Required Research Issues of Occupational Therapy for Patients with Stroke in Taiwan

[[abstract]]職能治療（occupational therapy, OT）遭遇的臨床瓶頸通常盤根錯節，必須結合眾人之力、長期投入，始能逐步解決。學術研究藉由科學方法及大量資源以探索及解決臨床瓶頸。然而國內OT研究資源有限，我們必須深思如何在有限的資源下，規劃長期研究計畫之取向，以有效解決我們遭遇的瓶頸。我們認為國內OT最主要的研究主題應是本土絕對必要的議題，且該研究議題可能受到文化國情等因素影響，其它國家研究人員未能代勞，或其它國家之研究成果難以概化應用至國內。因此國人僅能自行投入研究該議題或瓶頸，否則勢必難以突破該瓶頸。本文以中風病人為例，提出我們認為本土必要之中風相關的OT研究議題，以供研究人員參考。相關議題可分為二大類：一、治療相關：OT對於亞急性中風病人之治療理論與成效驗證、職能之訓練理論與成效驗證、外籍看護工對於中風個案日常生活活動（activities of daily living, ADL）/工具性日常生活活動（instrumental ADL, IADL）獨立之影響等；二、評估相關：評估工具之發展（含認知功能、ADL/IADL、OT知識與中風知識、生活品質、OT滿意度與順從度、環境評估等）。以上建議議題或屬主觀或有遺漏，然而這些議題皆牽涉關鍵之OT臨床瓶頸，必須依賴國內OT研究團隊長期投入，始能克服相關之臨床瓶頸，提升臨床效能，造福中風病人。 Clinical challenges of occupational therapy (OT) are often complex in nature. Occupational therapists have to be united and work together for long-term period to overcome the challenges. To overcome the clinical challenges, therapists can employ research which uses scientific methods and resources (including manpower, money, and time). However, our resources are so limited that we should consider how to develop long-term research plans to efficiently overcome the challenges.We think that the most essential issues have to be carried out by ourselves. Such issues are affected by culture and local characteristics so that these issues cannot and will not be addressed by foreigners. The foreign related findings are hardly generalized to our country.We provided the most essential research issues of OT for stroke patients. These issues had two categories. First, therapy-related issues included ”development and validation of OT interventions for subacute patients,” ”development and validation of a theory to promote occupational performance,” ”the effects of foreign caregivers on level of independence of activities of daily living (ADL) and instrumental ADL (IADL).” Second, assessment-related issues included development of measures to assess cognitive function, ADL/IADL function, knowledge of occupational therapy and stroke, quality of life, level of satisfaction and compliance, and environment.Our suggested research issues may be subjective and limited. The issues suggested are critical for overcoming the clinical challenges in Taiwan. The issues have to be addressed by OT research teams with long-term involvement to promote efficiency of OT and benefit stroke patients