Clinical decision making when addressing upper limb post-stroke sensory impairments

Doyle, Susan, Bennett, Sally and Gustafsson, Louise (2013) Clinical decision making when addressing upper limb post-stroke sensory impairments. British Journal of Occupational Therapy, 76 6: 254-263. doi:10.4276/030802213X13706169932789


Author Doyle, Susan
Bennett, Sally
Gustafsson, Louise
Title Clinical decision making when addressing upper limb post-stroke sensory impairments
Journal name British Journal of Occupational Therapy   Check publisher's open access policy
ISSN 0308-0226
1477-6006
Publication date 2013-06-01
Year available 2013
Sub-type Article (original research)
DOI 10.4276/030802213X13706169932789
Open Access Status DOI
Volume 76
Issue 6
Start page 254
End page 263
Total pages 10
Place of publication London, United Kingdom
Publisher College of Occupational Therapists
Language eng
Abstract Introduction: This study explored factors influencing occupational therapists' clinical decision making when choosing to assess upper limb post-stroke sensory impairments (ULPSSI) and selecting interventions.
Formatted abstract
Introduction: This study explored factors influencing occupational therapists' clinical decision making when choosing to assess upper limb post-stroke sensory impairments (ULPSSI) and selecting interventions.

Method: A survey of 187 American occupational therapists working with stroke survivors.

Findings: Respondents most commonly assessed ULPSSI to determine the impact on occupational performance and guide interventions, and most commonly did not undertake assessment if clients either reported no impairments or were unable to participate in testing. Being unaware of interventions, believing motor interventions addressed ULPSSI and lack of time most commonly led to the decision not to use interventions for ULPSSI. Clients' cognitive status, severity of ULPSSI and time since stroke influenced therapists when choosing between compensatory or remedial approaches. Prior experience, effects seen when trialling interventions and consulting other therapists most commonly influenced specific intervention choice.

Conclusion: Deciding to assess ULPSSI was influenced by theoretical knowledge and domain-specific clinical knowledge while decisions about interventions were largely influenced by the therapists' domain-specific clinical knowledge, clinical experience and by specific contextual factors such as time available for therapy. Respondents used both automatic and reflective or deliberate decision-making processes. Education on evidence-based interventions and strategies for decision making in areas of clinical uncertainty is warranted.
Keyword Sensory impairment
Occupational therapy
Cinical decision making
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
 
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