Wednesday, October 9, 2019

Occupational therapy leadership: promoting an autonomy-supportive environment based on self-determination theory, to improve patient outcomes in acute and post-acute stroke rehabilitation

The current state of stroke is a complete failure. None of the following have cures. 

1. 30% get spasticity NOTHING THAT WILL CURE IT.

2. At least half of all stroke survivors experience fatigue Or is it 70%?

Or is it 40%?

NOTHING THAT WILL CURE IT.

3. Over half of stroke patients have attention problems.

NOTHING THAT WILL CURE IT.

NO PROTOCOLS THAT WILL CURE IT.

4.  The incidence of constipation was 48%.

NO PROTOCOLS THAT WILL CURE IT.

5. No EXACT stroke protocols that address any of your muscle limitations.

6. Poststroke depression(33% chance)

NO PROTOCOLS THAT WILL ADDRESS IT. 

7.  Poststroke anxiety(20% chance) NO PROTOCOLS THAT WILL ADDRESS IT. 

8. Posttraumatic stress disorder(23% chance)  NO PROTOCOLS THAT WILL ADDRESS IT.

  912% tPA efficacy for full recovery NO ONE IS WORKING ON SOMETHING BETTER.

10.  10% seizures post stroke NO PROTOCOLS THAT WILL ADDRESS IT. 

11. 21% of patients had developed cachexia NO PROTOCOLS THAT WILL ADDRESS IT. 

 

12. You lost 5 cognitive years from your stroke  NO PROTOCOLS THAT WILL ADDRESS IT.

13.  33% dementia chance post-stroke from an Australian study?

       Or is it 17-66%?

       Or is it 20% chance in this research?

NO PROTOCOLS THAT WILL ADDRESS THIS 

The wishful thinking here:

Abstract

A major dilemma that is being addressed in the current project is the discrepancies between healthcare system's expectations for a rapid and successful rehabilitation process and patients after having a stroke ability to meet these expectations while striving to adapt to the calamitous event in their life. Emphasizing a more biomedical approach and under implementation of psychosocial approaches, poor acknowledging of patients' basic psychological needs lead to poor motivation, therapeutic disengagement and may lead to a rehabilitation failure. To cope with this gap in the process of stroke rehabilitation, an educational program aiming for occupational therapists working with patients after having a stroke in their acute and post-acute rehabilitation phases was constructed. The program guides practitioners for effective communication with their patients, building a needs-supportive environment and addressing their patients' basic psychological needs in light of the selfdetermination theory, theories of adaptation from occupational therapy perspectives and considering occupational justice and the ICF model. A clinical reasoning, step-by-step problem solving is introduced using adaptation of known models and innovated models for interventions that were created for this purpose. Program delivery through a series of 4-webinar modules is illustrated with their learning objectives, assignments and discussions. The program evaluation and implementation are expected to be the initiator of a change in the health and rehabilitation climate and in Israel.
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Attribution-NonCommercial-NoDerivatives 4.0 International

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