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支持后天性脑损伤后执行功能障碍的职业治疗实践:一项英国临床调查。

Occupational therapy practice to support executive function impairment after acquired brain injury: A UK clinical survey.

作者信息

de Charentenay Sarah, Whitney Julie, Logan Philippa A

机构信息

King's College Hospital NHS Foundation Trust, Therapies Rehabilitation and Allied Clinical Services, London, UK.

Kings College, London, UK.

出版信息

Br J Occup Ther. 2024 Apr;87(4):239-250. doi: 10.1177/03080226231206686. Epub 2023 Nov 3.

Abstract

INTRODUCTION

This study explored treatment of executive functioning impairment in adults after acquired brain injury (ABI), clinician's confidence and support received, in a sample of occupational therapists in the United Kingdom.

METHODS

A 24-item online questionnaire was sent to 750 members of the Royal College of Occupational Therapists Specialist-Section in Neurological Practice. Data was collected at a nominal and ordinal level and included yes/no Likert-type scale and free field comments. Descriptive statistical analysis was completed.

RESULTS

Seventy-six occupational therapists working in a range of neurological settings completed the survey. Frequently used interventions included education ( = 57, 75%), task modification ( = 56, 73%), instrumental activities of daily living (ADL) ( = 54, 71%), personal ADL ( = 53, 70%) and goal setting ( = 53, 70%). Seventy-one percent used metacognitive strategies. Occupation-based metacognitive approaches were rarely used. Thirty-one (41%) participants reported being fairly confident and 28 (37%) were very confident. Support for clinical practice was accessed most frequently through joint clinical sessions ( = 30, 39%).

FINDINGS

Participants used various clinical interventions to treat service users with executive dysfunction after ABI. Meta-cognitive strategies were employed; however, occupation-based metacognitive approaches were infrequently utilised, suggesting uncertainty in adopting these in practice. The need for further training on evidence-based interventions and knowledge translation support was highlighted.

摘要

引言

本研究在英国的职业治疗师样本中,探讨了后天性脑损伤(ABI)后成人执行功能障碍的治疗方法、临床医生获得的信心和支持。

方法

向皇家职业治疗师学院神经学实践专业组的750名成员发送了一份包含24个条目的在线问卷。数据收集采用名义和有序水平,包括是/否李克特量表和自由填写评论。完成了描述性统计分析。

结果

76名在一系列神经学环境中工作的职业治疗师完成了调查。常用的干预措施包括教育(n = 57,75%)、任务修改(n = 56,73%)、日常生活工具性活动(IADL)(n = 54,71%)、个人日常生活活动(PADL)(n = 53,70%)和目标设定(n = 53,70%)。71%的人使用元认知策略。基于职业的元认知方法很少使用。31名(41%)参与者表示相当有信心,28名(37%)非常有信心。临床实践的支持最常通过联合临床会议获得(n = 30,39%)。

研究结果

参与者使用各种临床干预措施来治疗ABI后有执行功能障碍的服务对象。采用了元认知策略;然而,基于职业的元认知方法很少被使用,这表明在实践中采用这些方法存在不确定性。强调了对循证干预措施和知识转化支持进行进一步培训的必要性。

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