Abstract
Background/Aims There is a paucity of evidence in the UK regarding cognitive screening performed by occupational therapists and whether, and how, cognitive impairments are identified and assessed. The aim of this study was to identify current occupational therapy practice for the assessment of cognitive problems in patients following stroke. Methods Occupational therapists were invited to complete an online vignette study. Participants were asked to: identify any presenting cognitive problems; decide whether to complete cognitive assessments; and list any assessments they would use. Data were analysed using descriptive analysis. Results A total of 53 occupational therapists from across the UK participated. Participants identified key cognitive issues, but some problems, such as apraxia and attention, were overlooked. A large number of potential assessments were suggested, the most common being the Montreal Cognitive Assessment and Oxford Cognitive Screen. Conclusions The variation found in occupational therapists' recognition and assessment of cognitive problems has the potential to impact on management and rehabilitation in stroke services, survivor outcomes, education and research.
Highlights
It is estimated that over 100,000 people have a stroke in the UK every year (Stroke Association 2018)
We provided a Montreal Cognitive Assessment (MoCA) (Nasreddine et al, 2005) score from a previous assessment in hospital, and in others the scenario unfolded over several statements in order to reflect gathering information over time and to find out at what point the occupational therapy (OT) would complete a cognitive assessment with the stroke survivor
The majority of OTs were employed at an NHS clinical Band 6 (56.6%, n=-30) and 7 (37.7%, n=7), with small numbers employed at Band 5 (1.9%, n=1), Band 8 (1.9%, n=1) and Band 9, (1.9%, n=1). (Note that the higher the banding, the more senior the OT was)
Summary
It is estimated that over 100,000 people have a stroke in the UK every year (Stroke Association 2018). Cognitive problems are common after stroke (Lincoln et al, 2011) and are reported in over half of stroke survivors six months post stroke (Mellon et al, 2015). Cognitive problems encompass impairments of attention, memory, language, visuospatial and executive abilities. Such impairments may vary in severity and may not be significant until after discharge from hospital when the patient returns home and undertakes daily living activities (Patel et al, 2017; Zinn et al, 2004), or when they return to work (Grant et al, 2014: Sinclair et al, 2014) and find that they are not independent or need substantial help and support with activities. A large number of potential assessments were suggested: the most common were the Montreal Cognitive Assessment and Oxford Cognitive Screen
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