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Title: Hand trauma and rehabilitation : the developemnt of an evidence based assessment framework
Author: Bücher, Catherine Anne.
ISNI:       0000 0001 3513 0364
Awarding Body: Manchester Metropolitan University
Current Institution: Manchester Metropolitan University
Date of Award: 2005
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Background In the UK there is a concerted drive to deliver evidenced based, patient centred care. Current hand therapy assessment might not reflect practice and policy recommendations particularly in respect of explicit patient centred approaches. The study aim was to develop an assessment framework, modelled on the ICF' to direct efficient and effective patient centred assessment. Objectives 1. Identify a baseline picture of UK hand therapy assessment practice 2. Explore patient perceptions of current assessment practice 3. Explore practitioner perceptions of assessment 4. Construct a framework to facilitate evidence based rehabilitation programmes Methods Purposive sampling and data and methodological triangulation were features of the studies, which included., 1. A postal questionnaire used to survey current hand therapy assessment practice (n=242). 2. Exploration of patient perceptions using a combination of assessment, self report and interview (n=3), semi-structured interviews (n=10) and laddered interviews (n = 5). 3. Exploration of practitioner perceptions using laddered interviews (n=5) and structured interviews (n=3). Data were analysed descriptively and using content analysis. Results Clinical assessment was primarily at the impairment level. Various other 'bespoke' methods, of questionable validity, were also in use. Inconsistent use of terminology was a potential barrier to effective practice. Impairment-based measures did not reflect patient needs and goals and discrepancies were noted between practitioner beliefs around assessment and its application. Conclusion The exclusive use of impairment measures for routine assessment is inadequate. An assessment framework to facilitate reasoned and explicit practitioner choices was developed, within which, patient partnership can be verified explicitly. The framework will enable practitioners to demonstrate clinically reasoned, evidence based and patient centred rehabilitation programmes.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available