Rosemarie Mason

Functional Benefit of Dupuytren’s Surgery

The results of surgery for Dupuytren’s disease were prospectively assessed to see if there is a correlation between hand function, the degree of deformity and the post-operative result. A total of 42 patients were followed-up for 6 months. The mean flexion deformity was 81° pre-operatively and 32° post-operatively. The mean Sollerman score improved from 71 (out of 80) pre-operatively to 77 post-operatively. There was a significant correlation between the degree of deformity and the Sollerman score, and also between the improvement in deformity after surgery, and the Sollerman score. We conclude that hand function is worsened by increasing deformity in Dupuytren’s disease and improved by correction of the deformity.

A Qualitative Study of the Experiences and Expectations of Surgery in Patients with Carpal Tunnel Syndrome

The aim of this study was to explore the impact of carpal tunnel syndrome (CTS) on individuals and their expectations of surgical decompression to identify what outcome domains need to be assessed in future clinical trials. This qualitative study used in-depth, face-to-face interviews with nine patients with CTS awaiting surgical decompression. The tape-recorded interviews were transcribed fully, data were coded and categorized independently by two researchers and emerging themes were identified. Patients identified relief of symptoms-tingling, numbness and sleep disturbance, and resumption of important activities-as their most important criteria for judging the success of surgery. Although they recognized the consequences of this disorder were minor in comparison to more serious diseases, patients expressed distress at the impact of this disorder on their quality of life and expressed hope that surgery would address this. The assessment of outcomes of surgical decompression of CTS needs to include measures of symptom resolution as well as of activity limitation and participation restriction. Using existing patient-rated, disease-specific, and region-specific outcome instruments is likely to capture those domains which patients consider important criteria of success.

Coping Strategies Used by People with a Major Hand Injury: A Review of the Literature

Introduction: The hand is a highly specialized part of the body used to perform many functions. Injury causing permanent change affects a person biologically, psychologically, and socially. This literature review aims to study coping strategies that people adopt in order to deal with a major hand injury. Method: A qualitative literature search was carried out using relevant databases. Inclusion/exclusion criteria were applied, which resulted in eight appropriate papers. Each one was critically appraised and analysed in a narrative way for patterns, consistencies, and variance. Findings: Coping strategies were found to alter over time. In the short term, strategies employed included avoidance, processing the trauma experience, seeking assistance, and maintaining control. In the long term, strategies included acceptance/resignation, resuming occupations, and adjusting occupational roles. Recommendations for intervention included addressing psychosocial impacts, involving significant others in therapy, and incorporating occupational adaptation. Conclusion: The effectiveness of coping strategies depends on the individual and their unique circumstances; hand therapists must work in a holistic and client-centred way to find effective strategies that meet the individuals needs. This involves addressing psychosocial and functional adaptation, as well as physical rehabilitation.

Dupuytren's Disease: Segmental Aponeurectomy — Surgical Procedure and Postoperative Splint Regime

At the Royal Hallamshire Hospital in Sheffield, a trial group of patients suffering from Dupuytrens contracture have undergone segmental aponeurectomy, a technique which the authors understand to be comparatively new to this country. The study is not yet complete but it was considered that a description of the technique and postoperative regime would be of Interest to those Involved in the treatment of hand problems.

Innovation and Creativity: Exploring Human Occupation and Professional Development in Student Education

This short evaluation report discusses the development of a creative project that encourages student-centred learning. Year 3 occupational therapy students are given the opportunity to explore occupational science theories, applied to an area of human activity through creative media, such as film making, poetry, textiles, animation and photography. Student evaluation of the project identified its value as a highly stimulating learning encounter. The article outlines the educational underpinnings for the project and how the use of creativity enables students to develop their understanding of human occupation, which informs their professional socialisation and identity.

Trust: Can Occupational Therapists Take It for Granted?

The trust that underpins the relationship between the Government, the public and professionals has been undermined, leading to proposed changes to the regulatory framework for professionals in order to strengthen clinical governance. In the National Health Service, the Knowledge and Skills Framework is suggested as a tool for revalidation, the implications of which are discussed. Occupational therapists should no longer take trust for granted, but neither is it something that can be managed entirely by legislation. Rather, occupational therapists have both a personal and a collective responsibility to re-forge public trust.

The symbolism of an academic journal

The professional journal was introduced in 1938 (Wilcock 2002). The facsimile of the first edition provides an insight into the early days of the profession (Journal of the Occupational Therapists’ Association, Summer, 1938, 2007). The purpose of a journal at that time was to convey the idea of a professional community, which could discuss work issues in an academic way. It was meant to demonstrate the competence of the association’s members and their willingness to strive for constantly improving standards. It was evidence of status, role, authority and good reputation, for which respect was due (Carr-Saunders and Wilson 1933). The act of reading a journal in a public place or displaying it in a department was loaded with the meaning that it was meant to convey to observers. The journal was confirmation of self-identity: an affirmation of professional status, which other people would recognise. Now, times change and the basic tenet of symbolic interactionism is that meanings are transformed the more we interact with one another. Since we seek meaning for our clientele, it seems appropriate to revert to the opening question: what does the journal mean to you? More especially, what would you like it to mean? Do participate in the membership survey: this is your chance to make your views known.