Date Presented 04/21/21
This study aims to provide the needs assessment data vital to understanding the current practice climate with rural OTs who work with clients who have sustained a traumatic brain injury. The aim is to identify the perceived outcomes, provide recommendations for practice, use for various service delivery applications (e.g., telehealth), and additional evidence-based treatment, as applicable.
Primary Author and Speaker: Kalyn Briggs
Additional Authors and Speakers: Sharon Gutman
Contributing Authors: Karl Lorenz, Maria Yefimova, Caroline Gray, Joy Goebel, and Karleen Giannitrapani
PURPOSE: This study aims to provide the needs assessment data vital to understanding the current practice climate of rural occupational therapists (OTs) who work with clients who have sustained a Traumatic Brain Injury (TBI). The aim is to identify the perceived outcomes, provide recommendations for practice, use for various service delivery applications (e.g. telehealth), and additional evidence-based treatment as applicable. Research question: What are the perceived outcomes of occupational therapists who provide services to adults with TBI in the Mountain region of the United States?
DESIGN: This is a mixed method study gathering both quantitative and qualitative data. This research design will be utilized to gain an in depth understanding of rural occupational therapists perceptions of outcomes of treatments provided to clients with TBI.
METHOD: A semi-structured interview consisting of nine open-ended questions will guide the elicitation of the participant’s responses. Interview questions will aim to identify and understand rural OTs perspectives on the effectiveness of treatments provided. Quantitative data will be collected through the use of an online survey. The survey will consist of 45 questions. Survey questions will include demographic information, Likert scale and multiple choice questions aiming to elicit information about specific treatment practices of occupational therapists who provide services to clients who have sustained a TBI and reside in rural areas. Themes from each interview will be identified and analyzed using inductive analysis and open coding. Student researchers and faculty preceptor will review each theme and interpretation. Intercoder reliability will be established when consensus is reached in regards to the written interpretations and titles for each of the themes. Analysis of each survey will be completed using descriptive and inferential statistical analysis to identify comparisons between survey questions.
RESULTS: Survey respondents were asked to rank the importance of 10 factors (total of 100% for each) related to their practice with adults with TBI. Preliminary descriptive statistics associated with this survey question identified that having an interdisciplinary team (75%) is very important in their practice with this population. The second factor respondents found very important included having access to resources (61%), and the third most important factor included having access to professional development (38%). Additional preliminary results evaluated the un-adjusted associations between age, highest degree level, and total OT practice experience with reasons for discontinuation of OT services, the importance of variables involved in the provision of services in rural areas, and the frequency of use of rehabilitation technology. Preliminary data suggests a relationship between age and the use of rehabilitation technology in providing interventions that address behavioral, emotional and psychosocial impairments (Fisher’s exact test, p-values < 0.05), with most respondents between ages 30-49 and 50-79 reporting that they rarely or never provide these services.
CONCLUSION: Results of this study aim to identify the benefits and limitations of the provision of services to this population, specifically related rural occupational therapists who practice in the Mountain region of the United States. Results of this study aim to add to the literature regarding common practices and outcomes of rural OT services for clients with TBI.
References
Brown, J. B., Kheng, M., Carney, N. A., Rubiano, A. M., & Puyana, J. C. (2019). Geographical Disparity and Traumatic Brain Injury in America: Rural Areas Suffer Poorer Outcomes. Journal of neurosciences in rural practice, 10(1), 10–15. https://doi.org/10.4103/jnrp.jnrp_310_18.
Lin, V., Zhang, X., & Dixon, P. (2015). Occupational therapy workforce in the United States: Forecasting nationwide sources. Physical Medicine and Rehabilitation, 7(9), 946-954.
