Primary Care Occupational Therapy: A Quick Reference Guide

✍ Scribed by Sue Dahl-Popolizio (editor), Katie Smith (editor), Mackenzie Day (editor), Sherry Muir (editor), William Manard (editor)

• Publisher: Springer
• Year: 2023
• Tongue: English
• Leaves: 473
• Category: Library

✦ Synopsis

Healthcare is shifting towards a holistic, whole person approach to improve population health, decrease cost of care, and improve patient, and provider experiences. To achieve this, the primary care sector is adopting an integrated, interprofessional care team model which addresses both biomedical and behavioral health, and includes preventative care, population health management, technology, and innovative strategies to increase access to care. Occupational therapy (OT) is uniquely positioned to add their distinct whole person mental/behavioral health and medical care scope and skill to these teams to address patient needs. As this is an emerging practice area for OT, and no guidelines specific to primary care exist, this book will be a first of its kind text for occupational therapy practitioners (OTP) in primary care settings.

As OTPs work with habits, roles, and routines that affect health, OT in primary care promotes health and improves patient self-managementof medical conditions and lifestyles, reducing patient dependence on costly health care services. This timely clinical manual guides best practices for primary care OT. It helps OTPs fit into the quick paced primary care practice model. In traditional OT settings, intervention sessions are longer, and focus on acute rehabilitation or mental/behavioral health conditions. In primary care, visits are brief, and address patient needs in the context of their presenting issue. No other published guide meets the unique needs of this emerging practice area.

Authors provide administrative information specific to OT in primary care, and interventions for specific health conditions, including chronic conditions, common to this setting. Written by experts in the field, Primary Care Occupational Therapy is the definitive resource for all primary care OTPs or those interested in lifestyle-based interventions for conditions frequently seen in primary care. It is also a useful guide for behavioral health care providers and administrators of general medical practices.

✦ Table of Contents

User Guide
Contents
Part I: General Topics for Primary Care Occupational Therapy
Chapter 1: Introduction
References
Chapter 2: Overview of Occupational Therapy in Primary Care
Introduction
Defining PC
OT Theory in PC
OT Practice in PC
Summary
References
Chapter 3: Administrative and Operational Considerations
Strategic Plan: Needs Assessment of Site, Population, and Stakeholders
Understand Your Environment
Reimbursement
Compliance
PC Populations
Regulatory Considerations
Setting Configurations
Synchronous vs. Asynchronous Collaboration
Reimbursement Models
Managing Barriers
Considerations for Success
Communicate and Disseminate Your Work
References
Chapter 4: Telehealth
What is Telehealth?
Why Use Telehealth?
How to Use Telehealth?
References
Chapter 5: Conducting Research
Why Do We Need Research on OT in PC?
What Is the Current Status of Research on OT in PC?
What Role Can Clinicians Play in Expanding the Evidence Base on OT in PC?
Challenges for Future Research on OT Services in PC
References
Chapter 6: Trauma-Informed Approaches
Introduction
The Need for Trauma-Informed Approaches in PC
A Trauma-Informed Approach
Six Key Principles Fundamental to a Trauma-Informed Approach (SAMHSA)
Ten Implementation Domains for a Trauma-Informed Approach [1]
Integrating Trauma-Informed Approaches in PC
Involve the Client in the Evaluation and Treatment Process
Screen for Trauma
Become Trained in Trauma-Informed Approaches and Trauma-Specific Treatment Approaches
Effects of Trauma on Health
PC Team Self-Awareness
Utilize Referral Sources and Partner with Trauma-Informed Organizations
Consider Language Choices Carefully
Create a Safe Environment
Conclusion
References
Chapter 7: Transitions Across the Lifespan
Introduction
Transition From Home to School During Early Years
Transition to Adulthood
Transition to College/Career
Transition to an Age of Significance (30, 40, 50, …..)
Transitions in Relationships (Single to Married, Married to Single, Loss or Gain of Family, Friends, or Others Close in Network)
Transitions Between Jobs or Out of Jobs (Like Retirement)
Transitions in Roles (Becoming a Parent, Caregiving for a Parent, Caregiving for an Adult Child)
Transitions in Environment (Moving, Increased Independence, Decreased Independence)
Transitions in the Healthcare System (Pediatrician to Internist, Specialist for a Health Concern/Change)
Summary
References
Part II: Conditions Addressed by Occupational Therapy in Primary Care
Chapter 8: Addiction and Substance Use Recovery
Introduction
Role of the PCP
Common Comorbidities
Role of the OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
Documentation and Billing
Suggested Referrals
Additional Resources
References
Chapter 9: Alzheimer’s Disease
Introduction
Sub-Types
Mild vs. Major Neurocognitive Disorder (NCD) Due to AD
Disease Stages
Stages [7]
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Areas of Assessment
Other Considerations for Assessment
Intervention Strategies
Mild Stage
Moderate Stage
Severe Stage
Other Considerations and Resources
References
Chapter 10: Amyotrophic Lateral Sclerosis
Introduction
Signs and Symptoms [1, 6]
Disease Stages [1, 7]
Role of PCP [6, 7]
Common Comorbidities
Role of OTP
Occupational Impact [8]
OT Areas of Emphasis
Evaluation
Intervention Strategies [8]
Other Considerations and Resources
References
Chapter 11: Anxiety
Introduction
Diagnostic Criteria
Categories of Anxiety
Diagnoses That Mimic Anxiety But Are Not Anxiety
Role of PCP
Common Comorbidities
Factors Contributing to Anxiety
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Screening
Consultation
Evaluation
Intervention Strategies
Psychoeducation
Cognitive Behavioral Therapy
Motivational Interviewing
Exposure
Session Topics
Medication Adherence
Self-Monitoring
Lifestyle and Routine Modification
Community Integration
Other Considerations and Resources
Discharge, Health Maintenance and Relapse Prevention, and Recovery
References
Chapter 12: Arthritis
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Suggested Areas to Assess/Assessment Tools
Functional Assessment
Intervention Strategies
Orthoses
Teach the Patient to Pace Activities
Adaptive Equipment
Other Considerations and Resources
References
Chapter 13: Chronic Obstructive Pulmonary Disease and Asthma
Introduction
Role of the PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
Additional Resources
References
Chapter 14: Concussion
Introduction
Signs and Symptoms
Role of PCP [5, 6]
Common Comorbidities
Role of OTP
Occupational Impact [2, 3]
OT Areas of Emphasis
Evaluation
Intervention Strategies [2–4, 7]
Other Considerations and Resources
References
Chapter 15: Dementia Care
Introduction
Role of PCP
Role of OT
Occupational Impact
OT Areas of Emphasis
Evaluation
Suggested Assessment Tools (Links to Online Site for Resources Provided When Available)
Intervention Strategies
Other Considerations and Resources
References
Chapter 16: Lewy Body Dementia
Introduction
Sub-Types
Signs and Symptoms
Disease Stages
Role of PCP
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Areas of Assessment
Other Considerations for Assessment
Intervention Strategies
Mild Stage
Moderate Stage
Severe Stage
Other Considerations and Resources
References
Chapter 17: Nonprogressive Neurocognitive Disorders
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Direct Intervention Approaches
Indirect Intervention Approaches
Other Considerations and Resources
Documentation and Billing
Referrals
Additional Resources for Clients and their Caregivers
For Professionals
References
Chapter 18: Depression
Introduction
Diagnostic Criteria for Depressive Disorders by Type
Major Depressive Disorder
Persistent Depressive Disorder (Dysthymia)
Bipolar Affective Disorder
Other Related Diagnoses
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Screening
Consultation
Evaluation
Managing Suicidal Ideation
Intervention Strategies
Interventions in the Initial Stages of Treatment
Techniques
Psychoeducation [32]
Behavioral Activation and Self-Monitoring [33]
Session Topics
Medication Adherence [34]
Sensory Processing
Lifestyle and Routine Modification
Community Integration
Other Considerations and Resources
Discharge, Health Maintenance and Relapse Prevention, and Recovery
References
Chapter 19: Diabetes
Introduction
Diagnostic Categories
Prediabetes, Type 1 Diabetes, and Type 2 Diabetes
Diagnostic Tests and Thresholds
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
References
Chapter 20: Dizziness
Introduction
Description: Vertigo
Description: Disequilibrium
Description: Presyncope
Description: Lightheadedness
Cause
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
References
Chapter 21: Driving and Community Mobility
Introduction
Role of the PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
When to Refer Offsite
Other Considerations and Resources
Legal Considerations
References
Chapter 22: Falls and Falls Prevention
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
Documentation and Billing
Additional Resources
References
Chapter 23: Gastrointestinal Disorders
Introduction
Chronic GI Disorders
Other GI Disorders
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Symptom Monitoring
Stress Management
Coping with Pain (Chap. 34)
Eating Routines
Sleep Routines
Physical Activity Routines
Medication Management
Self-Advocacy
Social Participation
Other Considerations and Resources
References
Chapter 24: Guillain-Barré Syndrome
Introduction [1–3]
Role of PCP [2, 4]
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis [1]
Evaluation
Assessment [5]
Intervention Strategies [1, 5]
Other Considerations and Resources
References
Chapter 25: Huntington’s Disease
Introduction
Sub-type
Signs and Symptoms
Disease Stages
Role of PCP
Common Comorbidities [2, 3]
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
References
Chapter 26: Hypertension
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
Documentation and Billing
Suggested Referrals or DME
Additional Resources
References
Chapter 27: Insomnia
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
References
Chapter 28: Multiple Sclerosis
Introduction [1]
Signs and Symptoms
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Role and Focus [6]
Evaluation
Intervention Strategies [1]
Other Considerations and Resources
References
Chapter 29: Nerve Impingement
Introduction [1, 2]
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Muscle Length and Myofascial Mobility
Neural Mobilization
Common Orthoses and Products for Protection
Activity Modifications
Other Considerations and Resources
References
Chapter 30: Overweight and Obesity
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Nutrition
Physical Activity
Behavioral Strategies
Other Considerations and Resources
Documentation and Billing
Suggested Referrals
References
Chapter 31: Parkinson’s Disease
Introduction
Signs and Symptoms
Disease Stages [16]
Role of PCP [17–19]
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
A Note about Exercise, Mobility, and Home Exercise Programs
References
Chapter 32: Pediatric Primary Care
Introduction
Newborn (0–4 Weeks of Age)
Overview
Developmental Milestones/Norms
Caregiver Education
Recommended Assessments
Recommended Intervention
Sensory Integration
Motor Learning and Motor Control
Biomechanical
Developmental
When to Refer for Further Evaluation
Infants (1–12 Months of Age)
Overview
Caregiver Education
Recommended Assessments
Developmental Milestones/Norms
One Month
Two Months
Four Months
Six Months
Nine Months
Twelve Months
Recommended Intervention
Sensory Integration
Motor Learning and Motor Control
Biomechanical
Developmental
Cognitive
When to Refer for Further Evaluation
Toddler (1–2 Years of Age)
Overview
Caregiver Education
Recommended Assessments
Fifteen Months
18 Months
24 Months
30 Months
Recommended Intervention
Sensory Integration
Developmental and Biomechanical
When to Refer for Further Evaluation
Additional Recommendations
Preschool (3–4 years of Age)
Overview
Caregiver Education
Recommended Assessments
Three Years
Four Years
Recommended Intervention
Sensory Integration
Behavioral
Developmental and Biomechanical
When to Refer for Further Evaluation
School-Aged Children (5–14 Years of Age)
Overview
Caregiver Education
Recommended Assessments
Developmental Milestones/Norms
5 and 6 Years
Seven and Eight Years
Nine and Ten Years
Eleven and Twelve Years
Recommended Intervention
Sensory Integration
Motor Learning and Motor Control
Biomechanical
Developmental
Cognitive/Psychosocial
When to Refer for Further Evaluation
Adolescence (15–21 Years of Age)
Overview
Developmental Milestones/Norms
Adolescence (15–21 Years)
Caregiver Education
Recommended Assessments
Recommended Intervention
Sensory Integration
Motor Planning/Motor Control
Biomechanical
Developmental and Cognitive/Psychosocial
When to Refer for Further Evaluation
References
Chapter 33: Pelvic Floor Dysfunction
Introduction
Common Pelvic Floor Dysfunction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Suggested Assessment Tools
Intervention Strategies
Urinary Incontinence
Fecal Incontinence
Pelvic Organ Prolapse
Constipation
Dyspareunia
Other Considerations and Resources
References
Chapter 34: Persistent Pain
Introduction
Role of PCP
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Suggested Intervention Strategies
Education and Training
Other Considerations and Resources
References
Further Reading
Chapter 35: Tendinopathies
Introduction
Role of PCP
Diagnostic Tests and Thresholds
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
References
Chapter 36: Visual Impairments
Introduction
Role of PCP
Vision Screening for Low-Risk Patients
Common Comorbidities
Role of OTP
Occupational Impact
OT Areas of Emphasis
Evaluation
Intervention Strategies
Other Considerations and Resources
Documentation and Billing
References
Correction to: Nonprogressive Neurocognitive Disorders
Correction to: Chapter 17 in: Sue Dahl-Popolizio, Primary Care Occupational Therapy, A Quick Reference Guide, https://doi.org/10.1007/978-3-031-20882-9_17
Appendix
Common Orthoses in Primary Care
CMC Short Thumb Spica/Opponens
Trigger Finger (Stenosing Tenosynovitis)
Trigger Thumb (Stenosing Tenosynovitis)
Volar Wrist Orthosis
Joint Protection Techniques
Mindfulness: Higher Literacy Level
What Is Mindfulness?
How Can it Help?
What Can I Do?
Where Can I Find out More?
Mindfulness: Simplified
What Is Mindfulness?
How Can it Help?
What Can I Do?
Where Can I Find out More?
Motivational Interviewing Created by Nicole Villegas
Conducting a Motivational Interview
Rulers
Nerve Glides
Median Nerve Glides—Distal Glide
Median Nerve Glides—Proximal Glide
Ulnar Nerve Glides—Version 1
Ulnar Nerve Glide—Version 2
Radial Nerve Glide
Brachial Plexus Glide
Occupational Balance
Daily Occupational Balance
Pediatric Primary Care: Caregiver Education (Newborn to 21 Years)
Newborn
Caregiver Education
Infants
Caregiver Education
Toddlers
Caregiver Education
Caregiver Considerations
Two to Five Years of Age
Caregiver Education
School-Aged Children (6–14 Years of Age)
Caregiver Education
Adolescence (15–21 Years)
Patient and Caregiver Education
Pediatric: Fine Motor, Bilateral Coordination, and Hand Strengthening Activities
Pediatric Primary Care Occupational Therapy
Pediatric: Getting Dressed
Pediatric Primary Care Occupational Therapy
Pediatric: Regulating Activities
Pediatric Primary Care Occupational Therapy
Pediatric: Self-Care Skills
Pediatric Primary Care Occupational Therapy
2 Years
2 ½ Years
3 Years
3½ Years
4 Years
5 Years
Patient Health QUESTIONNAIRE-9
Progressive Muscle Relaxation (PMR)
Preparation
Keep in Mind the Following:
Process
Sequence
Practice
Provocative Tests for Distal Nerve Compression
Carpal Tunnel
Cubital Tunnel Syndrome
Radial Tunnel Syndrome
Provocative Tests for Proximal Nerve Involvement
Sleep Hygiene
Schedule
Weekly Sleep Log
Weekly Sleep Goals:
SMART Goals and Monthly Tracker
Spoon Tracking Sheet
Transtheoretical Model (TTM)|Stages of Change
Strength, Weaknesses, Opportunities, and Threats (SWOT) Analysis
Stressors
Theraputty Exercises
Walk to Run Program
Water Tracker
Index