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Survey of Occupational and Physical Therapists Working with Burn Survivors. Survey Participation. - PowerPoint PPT Presentation
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Survey Participation
• Using the “Snowball Sampling Technique” an attempt was made to acquire an exhaustive list of contact information of Canadian OTs and PTs who dedicated a substantial portion of their clinical practice to burn survivor rehabilitation.
• 131 surveys were mailed out (both English and French versions were sent to each person)
• 62 participants responded to the survey• 31 participants responded that they no longer actively
worked with burn survivors• 8 surveys were returned as “wrong address”• There was no response for 30 surveys
• SECTION 1: Socio-demographics
• SECTION 2: Work Environment
• SECTION 3: Assessments and Therapeutic
Interventions
• SECTION 4: Education at Work
• SECTION 5: Continuing Education
Socio-demographicsUniversity Education
1
1
1
2
2
4
4
4
4
5
5
6
7
7
9
Queens University
University of Saskatchewan
Ottawa University
McGill University
No response
Dalhousie University
University of British Columbia
University of Western Ontario
Foreign University
McMaster University
University of Toronto
University of Alberta
University of Manitoba
Laval University
University of Montreal
16
21
14
11
< 2
2 to 5
6 to 10
> 10
Number of Burn Survivors Treated on a Weekly Basis
Socio-demographics
2
16
18
22
26
Other
Rehabilitation In-patient
Acute care Hospital Out-patient
Rehabilitation Out-patient
Acute care Hospital In-patient
Types of Work Settings
Work Environment
48
4
2
8
Public
Private Not For Profit
Private For Profit
Other
Work EnvironmentSource of Funding of the Work Setting
Work EnvironmentTeaching Institution and Research Within the Work
Setting
59
43
32
3
13
21
06
9
0
10
20
30
40
50
60
70
TeachingInstitution
Research Rehab.Research
Yes
No
I don't know
0
49
3
10
> 5 Students
1-2 Students
3-5 Students
No Students
Work EnvironmentThe Number of OT or PT Students Supervised
by Each Therapist Per Year
10
4
12
22
9
11
16
21
1 PT
1 OT
2-4 PT
2-4 OT
5-10 PT
5-10 OT
> 10 PT
> 10 OT
Work EnvironmentNumber of Therapists in the Work Setting
46
16
Yes
No
Work EnvironmentUse of a Multidisciplinary Team Approach
in the Treatment of the Burn Survivors
Work EnvironmentMultidisciplinary Team Members
4
6
7
12
17
20
22
24
26
32
35
38
48
51
51
56
58
59
Microbiologist
Family Physician
Intensivist
Special Educator
Massotherapist
General Surgeon
Infection Specialist
Case Manager
Physiatrist
Other
Speech Therapist
Psychologist
Dietician
Social Worker
Plastic Surgeon
Nurse
PT
OT
Assessments
10
10
10
11
13
20
23
25
28
31
54
Berg Balance Scale
Semmes-Weinstein Monofilaments
Numeric Pain Rating Scale
Purdue Peg Board
Measuring Tape (edema)
Visual Analogue Scale (pain)
Pinch Meter
Vancouver Scar Scale
Manual Muscle Testing
Dyanometer
Goniometry
The following assessment were reported as being typically used
Assessments
Pain Dallas Pain Questionnaire 1 Wound Pictures/Observation 5
McGill Pain Questionnaire 2 Scar Measuring Tape 1
Edema Volumeter 9 Photography 9
Sensation Tuning fork (vibration) 1 Scar depth 2
Pressure 1 Skin Braden Scale 1
Pin prick 1 Flexibility Thomas Test 1
Light touch 1 Atrophy Measuring tape 1
Hot/cold 6 Endurance Bruce Treadmill Test 3
Moberg Test 1 Oxygen Saturation Saturometer 2
Moving 2-pt discrimination 3 DVT Homan’s Test 1
Grip Strength Rapid exchange 7 ROM Maigne (cervical and lumbar) 3
Perceived Exertion Modified Borg Scale 1
Additional impairment assessments that were reported as being typically used
AssessmentsGeneral Function
Functional Independence Measure 5 U/E Function
Biometrics 8
COPM 3 Smith Hand Function Test 6
Assessment of Motor Process Skills 1 DASH 5
L/E Function Timed Up and Go 5 Minnesota Rate of Manipulation 5
10-meter walking speed test 2 TEMPA 5
FOAM and DOME test 2 Beaded Peg Test 4
2-minute walk test 2 Nine Hole Peg Test 4
6-minute walk test 1 Dellon Pinch Test 3
Lower extremity functional scale 1 Jebsen Hand Function Test 3
Driving Automatic Brake Reaction Timer 3 Manipulative Aptitude Test 3
UFOV 1 Grooved Pegboard 2
Work Valpar 3 Michigan Hand Questionnaire 2
Baltimore Therapeutic Equipment 2 Epic Hand Sort 1
Injured Workers Survey 1 PACT Hand Sort Function Test 1
Quality of Life Short Form Health Survey (SF-36) 1 Patient Rated Wrist and Hand Evaluation 1
Abbreviated Burn Specific Health Scale 1 Cognitive Function
Mini-Mental State Examination 4
JAS Scale 1 Cognitive Competency Test 2
Scott Scale 1 Cognistat 1
Pain Disability Index 1 Rivermeade Memory 1
Psychosocial Carroll Test 3 Woodcock Johnson 1
Additional outcome assessments that were reported as being typically used
Therapists were asked to rank the factors that affected their choice of assessment
Numbers of Therapists Who Selected Each Ranking
Factors affecting choice of assessment Top Ranking 2nd Reason 3rd Reason
It is available where I work
23 8 10
It is quick and easy to administer
6 19 6
It has known reliability and validity for assessment of burn survivors 8 7 11
I learned it during my professional training
15 6 6
Therapist were asked “In a perfect world, what assessment would they use?”
Equipment Standardized Assessments/Scales
Digital Photography 4 Vancouver Scar Scale 10
Scanner for Orthoses 3 Functional Independence Measure 4
Digital Goniometer 2 CMOP 4
Work Simulator 2 McGill Pain Scale 3
Volumeter 1 Short Form Health Survey (SF-36) 2
Durometer 1 Braden Scale 2
Isokinetic Assessment Device 1 Michigan Hand Outcome Questionnaire 2
Greenleaf Hand Assessment 1 Sickness Impact Profile 1
TEMPA 1 Assessment of Motor Performance (AMPS) 1
Semmes Weinstein Monofilaments 1
Assessments that do not yet exist
A complete, objective, painless scar and skin evaluation
17
A burn specific ADL and IADL assessment 3 Other
Work site and return to work assessment 5 No assessments other than those currently used
5
Therapists were asked to rank the barriers that limit their use of desired assessments
Numbers of Therapists Who Selected Each Ranking
Barriers Top Ranking 2nd Reason 3rd Reason
Time constraints
15 5 6
Equipment not available
9 9 2
Financial constraints
5 2 1
Requires special training
3 2 5
Interventions
11
12
12
13
14
14
14
15
15
20
24
26
28
34
34
35
36
51
Psychosocial Support and Conselling (body image, sexuality)
Heat (Hot packs, moist heat)
Cardiovascular and Endurance Training (Stationary bike, treadmill)
Silicone Gel Therapy
Paraffin Wax Bath
Adaptative Devices (Wheelchair)
Community Resources (Support groups, community programs)
Hydrotherapy (Contrast baths, w hirlpool)
Positioning Techniques
Edema Management (Compression therapy)
Mobilization (Gait training, stairs, transfers, parallel bars)
Stretching Exercises (PNF, manual)
Education (Patients, family and friends)
Strengthening (Manual resistance, w eights)
ADLand IADL Re-training and Functional Activities
Splinting and Orthotic Interventions
ROM Exercises (PROM, AAROM, AROM)
Scar Management (Pressure therapy and inserts, massage)
The following interventions were reported as being typically used
Interventions
Home Programs 9 Ice 4
Desensitization (vibration, friction) 8 School or work re-entry program 4
Wound Care (cleaning, débridement) 8 Continuous Passive Motion (CPM) machines 3
Joint Mobilization 6 Fine Motor Skill Training 3
Chest Therapy 6 Reversing Hand Dominance Training 3
Biometric Exercises 6 Laser 3
Ultrasound 6 Electrotherapy 2
Relaxation Training 5 Cream 2
Mock Situation Training 5 Exercises for Posture 1
Work Simulation (BTE, Valpar) 5 Carpentry Activities 1
Electronic Muscle Stimulation (EMS) 4 Energy Conservation Techniques 1
Pain Control (distraction) 4
Additional interventions that were reported as being typically used
Interventions
Duration of a Typical Treatment (Minutes) Frequency of Response
30 2
10 to 180 2
15-60 3
20-90 4
30-45 1
30-60 930-120 2
45 3
45 to 60 4
45-90 2
60 14
60-90 1260 twice per day (120) 3
180 1
InterventionsNumber of times per month that the burn survivor would typically receive treatment
IN-PATIENTFrequency of
Response OUT-PATIENTFrequency of
Response
12 to 16 2 1 3
12 to 20 7 1 to 2 1
16 to 20 3 1 to 5 3
Daily (20 to 28 times) 27 2 to 3 4
3 to 5 1
TYPE OF REHAB WAS NOT SPECIFIED
4 to 6 1
4 to 8 3
Depends on patient’s needs 7 4 to 12 2
4 to 20 3
8 to 12 8 12 to 16 3
16 1
20 to 25 2
1/3 months 2
InterventionsIN-PATIENT Frequency of
ResponseOUT-PATIENT Frequency of
Response
1 to 8 2 1 to 8 1
1 to 24 6 2 to 104 2
2 to 3 1 3 to 4 3
2 to 4 1 3 to 72 2
4 to 6 1 6 to 10 65 1 12 to 26 2
6 1 12 to 52 2
Daily until discharge 3 18 1
TYPE OF REHAB WAS NOT SPECIFIED 24 to 72 4
1 to 104 1 24 to 156 2
1 to 156 1 52 to 104 2
2 to 104 1 52 or more 5
4 to 104 3
6 to 8 1
Depends on the patient’s needs 15
Total number of weeks that the burn survivor would typically receive treatment
Therapists were asked to rank the factors that affected their choice of interventions
Numbers of Therapists Who Selected Each Ranking
Factors affecting choice of interventions Top Ranking 2nd Reason 3rd Reason
It has published evidence of effectiveness in treating burn survivors 17 13 5
I learned it during my professional training
17 13 4
I saw it described in a professional textbook or journal that I usually read 1 2 10
Resources required for the intervention are available where I work 16 5 9
Therapist were asked “In a perfect world, what therapeutic interventions would they use?”
Equipment Modalities
Continuous Passive Motion (CPM) Machine 5 Laser 2
Pool Therapy 4 Ultrasound 1
Biometrics 2 Any new modality that would decrease hypertrophic scar 1
JAS Static Progressive Stretch Device 1
Biofeedback 1 Services
Work Simulators 1 On Site Pressure Garment Manufacturing 4
Dynasplints 1 More Massage Therapy 4
Increased Community Reintegration Intervention 4
Education More Psychosocial Support 3
More Time for Treatment and Education 6 More Team Members 3
More Coping and Relaxation Strategies for Patients 3 More Available Research 3
More Fitness and Endurance Training 3 Adolescent Support Group 1
Global Postural Education 2 Other
Group Hand Class 1 Satisfied with the interventions currently being used 10
Relaxation Training 1 Do not know what else is out there due to a lack of time 6
Therapists were asked to rank the barriers that limit their use of desired interventions
Numbers of Therapists Who Selected Each Ranking
Barriers Top Ranking 2nd Reason 3rd Reason
Time Constraints
14 4 4
Financial Constraints
4 9 4
Requires Special Training
5 1 5
Equipment Not Available
1 7 4
10
52
Yes
No
Education at WorkAccess to New Information on Burn Injuries and
Burn Rehabilitation is Easily Available
7
18
19
26
42
51
55
Other
Burn Journal
Journal Club
Workshops
Library
Journal of Burn Care andRehabilitation
Internet
Education at WorkSources of Information at Work
Education at WorkTime Available for Learning at Work
and Availability of Funds for Continuing Education
52
10
29
33
Yes
No
Time forLearning
ContinuingEducation
7
3
12
25
6
6
3
1
No response
0 Hours
1 to 2 Hours
3 to 5 Hours
6 to 8 Hours
9 to 11 Hours
20 to 24 Hours
30 Hours
Continuing EducationNumber of Hours per Month Spent on
Continuing Education Activities
1 1
60
Yes
No
Maybe
Continuing EducationA Website Specifically Dedicated to Burn Survivor Rehabilitation in
Canada would be a Useful Learning Tool?
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