Document Type



Media is loading

Publication Date



psychosocial factors, hand therapy, rehabilitation, hand injury, biomechanical model


Presentation: 40:33

Presentation completed in partial fulfillment of a Post Professional Occupational Therapy Doctorate degree at Thomas Jefferson University.


Background: Hand therapists utilize special skills in assessing, planning, and treating patients to prevent dysfunction, restore function, and/or reverse the progress of pathology of the upper limb to enhance an individual’s ability to execute tasks and participate fully in life. However, little is known about how hand therapists address psychosocial factors in patients with complex traumatic hand injuries (CTHIs) and their perspectives on how physical and psychological adaptation is required following hand trauma to optimize care.1

Purpose: To identify Certified Hand Therapists’ (CHTs) perceptions of the impact and implications of psychosocial factors in patients with CTHIs by analyzing qualitative data from previously conducted interviews with CHTs.2

Study Design: Descriptive qualitative

Methods: CHTs participated in semi-structured interviews in a previously conducted study.2 Interview data from 14 participants was analyzed using Braun & Clarke’s3, 4 six phases of reflexive thematic analysis to explore the data.

Results: We identified multiple psychosocial factors exhibited by patients with CTHIs, the effects of these factors on a patient’s quality of life, and the barriers CHTs face when addressing these factors. Drawing upon the biopsychosocial model,5 we grouped themes into the four interrelated components of the Model: 1) rehabilitation practice patterns, 2) psychosocial factors, 3) social factors, and 4) physical factors.

Conclusion: Despite current evidence, CHTs are addressing psychosocial factors in the clinic. Many emphasized the use of therapeutic use of self (TUOS) and referral to other healthcare professionals, while others utilized therapy sessions to address these factors. Further, CHTs identified a need to address psychosocial issues by acknowledging the importance of a standardized assessment for patients with CTHIs. Some addressed psychosocial issues, and others focused on barriers to implementing the biopsychosocial model, such lacking training, being employed in settings with high caseloads, and having minimal access to privacy.


  1. Ladds E, Redgrave N, Hotton M, Lamyman M. Systematic review: Predicting adverse psychological outcomes after hand trauma. Journal of Hand Therapy. 2017;30(4):407-419. doi:10.1016/j.jht.2016.11.006.
  2. Dodson, J. Current practice guidelines of certified hand therapists in rehabilitation of complex traumatic hand injuries: A Cross-sectional Survey. 2022.
  3. Braun V, Clarke V. Thematic analysis: A practical guide. QMiP Bulletin. 2022;1(33):46-50.doi:4fcde8323e12a8b47b6d3ecb8bd03ced.
  4. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101. doi: 10.1191/1478088706qp063oa.
  5. Owen L. Highlights unlocking biopsychosocial. 2004.


This study was an important step towards understanding the perceptions of CHTs concerning the impact and implications of a patients’ overall well-being after experiencing a complex traumatic hand injury. Findings from this study highlights the unique ways in ways CHTs address mental health issues, the importance of addressing these issues, and how mental health issues can affect a patient’s recovery. This study also highlights the importance of a more holistic approach to care, like the biopsychosocial model. Addressing mental health issues is within the scope of practice for occupational and physical therapists, therefore applying a more holistic approach to care can facilitate a patients’ return to life roles more successfully.