Understanding Occupational Therapists’ Knowledge and Confidence When Assessing for Spatial Neglect: A Special Issue Review

Abstract

Importance: Spatial neglect (SN)—failure to respond to stimuli on the side of the body contralateral to a poststroke lesion—is one of the most disabling impairments for stroke survivors, and 80% of stroke survivors may have undetected SN. Occupational therapists’ evaluations should include determining the impact of poststroke SN. Objective: To investigate occupational therapists’ confidence, knowledge, current practices, barriers, and facilitators when assessing for SN in adult stroke survivors. Design: A 30-item survey was created with guidance from stroke rehabilitation occupational therapists who reviewed the survey for face and content validity. Setting: Online survey. Participants: Occupational therapist survey responders (N = 76). Outcomes and Measures: Self-report assessments were used to measure occupational therapists’ confidence in identifying SN, SN assessment practices, and barriers to and facilitators of SN assessment. Knowledge of SN signs and symptoms, neuroanatomy, and clinical presentation were measured with a three-question quiz. Results: Eighty-one percent of the respondents reported a high level of confidence in identifying SN, and 70% reported routinely assessing for SN, with 81% using clinical observation rather than standardized tools as the primary assessment method. Barriers to SN assessment included time and resources. Conclusions and Relevance: Most respondents, despite reporting high levels of confidence with routine SN assessments, did not use standardized SN measures and demonstrated suboptimal knowledge of SN. These results emphasize the need to increase clinical education about SN and its assessments. Plain-Language Summary: This study gathered baseline information on an underinvestigated topic—occupational therapists’ education, confidence, current practices, barriers, and facilitators when assessing for spatial neglect in adult stroke survivors. The study results also contribute to future research on occupational therapists’ current confidence and knowledge when assessing for spatial neglect.