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Aust Occup Ther J. 2011 Aug;58(4):241-50. doi: 10.1111/j.1440-1630.2011.00943.x. Epub 2011 Jun 3.

National survey of Canadian occupational therapists' assessment and treatment of cognitive impairment post-stroke.

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1
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 PromenadesSir-William-Osler, Montreal, Quebec, Canada. nicol.korner-bitensky@mcgill.ca

Abstract

AIM:

This study examined variations in management of cognitive impairment post-stroke among occupational therapists and factors associated with variations in practice.

METHODS:

Canada-wide cross-sectional telephone survey. Clinicians' practices were examined using standard patient cases (vignettes).

SETTING:

Acute care, inpatient rehabilitation and community-based sites providing stroke rehabilitation in all Canadian provinces.

PARTICIPANTS:

Occupational therapists (n=663) working in stroke rehabilitation as identified through provincial licensing bodies.

MAIN OUTCOME MEASURES:

Type and frequency of cognition-related problem identification, assessment and intervention use.

RESULTS:

Respectively, 69%, 83% and 31% of occupational therapists responding to the acute care, inpatient rehabilitation and community-based vignettes recognised cognition as a potential problem. Standardised assessment use was prevalent: 70% working in acute care, 77% in inpatient rehabilitation and 58% in community-based settings indicated using standardised assessments: 81%, 83% and 50%, respectively, indicated using general cognitive interventions.

CONCLUSION:

The Mini-Mental State Examination was often used incorrectly to monitor patient change. Executive function, a critical component of post-stroke assessment, was rarely addressed. Interventions were most often general (e.g. incorporated in activities of daily living) rather than specific (e.g. cueing, memory aids, computer-based retraining).

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