An investigation of allied health and medical clinicians’ viewpoint on prosthetic rehabilitation and cognition
Creators: name: Dawes, Erinn
name: Bliokas, Vida
name: Hewitt, Lyndel
name: Wilson, Val
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Space Science
subject: Medicine
subject: Immunology
subject: FOS: Clinical medicine
subject: Mental Health
subject: Computational Biology

description: To explore the factors that influence clinicians (occupational therapists, physiotherapists, vascular surgeons, and rehabilitation medicine physicians) when prescribing prosthetic rehabilitation. Additionally, the study aimed to gain insight into clinicians’ perspectives regarding the role of patient cognition in prosthetic rehabilitation. This research constitutes one segment of a broader action research study which was undertaken in 2022. A total of thirty-four key clinicians involved in the amputation and prosthetic rehabilitation pathway within a local health district in Australia were engaged through a combination of group and individual interviews as well as surveys. Five essential considerations when prescribing prosthetic rehabilitation emerged. These included patient’s goals, medical history, quality of life, cognitive abilities, and the support available on discharge. This study also revealed variations in opinions among different disciplines concerning appropriateness of prosthetic rehabilitation for the patient cohort. Despite this, there was a desire to build a consensus around a shared approach of identification for patients and clinicians. The identification of these key pillars for clinician consideration has simplified a complex area of care. These pillars could be used to guide pertinent conversations regarding prosthetic rehabilitation and are closely linked with the patient’s cognition. Five key areas should be considered when prescribing prosthetic rehabilitation; patients’ goals, medical history, quality of life, cognitive abilities and supports available on discharge.Qualitative findings show different clinician domains hold very different perspectives on the suitability of patients to receive a prosthesis and undergo prosthetic rehabilitation.Occupational therapists and rehabilitation medicine clinicians most frequently view patients as suitable to undergo prosthetic rehabilitation, followed by physiotherapists and finally vascular surgeons.Vascular surgeons view most patients’ complex vascular medical history as a reason why only certain (younger) patients should undergo prosthetic rehabilitation.Communication of expectations between all members of the treating team is paramount for patient outcomes. Five key areas should be considered when prescribing prosthetic rehabilitation; patients’ goals, medical history, quality of life, cognitive abilities and supports available on discharge. Qualitative findings show different clinician domains hold very different perspectives on the suitability of patients to receive a prosthesis and undergo prosthetic rehabilitation. Occupational therapists and rehabilitation medicine clinicians most frequently view patients as suitable to undergo prosthetic rehabilitation, followed by physiotherapists and finally vascular surgeons. Vascular surgeons view most patients’ complex vascular medical history as a reason why only certain (younger) patients should undergo prosthetic rehabilitation. Communication of expectations between all members of the treating team is paramount for patient outcomes.