Psychosocial Evaluation for Individuals With Upper Extremity Conditions: A Scoping Review—Part 1

For 40 years researchers have documented the role psychosocial factors play in physical healing and disability perceptions of adults with upper extremity (UE) conditions.1,2 There is minimal evidence guiding occupational therapy practitioners in best practice psychosocial evaluation for this population. The purpose of this project was to use the literature to identify the psychosocial constructs relevant to individuals with UE conditions to inform a comprehensive psychosocial evaluation. The following research questions were answered: 1) What psychosocial constructs are of interest for measurement in this population? and 2) What is the significance of the findings relevant to the psychosocial constructs to OT practice? A scoping review was chosen for this project as it provides a systematic method to map and discuss the relevant literature while clarifying vague concepts and identifying knowledge gaps. This review was developed following the Joanna Briggs Institute and PRISMA-ScR guidelines beginning with the population, concept, context framework.3 Evidence included are empirical studies published after 1984 in which adults with UE conditions were evaluated with at least one published psychosocial assessment. A data extraction tool was used to map and analyze the data. Ninety-four studies met the inclusion criteria and 85 unique psychosocial assessments were used representing 21 psychosocial constructs. The constructs were further categorized into three psychsocial evaluation clusters: psychological symptoms, personal characteristics and coping styles, and psychosocial resiliency factors. The presence of psychological symptoms and negative coping often correlate positively with participants' perceived disability and pain levels regardless of injury severity. Meanwhile, positive coping and resiliency factors tend to promote more desirable functional outcomes. It is recommended that comprehensive psychosocial evaluation include a balance of barriers and strengths.

References

Grob, M., Papadopulos, N. A., Zimmermann, A., Biemer, E., & Kovacs, L. (2008). The psychological impact of severe hand injury. Journal of Hand Surgery (European Volume), 33(3), 358–362. https://doi.org/10.1177/1753193407087026

Jayakumar, P., Overbeek, C. L., Lamb, S., Williams, M., Funes, C., Gwilym, S., Ring, D., & Vranceanu, A.-M. (2018). What factors are associated with disability after upper extremity injuries? A systematic review. Clinical Orthopaedics & Related Research, 476(11), 2190–2215. https://doi.org/10.1097/CORR.0000000000000427

Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A.C., & Khalil, H. (2020). Scoping reviews. In E. Aromataris & Z. Munn (Eds.), Joanna Briggs Institute Reviewer's Manual (4th ed.), (pp. 407-452). https://reviewersmanual.joannabriggs.org/