53 KB263 KB46 KB200820252012Švajger, AndrejaZupančič, Poloncaštevilka:1letnik:11str. 54-63ISSN:1580-9315COBISSID:1615209URN:URN:NBN:SI:doc-LBMDOJ0TslUniverzitetni rehabilitacijski inštitut Slovenije - SočaRehabilitacija (Ljubljana)Brain Injuriesdelovna terapijamožganske poškodbeOccupational Therapyoccupational therapy assessment and interventionpoklicna rehabilitacijarehabilitacijaRehabilitation, Vocationalvocational rehabilitationwork integrationDokazi za pristope in metode delovne terapije v poklicni rehabilitaciji oseb s pridobljeno možgansko poškodbo| Evidence for occupational therapy approaches and methods in vocational rehabilitation of persons after acquired brain injury|Background: In vocational rehabilitation, occupational therapists are daily faced with the challenges of deciding on methods of working with persons with acquired brain injury (ABI). To make these decisions, they need evidence about the effectiveness of different approaches and methods. Methods: We conducted a systematic literature review. The selection of literature was based on weighing best evidence from different types of studies, accessed mostly over electronic data bases (Medline, PEDro, OTseeker and MOHO Evidence Brief). The review process followed the Cochrane Handbook of Systematic Review. Studies were classified according to the American Association of Occupational Therapists' levels of evidence. Results: The strongest evidence confirms the effectiveness of cognitive rehabilitation of persons after ABI using the approach of teaching compensatory strategies and external devices. Strong evidence also exists for the client and occupation based approach. Studies on assessment approaches and methods support the use of assessments on all levels and in all areas of functioning, including barriers and opportunities in the environment. The strongest support can be found for the combination of standardised tests of memory, perception and apraxia with the assessment of the quality of occupational performance. Studies about approaches and methods of interventions support the efficiency of compensatory strategies and external aids for learning functional tasks and overcoming executive functions deficits. Conclusions: Literature review directs occupational therapists working in vocational rehabilitation of persons after ABI towards assessing person's functioning by combining approaches and methods on different levels and in relation to the characteristics and demands of the work environment. Successful inclusion into work is more likely when the intervention is work-place based and client-centredIzhodišča: Delovni terapevti se v poklicni rehabilitaciji dnevno soočajo z odločanjem o pristopih in metodah dela z osebami s pridobljeno možgansko poškodbo (PMP). Za odločanje o izbiri ustreznega pristopa in metode potrebujejo dokaze o učinkovitosti le-teh. Metode: Opravili smo sistematičen pregled literature. Izbor literature je temeljil na presoji najboljših dokazov iz različnih vrst študij, dostopnih predvsem v elektronskih podatkovnih zbirkah Medline, PEDro, OTseeker in MOHO Evidence Brief. Pri pregledovanju smo sledili Cochranovemu priročniku za sistematične preglede. Študije smo razvrstili v ravni dokazov po ocenjevalnem sistemu Ameriškega združenja delovnih terapevtov. Rezultati: Najmočnejši dokazi potrjujejo učinkovitost kognitivne rehabilitacije oseb s PMP s pristopom učenja nadomestnih strategij in uporabo zunanjih pripomočkov ter pomen k uporabnikom in v dejavnosti usmerjenega pristopa v delovni terapiji. Študije o pristopih in metodah ocenjevanja usmerjajo k uporabi postopkov ocenjevanja na vseh ravneh in področjih posameznikovega funkcioniranja ter ovir in možnosti v okolju. Najvišjo podporo ima kombinirana uporaba standardiziranih testov spomina, percepcije in apraksije ter ocenjevanje kakovosti izvajanja. Študije o pristopih in metodah obravnave opisujejo učinkovitost nadomestnih strategij in zunanjih pripomočkov za učenje funkcionalnih nalog ter obvladovanje težav pri motnjah izvršilnih funkcij. Zaključki: Pregled literature delovne terapevte na področju poklicne rehabilitacije oseb s PMP usmerja v ocenjevanjefunkcioniranja posameznikov s PMP ob kombinirani uporabi več pristopov in metod na različnih ravneh MKF v odnosu do značilnosti in zahtev delovnega okolja. Učinkovito vključevanje oseb s PMP v delovno okolje je verjetnejše, če obravnava poteka v realnem delovnem okolju ter s pristopom, usmerjenim k uporabnikuTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča