Evaluating Current Trends of Occupation-Based Practice in the Hand-Therapy Setting

The purpose of this study was to gain an understanding of the current use of occupation-based interventions (OBI) by occupational therapists working primarily in a hand therapy setting. Occupational therapy is responding to the current political climate and health care reform with a reaffirmation of the profession’s use of occupation to heal and prevent disease and illness. The use of occupation is effective in facilitating recovery and successful participation in activities of daily living (Colaianni, Provident, DiBartola, & Wheeler, 2015).

Under the leadership of President Amy Lamb, therapists are acknowledging and advocating for the power of occupation. The use of occupation has a long history as an evidence-based practice, yet in many settings is underutilized. While there is a desire to utilize occupation, previous research has shown that therapists face barriers in daily practice (Grice, 2015). This study examined the current trends and barriers in the use of occupation-based interventions within a hand therapy setting.

Participants were recruited from the American Occupational Therapy Association (AOTA), for members who identified hand therapy as a practice setting. The study utilized a mixed method design survey consisting of four demographic questions, two open-ended reflections, and thirteen 5-point Likert scaled questions.

Five hundred surveys were mailed and 108 participants completed the study (21.6% response rate). Initially, participants were asked to reflect on the following quote by AOTA President, Amy Lamb:

Our centennial year is an excellent time for the profession to reaffirm our commitment to our core, occupation. As we continue to navigate the changing times in both health care and education arenas, it is vital to demonstrate our distinct value and what sets us apart from other professions, our emphasis on participation and engagement in the everyday life.(Lamb, 2017)

Results showed 87% of participants agreed or strongly agreed with this message. Participants were asked if there are benefits to using occupation-based interventions within the hand therapy setting and 88% of participants agreed or strongly agreed with this question. When asked whether using occupations as treatment facilitated client recovery, results indicated that 72.2% of participants agreed or strongly agreed.

Participants were asked whether they felt they were able to successfully incorporate occupation-based interventions within their own treatment process. Results indicated that only 55.6% of participants agreed or strongly agreed with this statement. When asked to indicate barriers to the use of OBI, the top 3 barriers reported were: lack of time, unsupportive environment, and equipment needs.

These results are supported by previous literature indicating that therapists desire to utilize OBI, recognize the benefit, however, are faced with barriers to implementation. Application of a dynamic combination of occupation-based and traditional interventions, may allow clients the opportunity to optimize their daily occupational performance (Von der Heyde, 2011), define the unique contributions of OT, and advocate for the power of occupation to improve outcomes in the hand therapy setting.

Researchers used the literature and the results of this study to develop evidence-based occupation-based programming options for the hand therapy setting: pre-operative occupation based programming, occupation-based home programs, and occupation kits. These programs are being developed as doctoral projects to enhance current practice. Findings from this study can inform future practice and provide information regarding the effectiveness of utilizing occupation-based treatment in hand therapy settings.

References

Colaianni, D. J., Provident, I., DiBartola, L. M., & Wheeler, S. (2015). A phenomenology of occupation-based hand therapy. Australian Occupational Therapy Journal, 62, 177-186. doi:10.1111/1440-1630.12192

Grice, K. O. (2015). The use of occupation-based assessments and intervention in the hand therapy setting - A survey. Journal of Hand Therapy, 28, 300-306. http://dx.doi.org/10.1016/j.jht.2015.01.005

Lamb, A. J. (2017). Celebrating the OT centennial with a reaffirmation to occupation. Rom/content/connect/c1/1116523376/en/events/event/shared/default_template_simple/event_landing.html?sco-id=165326etrieved from https://events-na11.adobeconnect.c6911

Von der Heyde, R. L. (2011). Occupational therapy interventions for shoulder conditions: A systematic review. American Journal of Occupational Therapy, 65, 16–23. https://doi.org/10.5014/ajot.2011.09184