Date of Paper/Work

5-2011

Type of Paper/Work

Thesis

Degree Name

Master of Arts in Occupational Therapy

Department

Occupational Science/Occupational Therapy

First Advisor

Barbara C. Gilbertson, MS, OTR/L, CHT

Abstract

Occupational therapists can work in a variety of settings, and therefore use multiple frames of references, models of practice, and different outcome measures based on the populations they are treating. This study includes a literature review of the outcome measures used in occupational therapy and hand therapy, as well as the frames of references used, and the goal setting strategies employed in hand therapy. The purpose of this study is to identify assessments and outcomes measures used by occupational therapists specializing in hand therapy practice and to determine if that choice is affected by their chosen frames of reference, membership in professional organizations, and the measurement tools identified in their professional journals. This study benefits the occupational therapy community because it provides information on current trends in assessment and outcome measurement used for clients with upper extremity injuries and the primary frames of references therapists use with their clients. This study helps occupational therapists working primarily as hand therapists better understand their own practice by providing information that supports, recognizes, and reflects on the methods they use in treatment.

A survey was sent to 154 hand therapists in Minnesota. The results of this study indicated that few therapists differentiated between assessments and outcome measures and that frequently used assessment tools were also frequently identified as outcome measures. The survey results indicate 94% of therapists using the DASH or QuickDASH identified it as both an assessment and an outcome measure. Goal attainment and self report on progress were also identified by some respondents as an outcome measure. The biomechanical frame of reference was frequently used regardless of practice setting or experience and the majority of assessments and outcomes identified reflect this frame of reference (FOR). Other models and FORs therapists identified using were not represented in assessment or outcome measures selection. Therapists with less experience used a broader range of models and FOR, while therapists with over 15 years of experience identified very few. Three primary goal setting strategies with varying levels of client-centeredness were used by over 63% of respondents and included: Goals being set during specific client discussion, goals being set based on assessment results and are then described to client, and goals written based on client comments and in response to written self report assessments.

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