Page 207 - Hospital Authority Convention 2017
P. 207

Corporate Scholarship Presentations



                C3.3      Allied Health and Pharmacy                                       14:30  Room 428

               Bridging the Service Gap of Stroke Care – Formal Vision Screening by Orthoptists
               Tam WH
               Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong                HOSPITAL AUTHORITY CONVENTION 2017
               According to the statistical report of Hospital Authority (HA) in 2014-2015, there were about 3,000 stroke inpatients under
               care in HA hospitals.  Extensive international studies have shown that ocular and visual problems are common in post-stroke
               patients. In UK, 70% to 80% patients suffer from visual difficulties following stroke. There is no data of the prevalence of
               visual problems among stroke survivors in Hong Kong as many post-stroke patients had undetected or undiagnosed ocular
               and visual problems. Formal visual evaluation is not included in current stroke care pathway.
               Most of the visual problems are not detected by simply observing the individual. It requires questioning and assessment
               to detect and subsequently make an accurate diagnosis. Thus, visual impairment following stroke may be missed or
               misdiagnosed.  Visual  symptoms  can  be poorly  defined by  patients  and  particularly  when  individuals  have  co-existing
               communication problems and cognitive impairments.
               Orthoptists are allied health profession in the field of ophthalmology who work closely with ophthalmologists. They specialise
               in the assessment of visual function and monitoring of visual development. They also assess, investigate and treat ocular
               muscle  defects. Many tests used  by  the  orthoptist are non-verbal  and therefore  responses  can  still be  obtained even
               communication problem exists after stroke.

               In UK, orthoptists are essential in the care and management of stroke patients by contributing their specialist knowledge
               and skills as part of the stroke multi-disciplinary team. The role of orthoptic service is highly recommended and recognised
               in stroke rehabilitation. Through the collaboration with multi-disciplinary team, early orthoptic assessment can be provided.
               Realistic goals can be set and therapy can be adapted to suit the needs of the patients. It is hoped that through the precious
               experiences in UK, further improvement in the management of stroke patients could be achieved.










                C3.4      Allied Health and Pharmacy                                       14:30  Room 428

               STarT Back – a Biopsychosocial Approach in the Management of Low Back Pain
               Lam P
               Physiotherapy Department, Queen Mary Hospital, Hong Kong

               STarT Back Approach is a stratified care approach used in UK. The approach comprises of the STarT Back Screening Tool
               and the matched treatment pathway. The STarT Back Screening Tool is a simple prognostic questionnaire based on the
               identified and modifiable risk factors (biomedical, psychological and social) of poor clinical outcome or poor prognosis in
               persistent disability due to back pain. The questionnaire allocates non-specific back pain patients into high, medium or low
               risk group of chronicity. Each risk group is matched to corresponding treatment pathway.
               Back pain patients of low risk group are provided with advice, information and reassurance of self-management. Back pain   Wednesday, 17 May
               patients of medium risk group mainly have physical obstacles to recovery, and are provided with good quality physiotherapy
               treatment. Back pain patients of high risk group have additional psychological obstacles to recovery, and are given enhanced
               package of care with psychologically informed physiotherapy.

               The treatment approach emphasises the good use of communication skills. Therapist guides the patient with non-directional
               questioning  together  with  an  active listening  approach  that  facilitates  self-disclosure  on  the  patient side  with  an  aim  to
               understand how they feel and think about their pain. Explaining pain in neuroscience evidence, they encourage patients to
               accept it rather than control it. Through motivational skills, they are guided to build a meaningful life based on their chosen
               values. This biopsychosocial model allows the physiotherapist to have a better understanding of the patients’ behaviour in
               relation to their pain journey and would therefore be able to develop a treatment programme that suits the patient’s pace and
               encourages success in different stages of the rehabilitation process.
               The STarT Back Screening Tool and the matched treatment pathway in UK demonstrated to be clinically and cost effective for
               patients with back pain in primary care management.










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