Authors (including presenting author) :
Ng SHW(1), Sit KLM (1), Chan AYF(1), Chan APS(1)
Affiliation :
(1)Occupational Therapy Department, Tai Po Hospital
Introduction :
Shoulder pain is one of the common complications after acute stroke. Proper use of shoulder sling during activities of daily living can promote proper glenohumeral alignment, reduce shoulder subluxation and reduce shoulder pain of flaccid upper extremity. However, it was found that OTD staff may not have sufficient knowledge for the shoulder protection strategies and may not be confident or competent in the use of shoulder sling.
Objectives :
This study is to evaluate the knowledge, competence, confidence level and practical skills of OTD staff before, immediately after and 1 month after the training session in proper use of shoulder sling, as part of formal sessions in the continuous quality improvement plan for stroke rehabilitation services.
Methodology :
This is a cross sectional prospective study. The 1-hour training session included introduction on pathology of shoulder pain, rationale behind use of shoulder sling, therapist’s step-by-step demonstration on wearing shoulder sling and hands-on practice by all OTD staff. Educational leaflet with QR code was issued for their reference. Five-question knowledge test on general use of shoulder sling, self-rated competence and confidence level, practical test on use of shoulder sling were collected before, immediately after and 1 month after the staff training session. Data were analyzed to evaluate effectiveness of staff training on proper use of shoulder sling for hemiplegic patients.
Result & Outcome :
41 OTD staff (39.0% in medical team, 34.1% in psychiatric team and 26.8% in orthopedic team) with mean medical working experience 2.00 ±2.49 years (range: 0-10 years)were recruited in this program. One-way repeated measures ANOVA was used to compare the knowledge, competence, confidence and practical skill before, immediately after and 1 month after staff training. An overall significant difference was found in knowledge (F(2,80)=6.712, p< 0.002), competence(F(2,80)=37.884, p< 0.000), confidence (F(2,80)=32.713, p< 0.000), and practical skill(F(2,80)=33.379, p< 0.000). Post-hoc test (pair t-test with Bonferroni correction) showed that the practical score immediately after (p< 0.000) or 1 month after the staff training (p < 0.000) were both significantly from that before the staff training in both medical and orthopedic teams. However, the practical score before the staff training was significant from that immediately after the staff training (p=0.014) but not significant with that after 1 month (p=0.310) in psychiatric team. Staff training on proper use of shoulder sling for hemiplegic patients was shown to be effective to improve both professional and supporting staff’s knowledge, competence and confidence level with effect sustainable more than one month. However, more intensive training on practical use of shoulder sling may be required for OTD staff in psychiatric team.
