Clinical Scenario and PICO, Creative Essay Example

Scenario 1: Adults with Dementia

Patient George X. is a 73-year-old male with a diagnosis of moderate Alzheimer’s related dementia. Patient’s current Mini Mental State Examination (MMSE) score is 18, indicating moderate dementia. Patient’s wife states that George X is finding it difficult to do common tasks including dressing properly. Patient’s wife says sometimes George X has difficulty remembering how to put on shirts or socks. OT is to assist with developing compensation strategies for use by patient and by caregiver (wife) in dressing.

PICO Therapy Question: In a home-resident senior with moderate Alzheimer’s related dementia, what is the effect of twice-weekly OT sessions focused on compensation strategies on the patient’s ability to dress himself properly compared with a single standard consultation on appropriate strategies of dealing with impact of dementia on activities of daily living (ADL)? (Voigt-Radloff, et al., 2009).

Scenario 2: Children with ADHD

Peter J. is a 7-year-old male with a diagnosis of ADHD. Patient is otherwise healthy with no other morbidities. Mrs. J., a single parent and the mother of Peter J., states that Peter J. cannot sit still more than a few moments, and his teachers are complaining that he is disruptive. Mrs. J. is reluctant to medicate Peter J. and wants the OT to teach him strategies to self-regulate his behavior, and to teach Mrs. J. appropriate coping strategies to reduce patient’s outbreaks.

PICO Question: In a 7-year-old boy with ADHD, what is the effect of a more structured home environment on the patient’s unproductive and antisocial behaviors compared to the existing home environment? (Young, 2007).

Scenario 3: Children with Cerebral Palsy

Jennifer L. is a 4-year-old female with a diagnosis of spastic monoplegia cerebral palsy, displaying hypertonia in the afflicted limb, her left leg. Clonus is mild and relatively rare in this patient. Patient displays no other significant morbidities. The OT is being asked to evaluate patient’s ambulatory facility and provide therapies to improve Jennifer L.’s mobility.

PICO Question: In a 4-year-old female with spastic monoplegia cerebral palsy, what is the effect of sensorimotor function training on the patient’s mobility compared to the usage of splints or orthopedic devices to provide gait stability? (Steultjens et al., 2004; Steultjens, et al., 2008; Shikako-Thomas et al., 2007).

References

Shikako-Thomas, K., Majnemer, A., Law, M., Lach, L. (2008). Determinants of participation in leisure activities in children and youth with cerebral palsy: A systematic review. Physical & Occupational Therapy in Pediatrics, 28 (2), 155-169.

Steultjens, E. M. J., Dekker, J. J., Bouter, L M., Lambregts, B. B., Van den Ende, C. H. M., Els, C. M. H. Van de Nes, J. (2008). Occupational therapy for children with cerebral palsy: Cochrane Database of Systematic Reviews, 13 Nov. 2008.

Steultjens, E. M. J., Dekker, J. J., Bouter, L M., Van de Nes, J., Lambregts, B. B., Van den Ende, C. H. M. (2004). Occupational therapy for children with cerebral palsy: A systematic review. Clinical Rehabilitation, 18, 1-14.

Voigt-Radloff, S., Graff, M., Leonhart, R., Schornstein, K., Vemooij-Dassen, M., Olde-Rikkert, M., Huell, M. (2009). WHEDA study: Effectiveness of occupational therapy at home for older people with dementia and their caregivers—the design of a pragmatic randomised controlled trial evaluating a Dutch programme in seven German centres. BMC Geriatrics, 9, 44-58.

Young, R. L. (2007). The role of the occupational therapist in attention deficit hyperactivity disorder: A case study. International Journal of Therapy & Rehabilitation, 14 (1), 454-459.