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  • Title: National survey of Canadian occupational therapists' assessment and treatment of cognitive impairment post-stroke.
    Author: Korner-Bitensky N, Barrett-Bernstein S, Bibas G, Poulin V.
    Journal: Aust Occup Ther J; 2011 Aug; 58(4):241-50. PubMed ID: 21770959.
    Abstract:
    AIM: This study examined variations in management of cognitive impairment post-stroke among occupational therapists and factors associated with variations in practice. METHODS: Canada-wide cross-sectional telephone survey. Clinicians' practices were examined using standard patient cases (vignettes). SETTING: Acute care, inpatient rehabilitation and community-based sites providing stroke rehabilitation in all Canadian provinces. PARTICIPANTS: Occupational therapists (n=663) working in stroke rehabilitation as identified through provincial licensing bodies. MAIN OUTCOME MEASURES: Type and frequency of cognition-related problem identification, assessment and intervention use. RESULTS: Respectively, 69%, 83% and 31% of occupational therapists responding to the acute care, inpatient rehabilitation and community-based vignettes recognised cognition as a potential problem. Standardised assessment use was prevalent: 70% working in acute care, 77% in inpatient rehabilitation and 58% in community-based settings indicated using standardised assessments: 81%, 83% and 50%, respectively, indicated using general cognitive interventions. CONCLUSION: The Mini-Mental State Examination was often used incorrectly to monitor patient change. Executive function, a critical component of post-stroke assessment, was rarely addressed. Interventions were most often general (e.g. incorporated in activities of daily living) rather than specific (e.g. cueing, memory aids, computer-based retraining).
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