Occupational Therapy for Adults With Acute Hand Conditions: A Mixed-Methods Feasibility Study

Abstract

Hand injuries account for up to one third of acute hospital presentations. Current guidelines and standards of care recommend patients with hand trauma are seen by hand therapists, typically occupational therapists. This study explored the feasibility of implementing an occupational therapy–led hand therapy service for adults presenting acutely with a hand condition, using the RE-AIM framework. Purposeful sampling was used to recruit adult participants (n = 13). Outcome measures assessing function, health-related quality of life, pain, and occupational value and competence were completed. Focus groups were completed with patients and health care professionals. Data analysis revealed improvements in outcome measures post intervention and at 6-month follow-up. Participants were receptive of therapy-led services, and barriers and facilitators to service integration were identified using the RE-AIM framework. Occupational therapy–led hand therapy clinics show potential in treating people with acute hand conditions at emergency department settings, based on RE-AIM evaluation.

Plain Language Summary

Occupational Therapy for Adults With Acute Hand Conditions: A Mixed-Methods Feasibility Study

It is known that hand injuries account for up to one third of hospital presentations, with hospital departments such as accident and emergency (A&E) often patients’ first point of contact. Having a hand injury can impact on a person’s function, quality of life, and participation in work and sport activity. Current guidelines recommend patients with hand trauma are seen by hand therapists, typically occupational therapists. This study explored the feasibility of an occupational therapy–led hand therapy service for adults presenting acutely with a hand condition. The RE-AIM framework was used, which helps to translate research into practice. Adult patients who came to the occupational therapy–led hand therapy service completed outcome measures assessing function, quality of life, pain, and occupational value and competence. Data analysis of these outcome measure scores revealed improvements in patient outcomes. Focus groups were completed with patients and health care professionals who provide care for patients who have hand trauma. Participants were receptive of therapy-led services, and barriers and facilitators to the service were identified. Occupational therapy–led hand therapy services show potential in treating people with acutely presenting hand conditions from point of presentation at emergency departments to discharge, based on a comprehensive RE-AIM evaluation. Given the adverse outcomes associated with certain hand conditions, future research should investigate the sustainability of occupational therapy in the management of acutely presenting hand conditions.