Exploring factors influencing occupational therapists' perception of patients' rehabilitation potential after acquired brain injury

Abstract

Background/aim: Clinical practice guidelines advocate for early involvement of rehabilitation professionals in screening acquired brain injury patients' rehabilitation needs and determining the required rehabilitation services. Little is yet known about the nature of occupational therapists' role in this context. This exploratory study sought to identify factors influencing occupational therapists' perception of acquired brain injury patients' rehabilitation potential for inpatient rehabilitation.

Methods: A qualitative approach was used to analyse data from a focus group involving 12 occupational therapists working in acute care and inpatient rehabilitation. A consensus-seeking technique was used to identify patient-related factors participants perceived as most important to consider when assessing rehabilitation potential. The transcription of the group discussion was analysed using an interpretive description approach to identify additional factors influencing occupational therapists' perception.

Results: Participants agreed on 11 patient-related factors most important to consider: age, behaviour, cognitive abilities, endurance, home environment, medical status, observed improvement in acute care post-injury, physical abilities, post-injury functional status, pre-injury functional status, patient and family expectations. Additional factors included the influence of the organisational context (i.e. acute care and broader health care context) as well as occupational therapists' professional expertise, knowledge of scientific evidence, concerns for ethical decisions and interpretive activities (i.e. clinician's interpretation of patients' characteristics in light of all other factors).

Conclusions: Findings suggest that assessing rehabilitation potential is a complex process that goes beyond strictly appraising patients' characteristics. Additional factors influence clinicians' perception of patients' rehabilitation potential. Clinicians should pay more attention to these factors when making evidence-based decisions regarding patients' potential to benefit from rehabilitation.

Keywords: acute care; qualitative research; stroke; traumatic brain injury.