A Survey Study on the Use of Patient-Rated Outcome Measures Among Hand Occupational Therapists in Singapore

Abstract

Objective: The use of patient-rated outcome (PRO) measures in clinical practice can provide pertinent information regarding the limitations and restrictions in activities of daily living after an injury to the upper extremity from the patient’s perspective. The subjective information obtained is often vital to guide more client centered and hence effective therapy approach. This study specifically explored the current practice trends and the perception on the use of PRO measures among hand therapists in Singapore. This study aimed to identify the barriers that limit routine use of PRO measures locally. Materials and Methods: An online survey consisted of 10 questions was administered via SurveyMonkey. The link to the survey was distributed through e-mail to all hand therapists in the 7 acute general hospitals in Singapore on February 1, 2016. Occupational therapists who have more than 6 months of clinical experience in hand therapy were recruited. The survey was closed on February 29, 2016. Results: Information from 27 responses was analyzed in descriptive manner; 33.33% (n = 9) indicated that they use PRO measures with less than 25% of their patients and 2 therapists indicated they did not use PRO measures at all. Disabilities of the Arm, Shoulder and Hand (DASH)/quickDASH and Patient-Rated Wrist/Hand Evaluation (PRWHE) were more commonly used. The barriers to routine use of PRO measures were identified: (1) PRO measures taking too much time to administer, (2) patients having difficulty completing PRO measures, and (3) use of objective standardized assessment is more applicable in the setting. About 81.5% (n = 22) indicated that it is important for occupational therapists in hand therapy setting to use PRO measures and it should be used more often; 68% (n=19) agreed that there should be a PRO measure that is specifically designed for use in Singapore. “Fast to administer” was rated as the most important feature in PRO measures for the therapists to incorporate its use routinely. Conclusion: This study suggested that while hand occupational therapists in Singapore agree that it is vital to use PRO measures with their patients, they face various limitations in routine administration. It was found that Singapore therapists would prefer a PRO measure that is more culturally relevant and one that is fast to administer. Further research into seeking solutions to improve utilization rate of PRO measures in Singapore is required.