Understanding the occupational therapists use of splinting the affected hand of adult patients with neurological injuries

Abstract

ABSTRACT

This study explored the clinical reasoning expert therapists use in relation to splinting the affected hand following neurological injury. An exploratory, descriptive, qualitative methodology was used in three focus groups with occupational therapists, experienced in neurorehabilitation. Data was analysed based on priori themes, specifically

1. The Model of Practice Development (Higgs and Titchen 2001b) - most value was placed on Procedural knowledge or clinical experience; reflection on protocols, working with and learning from others and having clear outcomes. Undergraduate training and current literature is insufficient to provide guidelines for practice. 2. The Three Track Model of Clinical Reasoning (Fleming 1991) –splinting was used to improve range of motion, maintain muscle length and affect muscle tone. Effectiveness of the splints depended on the patient’s response and the therapists’ ability to adapt to preferences and goals. Interactive reasoning was essential in understanding the South African context. The study provided guidelines for a newly qualified therapist.