Date of Award

2017

Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)

Department

Occupational Therapy

First Advisor

Sonia Zimmerman

Keywords

Occupational Therapy -- methods; Psychosocial Support Systems; Stroke Rehabilitation

Abstract

Introduction: Following a stroke, individuals experience a wide variety of physical and psychosocial impairments. While physical impairments are commonly given attention by medical practitioners, psychosocial impairments are often overlooked or undiagnosed. (Hildebrand, 2015). Unfortunately, the same is true in occupational therapy, where physical and psychosocial issues have not been receiving the same amount of attention, physical issues being addressed far more than psychosocial issues (Gillen, 2014). The purpose of this scholarly project is to provide occupational therapists a guide to use of current evidence-based assessments and interventions to address psychosocial impairments following stroke. The guide focuses on evidence-based assessments, and interventions appropriate to a wide variety of occupational therapy settings.

Methodology: The review of the literature supported the need for a therapy guide translating current research literature for occupational therapists to address interventions and assessments specific to psychosocial impairments post-stroke. The Model of Human Occupation’s six steps of therapeutic reasoning were selected to structure the guide and emphasize the need to consider the individual as a collaborator in the intervention process.

Results: The product includes assessments and evidence based interventions that therapists can use throughout the therapeutic reasoning process. The guide focuses on evidence based assessments that can be used by occupational therapists to assess common psychosocial issues that occur after a patient experiences a stroke. The interventions included in this guide have been published in the Occupational Therapy Practice Guidelines for Adults with Stroke (Wolf & Nilsen, 2015). These interventions came from the work of Mary Hildebrand’s (2014), Effectiveness of Interventions for Adults With Psychosocial or Emotional Impairment After Stroke: An Evidence-Based Review. This guide, including assessment and interventions, is guided by the Model of Human Occupation (MOHO), specifically, MOHO’s 6 steps of therapeutic reasoning.

Conclusions & Significance: A product has been created to guide occupational therapists through the therapeutic process in order to encourage treatment of not only physical but also psychosocial impairments that accompany a stroke. A potential limitation for this product is that the interventions included are evidence based and have been tested by researchers in the past outside of the profession of occupational therapy. The product does not offer interventions that may be effective but just have not yet been tested in research. Future improvements to this product could include testing the specific evidence-based interventions in the profession of occupational therapy. Further, other intervention options that are not yet considered evidence-based can be tested and added to the product in order to increase options for clients and therapists.

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