, PhD, MSc, BSc, is Postdoctoral Associate, School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada, and Assistant Professor, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran;

Joy MacDermid, PhD, MSc, BSc, is Professor, Department of Physical Therapy and Surgery, Western University, London, Ontario, Canada; Codirector, Clinical Research Laboratory, Hand and Upper Limb Center, St. Joseph's Health Center, London, Ontario, Canada; and Professor, Department of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

出版信息

Am J Occup Ther. 2023 Sep 1;77(5). doi: 10.5014/ajot.2023.050180.

DOI:10.5014/ajot.2023.050180

PMID:37793017

Abstract

IMPORTANCE

Distal radius fractures (DRFs) frequently compromise independent functioning.

OBJECTIVE

To analyze occupational performance post-DRF using the Canadian Occupational Performance Measure (COPM) and related interviews, guided by the International Classification of Functioning, Disability and Health (ICF). COPM score was compared with standard metrics: Patient-Reported Wrist Evaluation (PRWE) and Participation Behavior Questionnaire (PBQ).

METHOD

Through a semistructured COPM interview, participants highlighted self-care, productivity, and leisure. They completed the PRWE and PBQ, linking results to ICF sets.

DESIGN

Prospective cohort.

SETTING

Outpatient hand surgery clinic at a trauma center.

PARTICIPANTS

Patients (N = 120), 1 yr post-DRF.

OUTCOMES AND MEASURES

Incorporated COPM, PRWE, and PBQ, linked to ICF.

RESULTS

Analysis identified 73 codes, aligning with 30 ICF Hand Conditions codes. Main concerns related to self-care (15.21%), leisure (12.16%), and productivity (16.22%). Major challenges pertained to domestic (67.00%) and civic life (64.53%) within ICF. Occupational performance was positively correlated with participation (r = .62) and inversely with disability (r = -.62).

CONCLUSIONS AND RELEVANCE

DRFs result in varied occupational challenges that are not always reflected in standard measures. The COPM offers a comprehensive insight into post-DRF patient challenges, emphasizing the value of diverse clinical assessment approaches. What This Article Adds: This study highlights the importance of a holistic approach in occupational therapy for DRF patients, revealing that standard measurements might overlook key challenges that they face. By adopting broader evaluative methods, occupational therapists can better address patient-specific needs and enhance their rehabilitation outcomes.

摘要