Date of Award

2014

Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)

Department

Occupational Therapy

First Advisor

Anne M. Haskins

Keywords

Home Care Services; Patient Compliance; Upper Extremity -- injuries; Wounds and Injuries -- rehabilitation

Abstract

The purpose of this project was to explore the relationship between occupational therapy home program of clients with acute upper extremity injuries, client factors, and performance patterns that are influential in clients’ adherence to their prescribed home programs. A secondary purpose was to develop an instrument intended to measure adherence in patients with an orthopedic injury of the upper extremity.

Using the Occupational Adaptation Model and Occupational Therapy Practice Framework Domain and Practice as guiding foundations, a thorough literature review of client home program adherence was completed. This led to the development of a prospective, online survey designed to capture variables that affected patient adherence to home programs after an orthopedic injury to the upper extremity. A convenience sample of 24 respondents completed the survey at a local hand therapy clinic. Following data collection, descriptive, correlational, and non-parametric analysis was completed using SPSS 21.0.

Overall, clients reported rather high adherence to completing their home program (52% to 79%). A moderate, positive relationship was found between respondents’ beliefs in the importance of completing their home programs as prescribed and home program adherence. No significant relationships were found between demographic factors, pain experienced, patient satisfaction/dissatisfaction of therapist or home program, level of understanding of home program, or integration of home program into a daily routine. These findings support the role of occupational therapists in creating home programs that patients believe are important for them to complete in order to return to previous levels of participation in occupations. These findings also suggest that further research is needed in order to explore factors that may influence client adherence to home programs including client factors and performance patterns, as greater adherence will likely result in improved function in occupations and increased quality of life.

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