Instructional Concurrent Session VIII
Compassionate Care in Hand Therapy: What's Love Got To Do with It?
This instructional course describes compassionate care and explains what hand therapists can learn from collaborating with rehabilitation colleagues who are not hand therapists. The presenters for this course represent hand therapists as well as occupational therapists who work in oncology, in academia, and in general rehabilitation. They are therapists who might not necessarily collaborate professionally, which is unfortunate. These therapists have in common, among other things, a passion for the field and a shared caring for their patients’ well-being. This course, which is appropriate for a moderate-to-advanced level of audience, identifies humanistic features of our clinical work that promote best outcomes and personal reward to both patients and therapists. A literature review will provide background and identify themes related to compassionate care. These themes will then be incorporated into case examples representing patients who are receiving or have received hand therapy. Strategies for developing and promoting compassionate care in hand therapy practice will be presented.
- Define compassionate care in hand therapy
- Explain why compassionate care promotes best clinical outcomes
- Give an example of compassionate care in hand therapy
Fostering a Paradigm Shift from Medical Model to Client-Centered Approach in Hand Therapy
The purpose of this course is to advocate for a client-centered approach in hand therapy practice. This capstone project includes: 1) the history of occupational therapy (OT) in the hand therapy setting, 2) the difference between medical model and client centered approach in hand therapy, 3) how the client-centered approach aligns with The Occupational Therapy Practice Framework: Domain and Process 3rd edition (Framework-III) (American Occupational Therapy Association [AOTA], 2014), the OT model, and the OT frame of reference, and International Classification of Functioning, Disability and Health (ICF), 4) the efficacy of client-centered therapy, 5) practical ways to a adapt client-centered approach in hand therapy settings, 6) integrating evidence-based practice into hand therapy, 7) ways to move hand therapy practice toward Vision 2025 (AOTA, 2017), and 8) using ICF to communicate client-centeredness with other allied health professions as part of a team. This capstone project demonstrates the application and sharing of knowledge as part of clinical scholarship. Through the combination of OT client-centered theories, and the existing strengths of hand therapy practice, OT can better facilitate clients’ performance outcomes and improve client satisfaction.
- Describe a client-centered approach in hand therapy
- Utilize evidence-based reviews to support client-centered approach
- Promote collaboration with physical therapists who also uses ICF model
- Renew the occupational therapy (OT) role through OT frame of reference, model and OT practice framework, domain and process 3rd edition (Framework-III) (American Occupational Therapy Association (AOTA), 2014) to support client-centered treatment
Optimizing Team Intervention with Outcome Measures Specific to the Upper Limb Amputee Population
A specialized medical team is necessary to maximize the function of upper limb amputees. In order to ensure functional success and satisfaction, outcome measures are essential to guide the team. Historically, there have been no industry standard outcome measures for upper limb prosthetic wearers. Instead, multiple outcome measures from other medical specialties have been adopted. Many of those outcome measures provide a limited interpretation and do not provide a holistic measure of patient status and progress. Evidence-based clinical practice necessitates the need for comprehensive, amputee-specific outcome measures. Three focused upper limb amputee outcome measures were created to (1) determine psychosocial issues that might affect the rehabilitation process, (2) inform prostheses design/component selection, (3) identify functional issues, (4) measure functional progress, (5) compare function of a prosthetic user to the function of non-amputees, and (6) monitor patient self-perception of function and satisfaction with the rehabilitation process. The information gained from the outcome measures is invaluable to delivering patient specific intervention and monitoring changes that may present challenges to a prosthesis user. Use of the outcome measures has positively impacted patient outcomes and analysis of aggregate data provides invaluable information for patients, clinicians, researchers, prosthetic manufacturers, payer sources and the Department of Defense.
- Articulate the importance of utilizing outcome measures to support team intervention for upper limb amputees.
- Identify limitations of currently available outcome measures.
- Describe how patient-specific, evidenced based upper limb prosthetic outcome measures can improve patient outcomes and provide invaluable feedback for clinicians, manufacturers, researchers, reimbursement companies, and government agencies.
Treatment of Musicians with Playing Related Musculoskeletal Disorders and Hypermobility
Playing a musical instrument can be an avenue for self-expression or an occupational road to injury. The flexibility that develops speed and coordination in a musician is often built off an unstable, underlying foundation of hypermobility. Sustaining pain while doing what musicians love has become par for the course. Joint laxity gives an advantage to reach strings easily, stretch across more keys and play faster until soft tissue reaches its limits. In these painless extremes is where injury occurs. People with hypermobility are more susceptible to being injured and take longer to heal. Therapists are in an optimal position to collaborate with the musician, physician and teachers to identify how the Playing Related Musculoskeletal Disorders (PRMDs) can be minimized by understanding postures, positioning and pacing essential to the instrumentalist. Treatment plans will be shared that address hypermobility while rebuilding speed, stamina and strength with motor control. Case studies will include progressive return to play programs, user friendly splints, self-regulation of symptoms and conditioning programs both in the clinic at home and on tour. Together we help the instrumentalist regain their therapeutic use of self and work life balance. Level: Intermediate to Advanced
- Attendees will be able to identify best postures, positions and pacing that restore alignment, joint stability and motor control to return a musician to play
- Participants can evaluate several progressive return to play programs addressing treatment of hypermobility and PRMDs
- Therapists can interpret how integrating splints timely at and away from the instrument can optimize healing and minimize re-injury.