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Open Access
Article
Publication date: 12 October 2018

Aisling Helen Stack, Orla Duggan and Tadhg Stapleton

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’…

2857

Abstract

Purpose

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’ evaluation practices, and there are no internationally agreed clinical guidelines to inform best practice. The purpose of this paper is to investigate occupational therapy evaluation practices for fitness to drive after stroke in Ireland.

Design/methodology/approach

This is a cross-sectional study design targeting occupational therapists working with people after stroke using an online survey. Summary and descriptive statistics were used to analyse the returned surveys.

Findings

In total, 47 occupational therapists participated. Off-road driving assessment was completed by 68 per cent of respondents. Functional assessment and non-driving-specific assessments were most widely used and perceived to be the most useful in informing the off-road assessment. A total of 89 per cent referred clients for on-road assessments; however, some referred without first completing an off-road assessment. The therapists who completed formal post graduate education/training in driving assessment reported greater confidence and competence in their skills and ability to assess fitness to drive. A vast majority of participants agreed that clinical guidelines regarding best practice in this area would be beneficial.

Research limitations/implications

A majority of occupational therapists are assessing fitness to drive after stroke in Ireland with non-driving-specific assessments and functional observations; however, there are many gaps and wide variations between services. Education/training in evaluating fitness to drive after stroke is recommended. The development of clinical guidelines to inform practice would facilitate a consistent approach nationally.

Originality/value

This is the first study completed in Ireland to investigate occupational therapy evaluation practices for fitness to drive after stroke.

Details

Irish Journal of Occupational Therapy, vol. 46 no. 2
Type: Research Article
ISSN: 2398-8819

Keywords

Open Access
Article
Publication date: 11 July 2023

Tadhg Stapleton, Kirby Jetter and Sean Commins

The purpose of this study was to provide an outline of the process of developing an on-road driving test route and rating form. Comprehensive evaluation of medical fitness to…

Abstract

Purpose

The purpose of this study was to provide an outline of the process of developing an on-road driving test route and rating form. Comprehensive evaluation of medical fitness to drive should comprise of an off-road and an on-road assessment. Much research attention has focussed on the off-road phase of assessment, while there is less standardisation evident in the completion and measurement of the on-road phase of fitness-to-drive assessment.

Design/methodology/approach

A scholarship of practice approach was used to inform the development of an on-road test route and an associated generic on-road assessment tool that was guided by research evidence and best practice recommendations.

Findings

A step-by-step guide, outlining seven recommended phases in the development of an on-road route for the assessment of fitness to drive that aligns with best practice recommendations, was developed. A preliminary generic on-road assessment tool (the Maynooth–Trinity Driving Test) that includes higher-order cognition alongside element of strategic, tactical and operational driving ability was developed and piloted alongside the newly developed on-road test route.

Originality/value

This paper offers an overview of an approach to developing evidence-based on-road test routes and an associated generic assessment tool that may assist occupational therapists and on-road driving assessors establish a standard practice for testing on-road behaviour as part of a comprehensive approach to evaluate fitness to drive.

Details

Irish Journal of Occupational Therapy, vol. 51 no. 2
Type: Research Article
ISSN: 2398-8819

Keywords

Open Access
Article
Publication date: 18 October 2021

Michelle Spirtos, Mary Naughton, Emma Carr, Tadhg Stapleton and Michelle O'Donnell

The post-operative management of flexor tendon injuries has been the focus of considerable exploration and there continues to be variation in approaches and methods of…

2274

Abstract

Purpose

The post-operative management of flexor tendon injuries has been the focus of considerable exploration and there continues to be variation in approaches and methods of mobilisation. The purpose of this paper is to explore therapy management following repair to flexor tendons at zone II and flexor pollicis longus (FPL) (all zones) in Ireland.

Design/methodology/approach

A descriptive survey questionnaire design through an online format was used. Therapists were recruited through the Irish Association of Hand Therapists, the national bodies for occupational therapy and physiotherapy, and therapy managers in acute hospitals, with 29 therapists participating in the study. Descriptive statistics were used to analyse the survey data.

Findings

Patients were generally seen three to five days following surgery. Early active mobilisation approaches were favoured by all but one therapist, with 62% using the Belfast protocol and 34% the Manchester Short Splint (MSS) protocol. Each early active protocol exercise session commences with passive motion followed by graded active flexion. Tenodesis is incorporated by the majority of respondents within the first four weeks. Therapy programme and splints are modified based on patient presentation. Resistance exercises are commenced from week seven. Patient compliance was identified as the most influential factor in the post-operative intervention approach taken.

Originality/value

This study provides the first Irish profile of current practice in the post-operative management of flexor tendon repairs at zone II and FPL which has not previously been reported. Further research should explore the reasoning behind the interventions chosen and also the implications for practice of changes to surgical techniques.

Details

Irish Journal of Occupational Therapy, vol. 49 no. 2
Type: Research Article
ISSN: 2398-8819

Keywords

Open Access
Article
Publication date: 20 November 2018

Ruth Usher and Tadhg Stapleton

In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statutory framework to adults who are experiencing difficulties with decision-making. This legislation has…

7357

Abstract

Purpose

In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statutory framework to adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care. Increasing age and life expectancy, alongside the rising incidence of chronic health conditions and dementia-related diseases, indicates that more individuals are likely to experience challenges regarding decision-making capacity. Therefore, the need for more consistent, best-practice processes to assess decision-making capacity is likely to increase. To ensure occupational therapists are responsible in their contributions, and to ensure those with disabilities are supported, clinicians must be well-informed of the principles underscoring the Act. The purpose of this paper is to provide an overview of this multidisciplinary issue, including recent legislation, and consider how occupational therapy can contribute.

Design/methodology/approach

The authors reviewed current literature and considered occupational therapy’s role in decision-making capacity assessment.

Findings

Occupational therapists have potential to play a key role in multi-disciplinary assessments of decision-making capacity for clients. Further research is required to explore professional issues, identify clinical best practices and determine training and resource needs.

Originality/value

This paper seeks to provoke consideration of how occupational therapists can contribute to capacity assessment from a client-centred, occupation-based perspective that is mindful of ethical and legislative considerations.

Details

Irish Journal of Occupational Therapy, vol. 46 no. 2
Type: Research Article
ISSN: 2398-8819

Keywords

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