Bridging the gap between clinical service and academic education of hand-splinting practice: Perspectives and experiences of Thai occupational therapists

A gap in knowledge about current splinting practice exists between the educational program and clinical service. To bridge this gap, we investigated the perspectives and experiences of Thai occupational therapists regarding contemporary hand splinting practices in clinical use. A mixed-method study was designed. An explanatory sequential mixed methods design was used. In the first quantitative phase, a survey questionnaire was mailed to occupational therapists. The questions were regarding contemporary hand splinting practices in clinical use at seven hospitals in the capital city of Bangkok and outskirt areas. In the second phase, semi-structured interviews were completed to explore expert occupational therapists\u27 perspectives on practice in the same hospital settings. Transcripts were analyzed using thematic analysis. The results showed that most conditions receiving splints were nerve injuries, orthopedics, and stroke, which represented the service frequency of splint types: functional resting (100 %), cock-up (93.3 %), and thumb spica splints (80 %). Bone and joint deformity prevention ranked first with muscle contracture prevention being ranked second, and the third-ranked was maintaining range of motion. Three themes emerged from the interviews: starting with the patient condition; effective function and value; knowledge and experiential skills. Perspectives and experiences of occupational therapists in splinting practice contribute to education based on the reality of practice. Integrated numerical and textual data of professional skills and knowledge in actual splinting practice can be reflected through splints and orthoses program revisions to meet future learning outcomes

Cross-Cultural Adaptation, Validity, and Reliability of the Patient-Rated Michigan Hand Outcomes Questionnaire for Thai Patients

Introduction. The Michigan Hand Outcomes Questionnaire (MHQ) is a patient-rated hand outcome instrument. It is widely used in orthopedic and neurological conditions of the hands and upper limbs. To gain more knowledge on hand outcomes from a Thai patient perspective, an MHQ-Thai version is required. Purpose of the Study. The study is aimed at translating and cross-culturally adapting the MHQ into Thai and at examining the validity and reliability of the translated version. Methods. The Beaton protocol for cross-cultural adaptation of self-reported measures was used in the translation process. Three occupational therapists were asked to assess content validity while 30 participants were asked to fill in the questionnaire in order to assess construct validity, internal consistency, and test-retest reliability. Results. All six domains of the MHQ were translated into Thai without any major problems. However, items related to the characteristics of the patients were adapted to suit the Thai context. The MHQ-Thai version had good content validity (IOC 0.972). The construct validity revealed a low-to-high correlation between every subscale of the MHQ-Thai version. The intraclass correlation coefficient (ICC) of the test-retest reliability for the six domains ranged from 0.788 to 0.956, with excellent correlation (ICC = 0.953) for the total score. Cronbach’s alpha was 0.835 for the total score of the MHQ-Thai version, indicating good internal consistency. Discussion and Conclusions. MHQ was successfully cross-culturally adapted into Thai. The MHQ-Thai version is a valid and reliable instrument for evaluating the self-perception of Thai people who have hand and upper limb injuries

Bridging the Gap between Clinical Service and Academic Education of Hand-Splinting Practice: Perspectives and Experiences of Thai Occupational Therapists

A gap in knowledge about current splinting practice exists between the educational program and clinical service. To bridge this gap, we investigated the perspectives and experiences of Thai occupational therapists regarding contemporary hand splinting practices in clinical use. A mixed-method study was designed. An explanatory sequential mixed methods design was used. In the first quantitative phase, a survey questionnaire was mailed to occupational therapists. The questions were regarding contemporary hand splinting practices in clinical use at seven hospitals in the capital city of Bangkok and outskirt areas. In the second phase, semi-structured interviews were completed to explore expert occupational therapists’ perspectives on practice in the same hospital settings. Transcripts were analyzed using thematic analysis. The results showed that most conditions receiving splints were nerve injuries, orthopedics, and stroke, which represented the service frequency of splint types: functional resting (100%), cock-up (93.3%), and thumb spica splints (80%). Bone and joint deformity prevention ranked first with muscle contracture prevention being ranked second, and the third-ranked was maintaining range of motion. Three themes emerged from the interviews: starting with the patient condition; effective function and value; knowledge and experiential skills. Perspectives and experiences of occupational therapists in splinting practice contribute to education based on the reality of practice. Integrated numerical and textual data of professional skills and knowledge in actual splinting practice can be reflected through splints and orthoses program revisions to meet future learning outcomes