Occupational therapists' self-rated service delivery satisfaction and vision loss accomodation during the cognitive screening of clients living with vision loss.

Abstract

Purpose : The literature contains a variety of cognitive screening tests that are suitable to be administered to clients with vision loss (VL). This study explored the use of cognitive screening tools adapted for VL by occupational therapists (OTs), as well as initiatives they undertake to accommodate VL when screening cognition. We hypothesized that OTs do not commonly use cognitive tests adapted for VL. If they do accommodate for VL during cognitive screening, they do not employ adaptive strategies systematically, which may in part be rooted in a self-perception of lower clinical competency.

Methods : Using a cross-sectional survey, we recruited a convenience sample of 87 Canadian OTs (M_age = 42.74, SD = 9.11, 95% female) working with clients living with VL. The survey contained questions about cognitive tool use in practice, self-perceived satisfaction with clinical service, cognitive test administration strategies as well as need for increased clinical competency through educational means. Data were analyzed using descriptive, parametric, and non-parametric tests.

Results : Only two OTs reported using cognitive measures that had been developed for clients with VL: the MoCA-Blind and the COGnitive Evaluation in VISual impairment. Service delivery ability was significantly lower when working with clients with dual sensory loss/DSL when compared to those with VL only (p < .001, d = -0,83). Accommodative strategies included encouraging clients to use their visual aids during the cognitive screening (VL: n = 83; DSL: n = 62). OTs also offered vision and/or hearing aids for their clients to perform the cognitive tests (VL: n = 40; DSL: n = 41). The number of strategies reported during the cognitive screening of clients with VL and self-reflected service delivery satisfaction were not correlated (r(85) = .17, p = .118, 95% CI [-0.04, 0.37]). However, a significant correlation was identified between service satisfaction with clients with DSL and the number of reported strategies (r(85) = .34, p < .05, 95% CI [-0.14, 0.52]).

Conclusions : Future steps are to bridge this gap between evidence-based research and clinical practice in occupational therapy with a continuing education approach. If proven effective, such training could be translated to other healthcare professions to enhance the detection of cognitive dysfunction in clients living with VL.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.