Prevalence and risk factors of hand problems and carpal tunnel syndrome among dental hygienists.

PURPOSE: Recent research indicates a growing presence of hand problems and carpal tunnel syndrome (CTS) in dental professionals, especially among dental hygienists. This study was designed to determine the prevalence of hand problems and CTS among dental hygienists and identify risk factors for these conditions. METHODS: As part of a study that surveyed more than 5,000 army dental personnel, 177 dental hygienists were analyzed in great detail. Because of the magnitude of the overall study, which included all types of dental professionals, it was not only possible to identify the prevalence and risk factors of hand problems and CTS affecting dental hygienists, but also the prevalence rates as compared to other dental personnel. RESULTS: While the overall response rate for all dental personnel was 81%, dental hygienists responded at nearly 92%. Seventy-five percent of dental hygienists reported having hand problems, and 56% exhibited probable or classic symptoms of CTS. By logistic regression, the data revealed that dental hygienists whose practice comprised a majority (> 50%) of patients with heavy calculus were 2.3 times more likely to develop hand problems than those treating fewer patients with heavy calculus. Those who had practiced more than 10 years were also 1.9 times more likely to manifest symptoms associated with CTS than those with fewer years in the profession. CONCLUSION: The prevalence of hand problems and CTS among dental hygienists was the highest among army dental personnel, with the exception of dental therapy assistants. Risk factors for both hand problems and CTS are multifactorial, and dental hygienists should be particularly aware of those factors that can be prevented.

Musculoskeletal pain: prevalence, prevention, and differences among dental office personnel.

Data regarding the presence and specific region of musculoskeletal pain were collected as part of a study that surveyed more than 5,000 dental personnel, dentists, and dental auxiliaries. The magnitude of the overall study, which included all types of dental professionals, made possible identification of the prevalence of musculoskeletal pain and comparison of regions of pain among the different dental professionals.

Carpal tunnel syndrome: effect on Army dental personnel.

The purpose of this study was 2-fold: (1) to determine the prevalence of hand problems, in particular carpal tunnel syndrome (CTS), among Army dental personnel; and (2) to identify dental professionals at risk. A 12-page survey was mailed to all U.S. Army military and civilian dental personnel. Of the 6,320 surveys mailed, 80.9% were returned completed. An analysis was performed identifying the prevalence of hand problems and CTS and noting differences between civilian and military dental personnel. Of the 5,115 surveys analyzed, 44.8% indicated hand problems and 25.4% were determined to indicate a high probability of CTS. Of the 18 dental job specialties, dental therapy assistants and dental hygienists had the highest prevalence of CTS, 73% and 57%, respectively. Army dental personnel are at greater risk of developing CTS than the general public, especially civilian dental personnel, who were female, older, and employed longer.

Program planning for an assisted living community.

Occupational therapy has long had a vested interest in activity programming for the elderly. During the past, this interest has been largely confined to adult day care centers for community dwelling elderly, and to nursing homes for long term care of the elderly. In light of the interest generated by the recent entry of assisted living into the housing continuum, program models and understanding of the population of people who choose this option are of interest. This article introduces one model of wellcare for assisted living residents and describes a population of 626 residents in approximately 30 Morningside assisted living communities dispersed over the Southeast. The Healthy Generation model outlined in this article emphasizes five separate but inter-related domains that have been shown to impact the quality of life of aging individuals. Through the use of a multidimensional instrument, these domains (intellectual, social, physical, spiritual and emotional) are surveyed at the time each resident moves into a Morningside community. The resulting picture of the population is utilized by the assisted living program planners to create a monthly balanced calendar that intentionally engages each domain to support and enhance resident function and well being. This model has a direct bearing on practice of geriatric occupational therapy and this emerging area of practice.

Utilization of occupational therapy in combat stress control during the Persian Gulf War.

This article chronicles the deployment and subsequent utilization of occupational therapy personnel in support of combat stress control operations during the Persian Gulf War. It presents a discussion of occupational therapy's military history, evolving doctrine, and selected training experiences which led to the attachment of occupational therapy personnel to the 528th Medical Detachment (Psychiatric OM Team). A description of roles, functions, methods of operation, and lessons learned help to clarify the direction of occupational therapy in its future wartime mission.

A study of organizational commitment and job satisfaction among Air Force occupational therapy officers.

The purpose of this study is to describe the levels of organizational commitment and job satisfaction found in Air Force occupational therapy officers assigned to the Biomedical Sciences Corps. A questionnaire was mailed to 27 eligible active duty Air Force occupational therapy officers. Of the 23 surveys returned, 22 were usable, an 82% response rate. The occupational therapy officer's demographic characteristics are detailed for all officers and then by company and field grade respondents. Results indicate that these officers have moderately high levels of organizational commitment and job satisfaction. Analyses of the results suggest that field grade officers express more organizational commitment than company grade officers. Both company grade and field grade officers display the same level of job satisfaction. Upon closer scrutiny, though, company grade officers are found to be more satisfied with promotions and rewards gained from their jobs. Field grade officers express higher levels of satisfaction with pay, supervision, and relationship with coworkers.

A third party assessment of work capabilities.

The "Third Party Assessment of Work Capabilities" is a timely method for evaluating an individual's pre-hospitalization work behavior. It was developed by Griffiths in 1973 to monitor progress of hospitalized psychiatric patients on work therapy assignments. This survey form has been adapted to evaluate acute/short-term hospitalized soldiers and to assist in their rapid return to duty status. The "Third Party Assessment of Work Capabilities" worksheet, completed by the soldier's work supervisor, identifies five factors that summarize work behavior: task competence, response to authority and supervision, social relationship with others, work enthusiasm and motivation, and confidence and initiative. Once scored and results interpreted, an Occupational Therapy treatment can be implemented and early discharge planning with the soldier's unit initiated. A case study is presented for illustration.

Functional hand evaluations: a review.

Describing hand prehension patterns in the context of functional hand evaluations may not provide the therapist or surgeon with an accurate portrayal of a patient's capabilities. Although dexterity involves both static and dynamic components of hand usage, most descriptions of prehension patterns study the static phase alone. Hand use is a function of anatomic integrity, mobility, strength, sensation, coordination, age, sex, mental status, disease or trauma, and the condition of other proximal extremity joints (shoulder, elbow, wrist). In this study, various descriptions of hand prehension patterns were reviewed and 11 functional hand evaluations were analyzed. The purpose was to see if the descriptions and the evaluations have common elements. The conclusions are that there are no common elements, that no hand function evaluation is appropriate for all types of patients, and that such evaluations should consist of tasks representative of everyday functional activities.

Treating the patient with digital hypersensitivity.

Digital hypersensitivity is a functionally disabling condition, which often responds to conservative treatment with structured sequential desensitization. This case study describes the treatment hierarchy as the patient responds with objective improvement at each stage.