Occupational therapists working in hand therapy: the practice of holism in a cost containment environment.

OBJECTIVE: Occupational therapists specializing in hand therapy are challenged to provide care that reflects foundational concepts of occupation and holism. The researchers investigated cost containment influences on occupational therapists specializing in hand therapy to determine how therapists provide holistic care within cost containment constraints. METHOD: Five hand therapists were chosen based on selection criteria of hand therapy and holistic care practice. Using a grounded theory approach, the researchers gathered data via interviews and clinical observations. Data were analyzed through open, axial, and selective coding, and critiqued by an expert panel for emerging theory and concepts. RESULTS: Occupational therapists developed new skills or refined existing skill through adapting, educating, and strategizing in response to environmental demands. Tenets of the occupational adaptation model matched the strategies used by the participants. CONCLUSION: Occupational therapists specializing in hand therapy adapted to cost containment constraints by modifying professional settings and skills, educating multiple consumers, and implementing innovative interventions.

Work-related upper extremity injuries: prevalence, cost and risk factors in military and civilian populations.

Persons with musculoskeletal-related disorders represent a prevalent source of outpatient visits, lost work time and disability in the military; however, research concerning the extent of work-related upper extremity disorders (WRUEDs) within this population is lacking. This literature review examined studies in civilian and military settings to ascertain the prevalence, cost and risk factors associated with WRUEDs. The results indicated that the prevalence and cost of WRUEDs in the civilian workforce are significant, justifying the need to research the military population. The literature also outlined physical, individual and psychosocial factors associated with WRUEDs that will help identify potential risk factors within military occupations.