Powerpoint

Report
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
SECTION 1:
Socio-demographics
Socio-demographics
Profession
24
38
OT
PT
Socio-demographics
Gender
4
Female
Male
58
Socio-demographics
Age
1
11
10
15
25
20-29
30-39
40-49
50+
No response
Socio-demographics
Preferred Language
7
16
39
English
French
No response
Socio-demographics
University Education
University of Montreal
9
Laval University
7
University of Manitoba
7
University of Alberta
6
University of Toronto
5
McMaster University
5
Foreign University
4
University of Western Ontario
4
University of British Columbia
4
Dalhousie University
4
No response
2
McGill University
2
Ottawa University
1
University of Saskatchewan
1
Queens University
1
Socio-demographics
Level of Education
3
2 0
57
Bachelor's Degree
Master's Degree
Diploma
Doctorate
Socio-demographics
Weekly Work Hours
18
44
Full-time
Part-time
Socio-demographics
Years of Clinical Experience
4
13
24
<1
1 to 3
4 to 10
> 10
21
Socio-demographics
Number of Burn Survivors Treated on a Weekly Basis
11
16
14
21
<2
2 to 5
6 to 10
> 10
SECTION 2:
Work Environment
Work Environment
Types of Work Settings
Acute care Hospital
In-patient
26
22
Rehabilitation Out-patient
Acute care Hospital
Out-patient
18
Rehabilitation In-patient
Other
16
2
Work Environment
Location of Work Setting
0
Urban
Rural
62
Work Environment
Source of Funding of the Work Setting
8
2
4
48
Public
Private Not For Profit
Private For Profit
Other
Work Environment
Teaching Institution and Research Within the Work
Setting
70
60
59
50
43
40
32
30
21
20
10
Yes
No
I don't know
13
3
6
9
0
0
Teaching
Institution
Research
Rehab.
Research
Work Environment
Number of OTs or PTs Who Supervise Students
0
62
Participated
Did Not Participate
Work Environment
The Number of OT or PT Students Supervised
by Each Therapist Per Year
0
10
3
49
> 5 Students
1-2 Students
3-5 Students
No Students
Work Environment
Number of Therapists in the Work Setting
> 10 OT
21
> 10 PT
16
5-10 OT
11
5-10 PT
9
2-4 OT
22
2-4 PT
1 OT
1 PT
12
4
10
Work Environment
Use of a Multidisciplinary Team Approach
in the Treatment of the Burn Survivors
16
46
Yes
No
Work Environment
Multidisciplinary Team Members
OT
59
PT
58
Nurse
56
Plastic Surgeon
51
Social Worker
51
Dietician
48
Psychologist
38
Speech Therapist
35
Other
32
26
Physiatrist
Case Manager
24
Infection Specialist
22
General Surgeon
20
Massotherapist
17
Special Educator
12
Intensivist
7
Family Physician
Microbiologist
6
4
SECTION 3:
Assessments and
Therapeutic Interventions
Assessments
The following assessment were reported as being typically used
Goniometry
54
31
Dyanometer
Manual Muscle Testing
28
25
Vancouver Scar Scale
Pinch Meter
23
Visual Analogue Scale (pain)
20
Measuring Tape (edema)
Purdue Peg Board
13
11
Numeric Pain Rating Scale
10
Semmes-Weinstein Monofilaments
10
Berg Balance Scale
10
Assessments
Additional impairment assessments that were reported as being typically used
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
Assessments
Additional outcome assessments that were reported as being typically used
General
Function
L/E Function
Driving
Work
Quality of Life
Psychosocial
Functional Independence Measure
5
COPM
3
Assessment of Motor Process Skills
U/E
Function
Biometrics
8
Smith Hand Function Test
6
1
DASH
5
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
Automatic Brake Reaction Timer
3
Manipulative Aptitude Test
3
UFOV
1
Grooved Pegboard
2
Valpar
3
Michigan Hand Questionnaire
2
Baltimore Therapeutic Equipment
2
Epic Hand Sort
1
Injured Workers Survey
1
PACT Hand Sort Function Test
1
Short Form Health Survey (SF-36)
1
Patient Rated Wrist and Hand Evaluation
1
Abbreviated Burn Specific Health Scale
1
Mini-Mental State Examination
4
JAS Scale
1
Cognitive Competency Test
2
Scott Scale
1
Cognistat
1
Pain Disability Index
1
Rivermeade Memory
1
Carroll Test
3
Woodcock Johnson
1
Cognitive
Function
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
6
19
6
8
7
11
15
6
6
It is quick and easy to administer
It has known reliability and validity for assessment of burn
survivors
I learned it during my professional training
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
9
9
2
5
2
1
3
2
5
Equipment not available
Financial constraints
Requires special training
Interventions
The following interventions were reported as being typically used
51
Scar Management (Pressure therapy and inserts, massage)
36
ROM Exercises (PROM, AAROM, AROM)
35
Splinting and Orthotic Interventions
ADLand IADL Re-training and Functional Activities
34
Strengthening (Manual resistance, w eights)
34
28
Education (Patients, family and friends)
26
Stretching Exercises (PNF, manual)
24
Mobilization (Gait training, stairs, transfers, parallel bars)
20
Edema Management (Compression therapy)
Positioning Techniques
15
Hydrotherapy (Contrast baths, w hirlpool)
15
Community Resources (Support groups, community programs)
14
Adaptative Devices (Wheelchair)
14
Paraffin Wax Bath
14
Silicone Gel Therapy
13
Cardiovascular and Endurance Training (Stationary bike, treadmill)
12
Heat (Hot packs, moist heat)
12
Psychosocial Support and Conselling (body image, sexuality)
11
Interventions
Additional interventions that were reported as being typically used
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
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
9
30-120
2
45
3
45 to 60
4
45-90
2
60
14
60-90
12
60 twice per day (120)
3
180
1
Interventions
Number of times per month that the burn survivor would typically receive treatment
IN-PATIENT
Frequency of
Response
OUT-PATIENT
Frequency 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
4 to 6
1
4 to 8
3
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
TYPE OF REHAB WAS
NOT SPECIFIED
Depends on patient’s needs
7
Interventions
Total number of weeks that the burn survivor would typically receive treatment
IN-PATIENT
Frequency of
Response
OUT-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
6
5
1
12 to 26
2
6
1
12 to 52
2
Daily until discharge
3
18
1
24 to 72
4
TYPE OF REHAB WAS NOT SPECIFIED
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
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
It has published evidence of effectiveness in treating burn
survivors
Top Ranking
2nd Reason
3rd Reason
17
13
5
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
I learned it during my professional training
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
More Psychosocial Support
3
Education
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
4
9
4
5
1
5
1
7
4
Financial Constraints
Requires Special Training
Equipment Not Available
SECTION 4:
Education at Work
Education at Work
Support for On-going Professional Learning
by the Work Environment
3
Yes
No
59
Education at Work
Access to New Information on Burn Injuries and
Burn Rehabilitation is Easily Available
10
52
Yes
No
Education at Work
Sources of Information at Work
Internet
55
Journal of Burn Care and
Rehabilitation
51
42
Library
Workshops
26
Journal Club
19
Burn Journal
Other
18
7
Education at Work
Time Available for Learning at Work
and Availability of Funds for Continuing Education
33
Time for
Learning
52
Continuing
Education
Yes
29
No
10
SECTION 5:
Continuing Education
Continuing Education
Number of Hours per Month Spent on
Continuing Education Activities
30 Hours
20 to 24 Hours
1
3
9 to 11 Hours
6
6 to 8 Hours
6
3 to 5 Hours
25
1 to 2 Hours
0 Hours
No response
12
3
7
Continuing Education
Number of Therapists Who Have Specialty Certification
10
52
Yes
No
Continuing Education
Number of Therapists Actively Teaching
at the University Level
23
39
Yes
No
Continuing Education
A Website Specifically Dedicated to Burn Survivor Rehabilitation in
Canada would be a Useful Learning Tool?
1 1
60
Yes
No
Maybe

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