gms | German Medical Science

Objective: Identifying purposeful activities that are difficult to perform is essential for occupational therapists to help the patients set goals and plan intervention. MAP-Hand is an 18-item patient-reported measure of hand function in performance of common everyday activities. Response-options (scores) are no- (1), some- (2), great- (3) difficulties and not able to do (4); sum-score 1-4 (1=no difficulties with any of the activities). MAP-Hand is validated in patients with rheumatoid arthritis and osteoarthritis. The aim of the present study was to investigate the relevance of the activities for patients receiving occupational therapy (OT) for hand-injuries.

Materials and Methods: Sixty adult outpatients receiving OT for a hand-injury were recruited in a hospital specialized in hand surgery, such as replantation surgery. Inclusion criteria included 'safe to perform the activities' and 'identification of activity problems relevant to set goals and plan interventions'. Data was analyzed by descriptive statistics, with the results presented as number of respondents or median (Q1-Q3). Interpretation and relevance of the items will be explored by cognitive interviews of 20 patients.

Results: Seventeen (28%) women and 43 (72%) men, age 53 (40-63) years scored the MAP-Hand 7 (4-22) months after injury: Sum-score 1.89 (1.63-2.33). The responses 'great difficulties' or 'not able to do' were most common for opening jam jars (n=27) and hermetic cans (n=26), carrying heavy objects (n=26), peeling raw vegetables (n=25), buttoning buttons (n=24), and tying shoelaces (n=24). Initial results from cognitive interviews suggest that the activities were considered relevant for the patients in this setting.

Conclusions: The 18 MAP-Hand-items represented common activity problems in the patients receiving OT for a hand-injury. This suggests that MAP-Hand may be useful to identify activity problems in a rehabilitation setting.