Erognomic education on housework for women with upper limb repetitive strain injury (RSI): a conceptual representation of therapists' clinical reasoning

Using the Rapid Upper Limb Assessment to examine the effect of the new Hotel Housekeeping California Standard

A housekeeper's job includes a variety of repetitive and strenuous tasks, which can put workers at high risk for musculoskeletal disorders. In 2018, a new standard was implemented in California aiming to prevent work-related injuries of hospitality industry workers. This paper assesses California housekeepers performing regular work tasks during their shifts from 2018 to 2020. Rapid Upper Limb Assessments (RULA) after the standard was implemented found average right-arm scores for scrubbing tasks (M = 6.93, SD = 0.00), vacuuming (M = 6.27, SD = 0.45), and trash-collecting (M = 4.48, SD = 0.50). Forces to move housekeeping carts were also evaluated, with 98% of pushing forces and 73% of turning forces observed within the accepted range. Results show that RULA scores remain high even after the implementation of the standard, with improvements only seen in tasks that required just changing of the method.

Clinical Reasoning in Occupational Therapy Practice: A Scoping Review of Qualitative and Conceptual Peer-Reviewed Literature

IMPORTANCE

The occupational therapy clinical reasoning literature includes a large proportion of peer-reviewed qualitative and conceptual articles. Although these articles can contribute to the understanding of how clinical reasoning has been conceptualized in occupational therapy, they have not yet received in-depth analytic attention. To address this gap, we conducted a scoping review.

OBJECTIVE

To examine how qualitative and conceptual literature has addressed clinical reasoning in occupational therapy.

DATA SOURCES

Database searches were conducted in Scopus, Web of Science, PsycINFO, Embase, and MEDLINE.

STUDY SELECTION AND DATA COLLECTION

Included articles were published between 2010 and 2019, were peer reviewed, addressed clinical reasoning in occupational therapy, were qualitative or conceptual articles, focused on practitioners, and were in English. Twenty-six articles met the inclusion criteria. Data were extracted according to relevant categories and were analyzed numerically and thematically.

FINDINGS

Four themes were identified: clinical reasoning processes, factors influencing clinical reasoning, new models or frameworks to guide clinical reasoning, and emergent perspectives on clinical reasoning.

CONCLUSIONS AND RELEVANCE

This review advances knowledge about how clinical reasoning has been conceptualized in occupational therapy and has been applied in a range of practice contexts. The review highlights discussions about types of reasoning, the dynamic and iterative nature of reasoning, contextual dimensions of reasoning, client-centered and occupation-based approaches, new frameworks and models, and emergent and innovative perspectives on clinical reasoning in occupational therapy. What This Article Adds: This scoping review represents an important contribution to knowledge about how clinical reasoning has been conceptualized in occupational therapy by mapping key themes and illuminating scholarly conversations in the qualitative and conceptual clinical reasoning literature.

Which is the most ergonomic mop? A comparison of three domestic mopping systems

PURPOSE

To assess musculoskeletal risk factors (repetitions, posture, forces) of the upper limb during domestic floor mopping tasks.

METHODS

Two hundred women were surveyed to determine the most common mopping system, mopping patterns and type of flooring used in their homes. The biomechanical demands of the three most common mopping systems were then evaluated in the laboratory. Participants were also asked to rate their perceived levels of exertion and cleanliness of each mopping system.

RESULTS

The use of wet wipes had the highest repetition count and exertion rates during mopping and scrubbing tasks. Higher peak scrubbing forces were noted for the plunge mop. All participants found the cotton fibre mop to be the cleanest. All 3 mops had medium postural risk.

CONCLUSION

The advantages and disadvantages of each mopping system were outlined and may be used by occupational therapists when providing ergonomic advice to patients with upper limb musculoskeletal conditions.

Razonamiento clínico en terapia ocupacional. Una revisión narrativa

 Introducción. El razonamiento clínico ordena el procesamiento de la información obtenida durante la evaluación, facilitando tomar decisiones para implementar planes de tratamiento. Esta área es cada vez más relevante para la formación de estudiantes y profesionales de terapia ocupacional. Objetivo. Analizar la literatura sobre razonamiento clínico en terapia ocupacional publicada entre 2009 y 2018. Materiales y métodos. Se realizó una revisión de la literatura en bases de datos, repositorios institucionales, monografías y literatura gris de alcance. Se establecieron criterios de selección para la obtención de documentos que luego se analizaron estableciendo un conjunto de variables que permitieron el análisis de la literatura. Resultados. La literatura sobre razonamiento clínico en el período estudiado fue de 99 publicaciones, más de la mitad que en los 33 años anteriores. El razonamiento clínico en el ámbito docente es el de mayor impacto (41.4%); 52.5% son publicaciones que mejoran la práctica con sus aportes al reforzar el desarrollo de destrezas profesionales y la calidad de las intervenciones. Conclusión. El aumento de la investigación sobre razonamiento clínico en terapia ocupacional dota a esta área de conocimiento y rigor, mejorando así la eficacia de los terapeutas ocupacionales.