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Asking Clinical Questions

What is a Clinical Question?. A clinical question is a question that typically arises naturally over the course of practice regarding the best care for clients.. Other Sources of Clinical Questions. Professional TrendsExisting Published ResearchExisting Theory. Why is the clinical question important??.

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Asking Clinical Questions

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    1. Asking Clinical Questions

    2. What is a Clinical Question? A clinical question is a question that typically arises naturally over the course of practice regarding the best care for clients.

    3. Other Sources of Clinical Questions Professional Trends Existing Published Research Existing Theory

    4. Why is the clinical question important?? The answer you do (or don’t!) get depends on the way you ask the question The question concept needs to be converted into key search words There are different kinds of questions – questions about diagnosis, assessment, interventions, theoretical approaches, etc….

    5. Categories of Clinical Questions Categories of clinical questions can include the topics of: Theory Assessment Intervention Outcomes

    6. So what are outcomes??

    7. Outcomes are changes in…. Impairments (bodily functions and structures) Occupations* Levels of participation* Issues in contexts Personal and environmental factors*

    8. Intervention strategies: range of motion exercises, adapting/grading activities, modalities, therapeutic activities, occupations, etc. Targeted outcomes: Impairment level – decrease joint swelling and pain increase range of motion Activities – improve grasp in picking up objects Occupation – be able to play cards Participation – be a member of the Monday night bridge club

    9. Developing the question is a way of establishing a search strategy which you can use successfully….

    10. Specific questions include: Client/populations Interventions Outcomes Comparisons

    15. Questions should be Relevant! Direct! Clear! Focused!

    16. The previous type of questions are “foreground” questions…questions which ask about specific care issues related to a client

    17. You can also ask “background” questions – those questions which seek to answer questions about a disorder…

    18. Background Questions include: A question root (who, what, where, how, why, when…) A specific disorder or aspect of a disorder

    21. Examples of Theory Questions 1. Do children with Autism benefit more from a Sensory Integration theoretical approach when compared to children with Autism who receive therapy based on Behavior Modification? 2. Do adults with Schizophrenia exhibit higher levels of engagement in activities of daily living when receiving intervention based on using the Model of Human Occupation, versus those who do not? 3. Do elders with Total Hip Replacements return home sooner when receiving intervention based upon the Occupational Adaptation Frame of Reference, versus those who do not?

    22. Examples of Assessment Questions 1. Does the Canadian Occupational Performance Measure have good reliability and validity for adults with multiple sclerosis, when compared to the Occupational Performance History Interview? 2. Does using the Canadian Occupational Performance Measure to write goals increase the functional performance of individuals with CVA at discharge when compared to not using any specific assessment to write goals?

    23. Examples of an Intervention Question Do patients in acute rehabilitation settings after a stroke improve in their abilities to do daily occupations better when treated with constraint-induced therapy or neurodevelopmental treatment? Do children with cerebral palsy demonstrate greater gains in IADLs when treated in weekly short sessions over extended periods or when treated intensively for long sessions over a brief time frame?

    24. Examples of an Outcome Question Do children with cognitive restrictions transfer social participation skills better when treated with peer-mediated interventions or adult-provided training? Do adults with developmental disabilities demonstrate greater community participation when supported in their parents’ home or when supported in group home environments?

    25. QUESTIONS AND ANSWERS ?

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