Ransby Thea Birch, Jacobsen Nicolaj Schøler, Hansen Alice Ørts
Department of Occupational Therapy, VIA University College, Aarhus, Denmark.
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.
Hand Ther. 2024 Sep;29(3):124-134. doi: 10.1177/17589983241268188. Epub 2024 Aug 28.
The dominance of the biomedical approach has previously caused a limited focus on occupation within hand therapy. This study aimed to investigate the rehabilitation offered to patients with a hand-related disorder (HRD) in Denmark including to determine the extent to which occupation-focused and/or occupation-based assessments and interventions are used and to identify barriers against their use.
A cross-sectional survey with 45 questions was conducted among members of the Danish Association for Hand Therapy. Data were analysed with descriptive statistics. Categorical variables were reported with frequency and percentage, and continuous variables with average and standard deviation.
One hundred and six occupational therapists working as hand therapists ( = 106) completed the survey. They reported common use of assessments measuring range of motion, pain, edema, and occupational performance. Occupational performance was assessed by non-standardized occupation-focused assessments, such as informal conversations. Exercise, pain management, and occupation-focused informal conversations were reported as the most frequently used interventions. Out of 82 respondents, 74 (91.4%) reported that they used interventions focused on body function and structures to the extent they wanted. Only 41 (50.0%) used occupation-focused or occupation-based interventions to the extent they wanted.
Assessments and interventions reporting body function and structure were used most frequently whereas assessments and interventions reporting activity and participation were used to a lesser extent. Occupation-focused assessments and interventions were used more commonly than occupation-based. Hand therapists considered occupation-based assessments and interventions to be important in rehabilitation after HRD, despite using them with few patients. Several barriers were reported regarding the implementation of an occupation-centered approach: habit, workload, time constraints, and setting.
生物医学方法的主导地位此前导致手部治疗中对活动的关注有限。本研究旨在调查丹麦为手部相关疾病（HRD）患者提供的康复治疗，包括确定以活动为重点和/或以活动为基础的评估及干预措施的使用程度，并识别其使用的障碍。
对丹麦手部治疗协会成员进行了一项包含45个问题的横断面调查。采用描述性统计方法分析数据。分类变量以频率和百分比报告，连续变量以平均值和标准差报告。
106名从事手部治疗的职业治疗师完成了调查。他们报告了常用于测量运动范围、疼痛、水肿和职业表现的评估方法。职业表现通过非标准化的以活动为重点的评估进行，如非正式交谈。运动、疼痛管理和以活动为重点的非正式交谈被报告为最常用的干预措施。在82名受访者中，74人（91.4%）报告他们根据自身意愿使用了专注于身体功能和结构的干预措施。只有41人（50.0%）根据自身意愿使用了以活动为重点或以活动为基础的干预措施。
报告身体功能和结构的评估及干预措施使用最为频繁，而报告活动和参与的评估及干预措施使用较少。以活动为重点的评估和干预措施比以活动为基础的更常用。手部治疗师认为以活动为基础的评估和干预措施在HRD后的康复中很重要，尽管使用的患者较少。报告了实施以活动为中心方法的几个障碍：习惯、工作量、时间限制和环境。
