Occupational therapists’ assessment and reporting of functional cognition in stroke care

To investigate how functional cognition of people post-stroke is evaluated and reported by occupational therapists in Ireland. Functional cognition refers to the use and integration of cognitive skills for daily function. This study used a qualitative design. Six focus groups and one individual interview were conducted with 20 occupational therapists purposively sampled for variation across different clinical grades. Data were analysed according to the Braun and Clark thematic analysis framework. Participants felt that assessment of functional cognition was an integral feature of occupational therapy assessment in stroke care but acknowledged that terminology used by occupational therapists for functional cognition was inconsistent. Non-standardised observational assessment was routinely used by participants. Challenges were reported with respect to written documentation of non-standardised observations. Participants reported that use of standardised cognitive assessments required considered clinical reasoning before administration. Standardised performance-based assessments were not widely implemented by participants. Occupational therapists in Ireland reported a multi-component assessment process to evaluate functional cognition post-stroke. Establishing practice guidelines for the assessment of functional cognition may be of benefit to occupational therapists working in stroke care. Further research is needed to quantify procedures in this assessment process to account for variation in practice. The assessment of functional cognition in stroke rehabilitation is integral to occupational therapy practice.Occupational therapists described the assessment of functional cognition as a multi-component assessment drawing from three main modalities: standardised cognitive assessments; non-standardised observations; and performance-based assessments.Professional education in, and practice guidelines, for the assessment and reporting of functional cognition could be beneficial for occupational therapists in stroke care to streamline their assessment and reporting of functional cognition. The assessment of functional cognition in stroke rehabilitation is integral to occupational therapy practice. Occupational therapists described the assessment of functional cognition as a multi-component assessment drawing from three main modalities: standardised cognitive assessments; non-standardised observations; and performance-based assessments. Professional education in, and practice guidelines, for the assessment and reporting of functional cognition could be beneficial for occupational therapists in stroke care to streamline their assessment and reporting of functional cognition.本研究旨在探究爱尔兰作业治疗师（occupational therapist）如何对卒中后患者的功能性认知（functional cognition）进行评估与报告。功能性认知指为实现日常功能而对认知技能的运用与整合。本研究采用质性研究设计，对按临床职级差异进行目的性抽样的20名作业治疗师开展了6次焦点小组访谈与1次个人访谈。研究依据布朗-克拉克主题分析框架（Braun and Clark thematic analysis framework）对数据进行分析。 参与者指出，功能性认知评估是卒中照护中作业治疗评估的核心组成部分，但同时承认作业治疗师针对功能性认知所使用的术语并不统一。参与者常规采用非标准化观察评估，且在非标准化观察结果的书面记录方面存在诸多挑战。参与者提出，实施标准化认知评估前需进行审慎的临床推理，而标准化实操性能评估并未在参与者中得到广泛应用。 爱尔兰作业治疗师表示，卒中后功能性认知的评估采用多维度评估流程。制定针对功能性认知评估的实践指南，或将对卒中照护领域的作业治疗师有所裨益。未来仍需开展进一步研究，对该评估流程中的操作步骤进行量化，以兼顾实践中的差异。 卒中康复中的功能性认知评估是作业治疗实践的核心组成部分。作业治疗师将功能性认知评估描述为一种多维度评估，涵盖三大主要方式：标准化认知评估、非标准化观察评估以及标准化实操性能评估。 针对功能性认知评估与报告的专业教育及实践指南，可帮助卒中照护领域的作业治疗师简化功能性认知的评估与报告流程。 卒中康复中的功能性认知评估是作业治疗实践的核心组成部分。作业治疗师将功能性认知评估描述为一种多维度评估，涵盖三大主要方式：标准化认知评估、非标准化观察评估以及标准化实操性能评估。针对功能性认知评估与报告的专业教育及实践指南，可帮助卒中照护领域的作业治疗师简化功能性认知的评估与报告流程。