Authors (including presenting author) :
HUI HM(1), KWAN WL(1), YAU SF(1)
Affiliation :
(1) Department of Occupational Therapy
Introduction :
Splintage is one of the essential rehabilitation interventions provided by occupational therapists. It is an external device designed to promote joint alignment by providing a low load passive stretch over time. It reduces the risk of developing deformities and prevent contractures. In Tung Wah Hospital (TWH), splintage is often applied to patients with neurological conditions such as stroke and brain injuries. They may experience increased or decreased tone muscle tone in their limbs, and even pain or swelling. We used to provide a face-to face education session on splint wearing technique with supplementary notes given for caregivers to follow. However, it is usually reported of poor compliance to splint wearing regime after discharge, especially for those living in Old Age Home (OAH). Nevertheless, carer education session has been prohibited in local hospitals with during the surge of COVID-19 pandemic from early 2020 to present, aiming to reduce the risk of coronavirus spread by human factor. To tackle this difficulty, carer education on splint wearing technique has been enhanced and adapted. Video clips has been made with QR code support delivered via telecare.
Objectives :
(1) To ensure quality delivery of carer education on splint wearing technique
(2) To promote compliance to splint wearing regime via telecare during COVID-19 pandemic
Methodology :
Seven commonly prescribed splints were chosen to develop video clips for carer education in July 2020. It included the elbow extension splint, elbow gaiter, wrist extension splint, paddle resting splint, hand cone splint, knee extension splint and anti-footdrop splint. All these videos were taken with patient consent for educational purpose. Details of splint wearing sequences were added in subtitle of video, which allowed caregivers to follow systematically. For those indicated cases who required splintage upon discharge, corresponding video clips were sent to their caregivers via Whatsapp as a means of education since October 2020. QR code of video clips were also provided to caregivers for their timely review. With the use of pre-recorded video clips and QR code, education on splint wearing technique could also be extended to OAH staffs in order to promote compliance to splint wearing regime despite controlled or prohibited visiting during COVID-19 pandemic. Caregiver Satisfaction Survey, a 5-point rating scale, was used as outcome measure for evaluating the effectiveness and satisfaction on this new delivery mode of carer education on splint wearing technique at 1 month after discharge via telephone follow up.
Result & Outcome :
A total of 18 patients were provided carer education on splint wearing technique under this new delivery mode from October to December 2020. Sixteen of them were from stroke rehab ward (L2) and two of them were from neurosurgical ward (C7) in TWH. All of them have completed the Caregiver Satisfaction Survey at 1 month after discharge via telephone follow up. 89% agreed that the video clips are useful and effective in delivering education on splint wearing technique. 95% agreed that the video clips are clear and easy to follow. 83% expressed that they can comply to the suggested regime for most of the time (70%). A patient from neurosurgical ward, who lived in OAH, was a candidate of the Botox injection program for spasticity management. His 3-month post-Botox review assessment showed that the Range of Motion (ROM) of injected site at hip and knee were well maintained with the support of telecare. Enhancement of carer education on splint wearing technique with application of telecare shows a positive impact on quality delivery and compliance to splint wearing regime during COVID-19 pandemic. Further promotion on telecare for education of splint wearing technique are warranted especially to OAH residents.
