Occupational Therapy and Stroke E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 410

Veröffentlichungsjahr: 2011

Beschreibung

Occupational Therapy and Stroke guides newly qualified occupational therapists (and those new to the field of stroke management) through the complexities of treating people following stroke. It encourages and assists therapists to use their skills in problem solving, building on techniques taught and observed as an undergraduate.

Written and edited by practising occupational therapists, the book acknowledges the variety of techniques that may be used in stroke management and the scope of the occupational therapist's role. Chapters span such key topics as early intervention and the theoretical underpinnings of stroke care, as well as the management of motor, sensory, cognitive and perceptual deficits. They are written in a user-friendly style and presented in a form that enables the therapist to review the subject prior to assessment and treatment planning. Complex problems are grouped together for greater clarity.

This second edition has been fully revised and updated in line with the WHO ICF model, National Clinical Guidelines and Occupational Therapy standards. It is produced on behalf of the College of Occupational Therapists Specialist Section - Neurological Practice.

Leseprobe

Contents

List of Contributors

Foreword

Preface

Acknowledgement

Chapter 1: IntroductionJudi Edmans, Fiona Coupar and Adam Gordon

Definition of stroke

Impact of stroke

Symptoms of stroke

Causes of stroke

Classification of stroke

International Classification of Functioning, Disability and Health

Medical investigations following stroke and TIA

The prevention of recurrence of stroke (secondary prevention)

Neuroanatomy

Damage that can occur in different areas of the brain

Policy documents relating to stroke

Self-evaluation questions

Chapter 2: Theoretical BasisJanet Ivey and Melissa Mew

Introduction

Theoretical constructs

Conceptual models of practice

Frames of reference

Neuroplasticity

Intervention approaches

Self-evaluation questions

Chapter 3: The Occupational Therapy ProcessMelissa Mew and Janet Ivey

Introduction

The occupational therapy process

Procedural reasoning in different stroke care settings

Professional duties

Self-evaluation questions

Chapter 4: Early ManagementSue Winnall and Janet Ivey

Introduction

Prior to assessment

Initial interview

Initial assessment

Intervention

Equipment

Other impairments impacting on functional ability

Swallowing

Mood

Fatigue (Carr and Shepherd, 1987; Laidler, 1994)

Self-evaluation questions

Chapter 5: Management of Motor ImpairmentsStephanie Wolff, Thèrèse Jackson and Louisa Reid

Introduction

Assessment

Management principles and intervention

Therapeutic aims of intervention

Positioning the early stroke patient

Clinical challenges

Upper limb re-education

Avoiding secondary complications

Self-evaluation questions

Chapter 6: Management of Visual and Sensory ImpairmentsMelissa Mew and Sue Winnall

Introduction

Visual processing

Somatosensory processing

Auditory processing

Vestibular processing

Olfactory and gustatory processing

Self-evaluation questions

Chapter 7: Management of Cognitive ImpairmentsThèrèse Jackson and Stephanie Wolff

Definition of cognition

Cognitive functions

Assessment of cognitive functions

Cognitive rehabilitation

Attention

Memory

Language

Motor planning and apraxia

Executive dysfunction

Self-evaluation questions

Chapter 8: Management of Perceptual ImpairmentsLouisa Reid and Judi Edmans

Introduction

Definition of perception

Normal perception

Perceptual impairments

Perceptual assessment

Intervention

Self-evaluation questions

Chapter 9: ResettlementPip Logan and Fiona Skelly

Home visits

Community rehabilitation

Support available after a stroke and self-management

Carers

Younger people

Lifestyle and long-term management

Leisure rehabilitation

Getting out of the house and transport

Driving after stroke

Vocational rehabilitation

Resuming sexual activity

Stroke education

Self-evaluation questions

Chapter 10: EvaluationFiona Coupar and Judi Edmans

Record keeping

Standardised assessments

Evidence-based practice (EBP)

Outcome measures

Standards

Self-evaluation questions

Appendix: One-Handed Techniques

References

Definitions

Useful Books

Useful Organisations

Index

This edition first published 2010

© 2010 Blackwell Publishing Ltd

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Library of Congress Cataloging-in-Publication Data

Occupational therapy and stroke/edited by Judi Edmans on behalf of the Stroke Clinical Forum of the College of Occupational Therapists Specialist Section Neurological Practice. - 2nd ed.

p.; cm.

Includes bibliographical references and index.

ISBN 978-1-4051-9266-8 (pbk.: alk. paper) 1. Cerebrovascular disease-Patients-Rehabilitation. 2. Occupational therapy. I. Edmans, Judi. II. College of Occupational Therapists. Specialist Section Neurological Practice. Stroke Clinical Forum.

[DNLM: 1. Stroke-therapy. 2. Disabled Persons-rehabilitation.3. Occupational Therapy-methods. WL 355 O15 2010]

RC388.5.O33 2010

616.8′1062-dc22

2010003297

A catalogue record for this book is available from the British Library.

Set in 10/12.5 pt Times by Aptara ® Inc., New Delhi, India Printed in Malaysia

1 2010

List of Contributors

Fiona Coupar, University of Glasgow, Glasgow

Dr Judi Edmans, University of Nottingham, Nottingham

Dr Adam Gordon, University of Nottingham, Nottingham

Janet Ivey, Llwynypia Hospital, RCT, Mid-Glamorgan, South Wales

Thérèse Jackson, NHS Grampian, Scotland

Dr Pip Logan, University of Nottingham, Nottingham

Melissa Mew, Bournemouth University, Bournemouth

Louisa Reid, National Hospital for Neurology and Neurosurgery, London

Fiona Skelly, Community Rehabilitation Team, Rotherham

Sue Winnall, Mile End Hospital, London

Stephanie Wolff, Manchester Royal Infirmary, Manchester

Foreword

Occupational therapists working with people who have had a stroke will be delighted to learnthatthereisaneweditionofthispopulartextbook.Thebookhasagainbeenproduced on behalf of the College of Occupational Therapists Specialist Section Neurological Practice, under the enthusiastic editorship of Dr Judi Edmans.

Since the last edition, the text has been substantially and comprehensively updated in terms of the research evidence presented. It has also been placed in the context of national developments and initiatives in stroke care to span the entire stroke spectrum - from aetiology through to resettlement and evaluation. However, it still remains a practical guide, written in user-friendly terms, which provides an excellent reference manual for both those starting out in the stroke field and established practitioners.

The overall format and structure of the book is clear and logical. The addition of good-quality illustrations brings the text to life, and many will find the self-evaluation questions with each chapter useful. Special mention must go to Chapter 1 which provides a comprehensive background to stroke and to Chapter 4 on early management.

Above all, the book underlines the important and unique role of occupational therapy in the treatment and care of people with a stroke.

Dr Avril Drummond

Associate Professor in Rehabilitation University of Nottingham

Preface

This book is a timely update of the first edition of Occupational Therapy and Stroke (Edmans et al., 2001). Although targeted for practice in the UK, the first edition sold over 5000 printed copies with countless hits from e-book access worldwide and has proven to be a well-thumbed and well-known book for occupational therapists working in stroke all over the world.

Since the last edition of the book, evidence-based quality stroke services have come to the forefront of the government agenda throughout the UK with the release of national stroke guidelines, stroke service strategies and initiatives such as the Stroke Research Networks, the Stroke Association’s annual multidisciplinary UK Stroke Forum conference and an imminent Stroke-Specific Educational Framework. It is an exciting time to work in stroke services, and this book is intended to compliment these works to provide a more in-depth, practical, evidence-based guide for occupational therapy students, newly qualified occupational therapists, those new to stroke management and those who have beenworkinginstrokeforsometimewantingtorefreshthefoundationsoftheirknowledge and skills.

The reader will notice substantial changes since the last edition including use of the International Classification of Functioning Disability and Health [World Health Organisation (WHO), 2002], orientation to updated policy documents (Chapter 1), standards and audits (Chapter 10), neuroplasticity (Chapter 2), procedural reasoning in different stroke care settings (Chapter 3) and more detailed user-friendly chapters on early management and screening (Chapter 4), management of impairments (Chapters 5–8) and resettlement (Chapter 9). Therapeutic/clinical challenges have been integrated into appropriate sections with self-evaluation questions to support therapists’ commitment to continuous professional development at the end of each chapter.

Throughout this book, the client or service user is referred to as ‘the patient’, for ease of terminology, irrespective of whether they are being treated in hospital or in the community. This by no means undervalues occupational therapists, key principle of clientcentred practice to empower the patient to actively participate in partnership and negotiate goals in the rehabilitation process (Sumsion, 2000). Similarly, treatments are referred to as ‘interventions’, remedial approaches are referred to as ‘restorative’ approaches and compensatory/functional approaches are referred to as ‘adaptive’ approaches.

Thanks are extended to everyone who has assisted in the production of this book. Particular thanks go to Dr Judi Edmans, whose leadership and tireless efforts have kept fellow contributors (from the 2009 stroke clinical forum committee members of the College of Occupational Therapists Specialist Section Neurological Practice and returning authors Thérèse Jackson and Fiona Skelly) on target to reach tight deadlines.

Finally, the reader is reminded that the contents of this book should be reviewed in light of new ideas, research evidence and practice as they emerge. Suggestions for improvements to future editions would be gratefully received and should be forwarded to Dr Judi Edmans, Division of Rehabilitation and Ageing, University of Nottingham Medical School, Queens Medical Centre, Nottingham NG7 2UH.

Melissa Mew

Stroke Clinical Forum Secretary 2008-09 College of Occupational Therapists Specialist Section Neurological Practice

Acknowledgements

I would like to give particular thanks to Melissa Mew for her immense assistance in editing the book; all the contributors for their contributions and editing suggestions; Dr Iris Musa and Mary Warren for permitting us to include their figures in the book; the College of Occupational Therapists Specialist Section Neurological Practice for funding to enable us to update the book; and last but not least, my long-suffering husband, Mr Paul Fowler, not only for acting as a model for the dressing photographs but also for his endless support and patience during the time taken to update this book.

Dr Judi Edmans

Editor

Chapter 1

Introduction

Judi Edmans, Fiona Coupar and Adam Gordon

This chapter includes:

Definition, impact, symptoms, causes, classification of strokeInternational Classification of Functioning, Disability and Health (ICF) Medical investigationsSecondary prevention NeuroanatomyDamage to different areas of brainPolicy documents: strategies and guidelines Self-evaluation questions

Stroke is a complex condition where the knowledge base is continuously increasing. There are constant advances in the understanding of the condition, assessment and intervention techniques. Occupational therapists are a vital component in the rehabilitation of patients with this condition. It is vital that they understand the condition itself and the theoretical basis for intervention.

Definition of stroke

The World Health Organization (WHO) defines stroke as ‘a clinical syndrome, of presumed vascular origin, typified by rapidly developing signs of focal or global disturbance of cerebral functions lasting more than 24 hours or leading to death’ (WHO, 1978).

Impact of stroke

Stroke is a major public health care concern and has a significant impact on individuals, their families and wider society. Within the UK, an estimated 150,000 people have a stroke each year (Office of National Statistics, 2001). Stroke is the third most common cause of death, after heart disease and cancer, with over 67,000 deaths each year (British Heart Foundation, 2005). However, the most significant and lasting impact of stroke is long-term disability. Stroke is the single, greatest cause of complex and severe adult disability in the UK (Wolfe, 2000; Adamson et al., 2004). A third of people who have a stroke will have some long-term disability (National Audit Office (NAO), 2005). Common problems following stroke include aphasia, physical disability, loss of cognitive and communication skills, depression and other mental health problems.

In addition to the individual impact, stroke places a significant burden on health and social services. In England alone, stroke costs the National Health Service (NHS) and the economy about £7 billion a year: £2.8 billion in direct costs to the NHS, £2.4 billion of informal care costs (e.g. the costs of home nursing borne by patients’ families) and £1.8 billion in income lost to productivity and disability (NAO, 2005). Unfortunately, outcomes in the UK compare poorly internationally, despite our services being among the most expensive, with unnecessarily long lengths of stay and high levels of avoidable disability and mortality (Leal , 2006).