Evaluative processes of occupational therapists in stroke rehabilitation facilities
Portrait des pratiques évaluatives des ergothérapeutes en réadaptation post-AVC
Creators: name: Apollon-Roy, Deborah
name: Miéville, Carole
name: Poissant, Lise
Publisher: name: Communauté pour l’Avancement de la Recherche Appliquée Francophone en Ergothérapie (CARAFE)
Year: 2021
Subjects: Outils d’évaluation, AVC, Réadaptation, Meilleures pratiques
Evaluation tools, Stroke, Rehabilitation, Best practices

description: Introduction : Stroke impacts the well-being, the activities and the social participation of stroke survivors. Despite the known benefits of rehabilitation and well documented stroke recommendations, systematic application of best practices remains low. In fact, little is known on the type of rehabilitation services that are offered in Quebec. Thereby, the objective of this study was to describe the utilization of evaluation tools by occupational therapists (OTs) working in a rehabilitation facility in Quebec and to characterize the gaps between the utilization of tools and the Canadian Stroke Best Practices.
Méthods : This is a secondary analysis of the data obtained from a provincial audit of 735 charts of stroke patients who received rehabilitation services on a in- or out-patient facility. The frequency of; clinical problems as defined by the International Classification of Functioning, Disability and Health (ICF); evaluation processes and; evaluation tools used by OTs were estimated. Chi-Square tests were calculated to compare in-patient and out-patient results.
Results : A total of 46&nbsp; tools were used by OTs while only 22 of those met the best practices. The most frequently ICF domains evaluated by OTs were associated to the motor, cognitive, and visuo-perceptual functions as well as driving, daily and instrumental activities. Overall, OTs working in in-patient facilities used more tools than those working in out-patient facilities.
Conclusion : Despite gaps between OTs practice and best practices, clinical problems of patients are evaluated. Future studies are necessary to understand the factors justifying those gaps.&nbsp;
description: Introduction : L’AVC affecte les activités, la participation sociale et le bien-être des personnes touchées. Malgré les bienfaits connus de la réadaptation et la documentation de meilleures pratiques, aucune application systématique de celles-ci n’est observée au Canada. De plus, aucune étude ne fait état des services de réadaptation actuellement offerts au Québec. Ainsi, cette étude visait à décrire l’utilisation d’outils d’évaluation par les ergothérapeutes en réadaptation post-AVC au Québec et à caractériser l’écart entre cette utilisation et les Recommandations canadiennes pour les pratiques optimales de soins de l’AVC.
Méthodologie : Les données étaient issues de l’audit de 735 dossiers de patients ayant subi un AVC et recevant des services d’établissements de réadaptation interne (RI) et externe (RE) au Québec. La fréquence des problèmes cliniques définis selon la Classification internationale du fonctionnement, du handicap et de la santé (CIF); des processus et des outils d’évaluation utilisés par les ergothérapeutes a été calculée. Des tests khi-carré ont été effectués pour comparer les résultats de la RI à ceux RE.
Résultats : Parmi 46 outils utilisés par les ergothérapeutes, 22 rencontraient les meilleures pratiques. Les ergothérapeutes évaluent les fonctions motrices, cognitives, perceptuelles et visuelles, la conduite automobile, les activités quotidiennes et domestiques. Les ergothérapeutes travaillant en RI utilisent plus d’outils que les ergothérapeutes en RE.
Conclusion : Bien que des écarts existent entre la pratique actuelle en réadaptation et les pratiques recommandées, les problématiques des patients sont bien évaluées. Des études futures sont nécessaires pour documenter les facteurs justifiant ces écarts.
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Introduction. Stroke impacts the well-being, the activities and the social participation of stroke survivors. Despite the known benefits of rehabilitation and well documented stroke best practices, systematic application of these remains low. In fact, little is known on the type of rehabilitation services that are offered in Quebec. Thereby, the objective of this study was to describe the utilization of evaluation tools by occupational therapists (OTs) working in a rehabilitation facility in Quebec and to characterize the gaps between the utilization of tools and the Canadian Stroke Best Practices.
Methods. This is a secondary analysis of the data obtained from a provincial audit of 735 charts of stroke patients who received rehabilitation services on a in- or out-patient facility. The frequency of clinical problems as defined by the International Classification of Functioning, Disability and Health (ICF), evaluation processes and evaluation tools used by OTs were estimated. Chi-square tests were calculated to compare inpatient and outpatient results.
Results. A total of 46 tools were used by OTs while only 22 of those met the best practices. The most frequently ICF domains evaluated by OTs were associated to the motor, cognitive, and visuo-perceptual functions as well as driving, daily and instrumental activities. Overall, OTs working in inpatient facilities used more tools than those working in outpatient facilities.
Conclusion. Despite gaps between OTs practice and best practices, clinical problems of patients are evaluated. Future studies are necessary to understand the factors justifying those gaps.