South African occupational therapists’ understanding of post traumatic amnesia following traumatic brain injury

Abstract

Background: Post traumatic amnesia (PTA) is a transient state following traumatic brain injury (TBI) and is characterized by cognitive and behavioural deficits which have a profound impact on individuals’ functional ability. The duration of PTA is considered the “gold standard” indicator for the severity of TBI and predictor of long term functional and cognitive outcomes. Despite this, there appears to be a lack of South African research on the condition from all healthcare disciplines. Given that occupational therapists are key role players in TBI rehabilitation, it is important to establish what they understand about the condition and how it informs their clinical practice. Aim: This study aimed to determine South African occupational therapists’ knowledge of post traumatic amnesia following traumatic brain injury. Methods: This study utilised a descriptive quantitative, cross sectional research design with the use of a web-based questionnaire. The questionnaire was distributed to participants via the Occupational Therapy Association of South Africa (OTASA) as well as by means of convenience snow ball sampling. Fifty eight responses were recorded but only 53 were used in the data analysis due to incomplete surveys and participants who did not meet the inclusion criteria. Results: Forty three percent of participants do not assess for PTA at the time of initial consultation, thus, intervention selection for patients in PTA may be in inappropriate. The most common means of assessment was reported as clinical observation (52%) despite international TBI guidelines and literature recommending the use of a validated assessment tool. The most common interventions used by this group of occupational therapists in the treatment of PTA included family or caregiver education (62%), occupational performance interventions (68%), reorientation (66%) and cognitive skills retraining (60%). Conclusion: It appears that this group of South African occupational therapists has a limited understanding of PTA. The use of reorientation and cognitive skills retraining with patients in PTA is discouraged by international TBI guidelines and literature based on the associated risk for increased agitation which is known to worsen long term functional outcomes. It would beneficial to address this gap in knowledge through certified training and an introduction to TBI rehabilitation provided at an undergraduate level given its significant contribution to the global burden of disease.