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Current practice and challenges in screening for visual perception deficits after stroke: a qualitative study.

Kathleen Vancleef1, Michael J Colwell1, Olivia Hewitt2

  • 1Department of Experimental Psychology, University of Oxford, Oxford, UK.

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Current stroke rehabilitation practices for visual perception screening are inconsistent and lack standardized tools. There is a clear need for evidence-based, efficient visual perception screening methods to improve patient care.

Keywords:
Visual perceptionassessmentbarriersclinical needsfacilitatorsscreeningstroke

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Ophthalmology

Background:

  • Visual perception deficits are common after stroke.
  • Current screening practices are varied and often inadequate.
  • There is a need for improved screening tools.

Purpose of the Study:

  • To document current clinical practices and identify needs in visual perception screening post-stroke.
  • To inform the development of new, effective screening tools.

Main Methods:

  • Qualitative study involving interviews with 12 occupational therapists and 13 orthoptists.
  • Thematic analysis using the Value Proposition Canvas framework.

Main Results:

  • Understanding of visual perception varied among clinicians.
  • Occupational therapists primarily screened for visual field deficits and hemispatial neglect.
  • Common challenges included lack of time, training, and non-evidence-based tools.
  • Facilitators included practical, quick tools and streamlined care pathways.

Conclusions:

  • Current screening is non-standardized and often misses higher-level visual perceptual deficits.
  • An evidence-based, brief (≤15 min), portable, and aphasia-friendly screen is needed.
  • Enhanced training and collaboration between occupational therapists and orthoptists are crucial.
  • Standardized assessments like the Rivermead Perceptual Assessment Battery are recommended.