Date of Paper/Work

5-2021

Type of Paper/Work

Doctoral Project

Degree Name

Doctor of Occupational Therapy

Department

Occupational Science/Occupational Therapy

First Advisor

Darla Coss

Second Advisor

Susan Hoey

Third Advisor

Teresa Wickboldt

Department/School

Doctor of Occupational Therapy

Abstract

The prevalence of post-stroke visual impairment is alarmingly high, with estimates of up to two-thirds of stroke survivors experiencing deficits (Rowe, Hepworth, Howard et al., 2019). However, research indicates that greater than 60% of visual acuity deficits and visual-spatial neglect in patients with stroke are undetected by standard clinical practice (Edwards et al., 2006). Thus, many patients with stroke have clinically significant visual impairments that are not being detected, and therefore, are not being adequately addressed. Visual impairments can substantially influence an individual's everyday functioning, safety, social interaction, and quality of life. Without skilled intervention and support, individuals experiencing these deficits may develop reduced self-efficacy, social isolation, and occupational deprivation (Perea et al., 2018).

The aim of this thesis is to spread awareness of the high prevalence and underdiagnosis of post-stroke visual impairment, educate current and future occupational therapy practitioners on recommendations to reduce heterogeneity in assessment practices, and advocate for the role of occupational therapy in improving detection of post-stroke visual impairment to optimize the functional recovery and quality of life of stroke survivors. This knowledge was disseminated in three ways. The first method was to educate occupational therapy practitioners and students via a Minnesota Occupational Therapy Association virtual continuing education session. The second method was to inform readers of the American Occupational Therapy Association’s Rehabilitation and Disability Special Interest Section Quarterly Practice Connection through an article submitted for publication. The final method was to raise awareness and educate occupational therapy practitioners, students, and educators attending the 2021 Iowa Occupational Therapy Association annual conference by presenting a poster.

Completion of these three knowledge translation projects generated awareness and greater understanding of the factors resulting in the underdiagnosis of post-stroke visual impairment and affirmed occupational therapy’s role in screening for visual impairments poststroke. However, there is need for continued education aimed at improving knowledge and awareness of the visual problems that can occur after stroke amongst occupational therapists, other members of the stroke care team, and the general public. Furthermore, now that core outcome sets for vision screening and full vision assessment have been developed to assist in reducing the heterogeneity in assessment practices, efforts to disseminate this information to clinicians and researchers involved in screening and assessment of post-stroke visual impairment should be prioritized. Future research should evaluate the use of these outcome sets and attempt to achieve consensus on how the outcomes should be measured.

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