Occupational therapy practice in emergency care: Occupational therapists’ perspectives

Neuro-behavioural changes after acquired brain injury: The role of the occupational therapist; the interventions they use and why

INTRODUCTION

Almost half of the people living with acquired brain injury experience behavioural changes, yet there is lack of clarity both in the literature, and through major stakeholders internationally, regarding how occupational therapists contribute to neuro-behavioural rehabilitation and what their role is in this context.

METHODS

This study answers the research question: What do occupational therapists perceive as their role in behavioural rehabilitation with adults living with acquired brain injury, and what treatment approaches, if any, are they using to promote occupation? A national, qualitative, bounded case study design using semi-structured interviews was used to explore what the role of the occupational therapist is in neuro-behavioural rehabilitation across subacute brain injury units in Australia.

FINDINGS

Four themes were identified which provide clarification on the role of the occupational therapist in neuro-behavioural rehabilitation: You change the task, you change the environment, change the person; build a safe rapport; the sensory stuff is huge and, finally, owning how we think.

CONCLUSION

This bounded case study provides insight into how occupational therapists perceive their role and the interventions they use to promote occupational engagement. The lack of recognition of the occupational therapist role is a barrier to providing appropriate neuro-behavioural rehabilitation. This case study identified sensory approaches, building safe rapport and adapting the environment as the main interventions used in neuro-behavioural rehabilitation by occupational therapists.

Physical Therapy, Occupational Therapy, and Speech Language Pathology in the Emergency Department: Specialty Consult Services to Enhance the Care of Older Adults

The rehab services of Physical Therapy, Occupational Therapy, and Speech Language Pathology (PT/OT/SLP) are areas of emerging practice in the emergency department (ED). These specialty consult services can provide ED physicians with valuable, nuanced assessments for the older adults that will assist in determining a safe discharge plan. PT and OT interventions in the ED have been shown to decrease hospital admissions and readmissions, increase patient satisfaction, and decrease cost. Rehab specialists provide physicians with an expanded scope of management options that can greatly enhance the care of patients in the ED.

Analysis of the occupational therapist's professional identity when working in acquired brain injury rehabilitation within a municipal service

Background

Changes in rehabilitation pathways are reducing the amount of time patients spend in hospital, resulting in an earlier return to municipal care. Studies show that occupational therapists find working with patients with acquired brain injury to be complex and that, in some situations, they fail to believe in their own professional expertise. This qualitative study aimed to explore how the professional expertise of occupational therapists working in acquired brain injury rehabilitation within a municipal service is understood.

Methods

One monoprofessional focus group interview with occupational therapists and five focus group interviews with professionals from municipal interprofessional rehabilitation coordinating units formed the basis for the study. Data were analysed using systematic text condensation.

Results

A holistic view and strategically selected areas of expertise were found to characterise the work of occupational therapists in the municipal setting. A composed base of knowledge enables occupational therapists to be rehabilitators while working in collaboration with multiple professional partners.

Conclusions

Expertise in the areas of adaptation, assistive devices and cognition are considered to be valuable in acquired brain injury rehabilitation in a municipal setting. A practical synthesis of knowledge, transprofessional collaboration and role release enable the occupational therapist to act as a multifarious rehabilitator.