F E AT U R E
A gallery of measuring meaning in hand therapy Vicki Strelan, Principal Occupational Therapist and Hand Therapist at Arm to Palm Upper Limb Clinic “Occupational therapists don’t ask what’s the matter with you, they ask what matters to you.” These words were inscribed on mugs gifted in thanks from a young woman at the end of her hand rehabilitation. OT Week 2021 provided an opportunity to reflect on the role of occupational therapy in meaning-making. How do we measure
Shortbread biscuits – baked by a labourer who had 200kg of metal fall from a two-metre height onto both his thumbs – are periodically handmade and hand-delivered to our clinic via a 200km round trip. At the beginning we saw fear, anger and despair. While he was waiting for a suitable duties program to start, he decided to teach himself something new, and took up baking. At the end of hand therapy, he was fully employed in his original job, engaging in long distance cycling, home renovating, and hobby farming cows. He offers us a calf when they birth, however to date we have only accepted biscuits.
“Handybear” was handmade and gifted by a woman with a tissue erosion form of scleroderma. She was one of the first clients to our private practice 21 years ago, and has cycled back to us after subsequent surgeries. Today we see meaning and function as she is planning new ways to explore handcrafts.
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outcomes in occupational therapy intervention? Technology, albeit inherently useful, is a superficial measurement. One of the founders of the occupational therapy profession was Eleanor Clark Slagle, and if her beliefs stand the test of time, the true measurement of therapy outcome is in the narrative of occupation and meaningful activity (Reed, 2019).
The hand therapy strap storage debacle well known to anyone working in splinting has had two skilled tradesmen volunteer solutions. One female tradie recovering from a circular saw injury to her non-dominant hand installed an inbuilt splint strap holding system inside a cupboard at our former workplace. A second quietly spoken worker with a tendon and wrist injury spent months fabricating a stunning portable splint strap storage system which has hands at each end, with carved fingernails!
To measure outcomes in hand therapy we have technology in the form of goniometers and dynamometers, gauges and tape measures. Is this a true measure of outcome?
