Date of Award

3-7-2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.)

School Name

College of Health Professions

Department

Health Professions

Major Advisor

Dr. Megan Danzl, PT, DPT, PhD, NCS

Second Advisor

Dr. Barbara Jackson, PhD, RN

Third Advisor

Dr. Tara Ising, PhD

Abstract

Hand allotransplantation is a treatment option available for individuals who have suffered a traumatic upper extremity injury. To date, there is not an industry-standard recognized measurement tool for assessing post-hand allotransplantation functional performance. A commonly used observational functional assessment tool is the Carroll Upper Extremity Function Test (UEFT). This dissertation explores therapists’ perceptions of the Carroll UEFT applicability to measure functional outcomes post-hand allotransplantation. The study employed a qualitative phenomenological approach with in-depth, semi-structured interviews with seven occupational and physical therapists representing five hand transplant centers in the United States. Braun and Clarke’s (2006) six-phase thematic analysis approach was utilized for data analysis. The findings revealed four primary themes: 1) scoring is too vague and subjectivity prevails, 2) questionable reliability of the scores, 3) translates to real-life functional tasks, and 4) outcomes affecting decisions. The four themes were then analyzed through the theoretical framework lens of Kane’s argument-based approach to validation in which four inferences must be met: scoring, generalization, extrapolation, and implications. Empirical data from this study did not fully meet the criteria of Kane’s four inferences to support the use of the Carroll UEFT to measure functional outcomes post-hand-allotransplantation. The rehabilitation services fields associated with hand allotransplantations can incorporate the findings of this study into existing literature and collaborate to continue the investigation of an industry standard to measure functional outcomes post-hand allotransplantation.

Keywords: hand transplant, functional outcomes, treatment outcomes, Carroll UEFT, Kane’s argument-based approach to validation

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