Myers, H, Thomas, E and Dziedzic, KS ORCID: (2010) What are the important components of the clinical assessment of hand problems in older adults in primary care? Results of a Delphi study. BMC Musculoskeletal Disorders, 11. 178 -?.

What are the important components of the clinical assessment of hand problems in older adults in primary care? Results of a Delphi study..pdf - Published Version
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Background: To identify clinical questions and assessments regarded by health care practitioners as important when assessing undifferentiated hand pain or problems in adults aged 50 years and over presenting to primary care.

Methods: A purposively selected panel of 26 UK-based Health Care Practitioners comprising occupational therapists, physiotherapists, rheumatologists and general practitioners, were invited to take part in a consensus study involving three postal rounds of a Delphi questionnaire with accompanying case scenarios. Participants were asked to generate questions and assessments (round 1), rate their importance (round 2), and vote on which items were most important (round 3).

Results: Sixteen Health Care Practitioners agreed to participate with 11 completing all three rounds. The first round of the Delphi study generated 156 questions and 143 assessments. After three rounds agreement was reached on the importance of 25 questions and 19 assessments. Questions were weighted towards current symptoms, but also included the history of previous hand problems, self-reported hand function, co-morbidity and general health. Observation and palpation of features predominated in the choice of assessment, but specific tests, grip strength, evaluation of sensation and hand function were also included.

Conclusions: A pool of clinical questions and assessments were generated by Health Care Practitioners, and those considered most important for assessing older adults presenting with undifferentiated hand pain and hand problems in primary care were identified. Further evaluation is required to establish the reliability and feasibility of using these questions and assessments in primary care. In particular, the relative contribution of these questions and assessments in evaluating the nature and severity of hand problems, assisting diagnosis, indicating appropriate management, and predicting future course requires further investigation.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via BioMed Central at - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: pain, hand pain, hand function
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 19 Nov 2014 10:45
Last Modified: 17 Dec 2018 12:12

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