Pain is common in adults with CF, irrespective of clinical status, and may interfere with important physiotherapy treatments. Although pain intensity is generally mild, those with a negative emotional response to pain have significantly impaired HRQOL.

Occupational therapists have a unique contribution to make in encouraging meaningful occupation on hospital wards. Identifying the manner by which occupational therapists can most effectively implement the assessment of occupational performance in the acute care setting should constitute a research priority for future investigations.

Occupational therapists working in the field of hand therapy tend to follow a reductionist biomedical approach in their practice. This emphasis means that there is the potential to lose the occupational focus in interventions with this client group. The International Classification of Functioning, Disability and Health (World Health Organisation 2001) could be used as a framework to examine the consequences of hand injuries. By taking all four conceptual domains into account when treating this client group, it may be possible not only to examine, for example, range of movement and tendon glide but also to start looking at the occupational impact on people's activity performance and social participation following hand impairment, as well as to explore the variations of the occupational impact that these injuries have on people's lives.

No abstract