Uptake of Standardised Hand Assessments in Rheumatology: Why is It so Low?

Abstract

Occupational therapists are under increasing pressure to incorporate standardised assessments into clinical practice, but little evidence of the actual uptake has been published to date. This paper begins to address this knowledge gap by reporting the results of a United Kingdom survey of the uptake of standardised hand assessments by occupational therapists in hospital-based rheumatology services. A purpose-designed postal questionnaire was mailed to ‘The Senior Occupational Therapist in Rheumatology’ at every hospital in the United Kingdom where a consultant rheumatologist was known to practise, seeking information on participants' knowledge about, use of and attitudes towards standardised hand assessments. The overall response rate was 80% (160/200). The 118 respondents who returned completed questionnaires reported a very low uptake of standardised hand assessments, with fewer than 10% using measures of observed task performance. The reasons for preferring non-standardised instruments clustered under six themes: advantages of non-standardised measures, access, delivery of care, training, barriers and exceptions. The barriers to increasing the uptake of standardised hand assessments by occupational therapists working in rheumatology need to be addressed. Initiatives are recommended to assist clinicians in selecting suitable standardised hand assessments, but occupational therapists must also accept their individual responsibility for implementing standardised assessments.