一位60歲男性罹患嚴重的類風濕性關節炎，導致明顯的天鵝頸畸形，目前正準備出院。他告訴護理師：「我以前很喜歡煮飯，但現在我的手痛到連拿菜刀、轉開罐子或自己扣襯衫的釦子都沒辦法。我回家後到底該怎麼辦？」護理師應優先將其轉介給哪一位跨領域團隊成員？
A 60-year-old male with severe rheumatoid arthritis resulting in pronounced swan-neck deformities is preparing for discharge. He tells the nurse, "I used to love cooking, but now my hands hurt so much I can't even hold a knife, twist open a jar, or button my own shirt. How am I supposed to manage at home?" The nurse should prioritize a referral to which interdisciplinary team member?
- ADietitian營養師
- BPhysical Therapist (PT)物理治療師 (PT)
- CMedical Social Worker (MSW)醫療社工師 (MSW)
- DOccupational Therapist (OT)✓ 正解職能治療師 (OT)
本題測驗病患出院準備與正確的跨領域團隊（Interdisciplinary Team）轉介。此病患的生命徵象穩定，主要的困境在於手部關節變形阻礙了精細動作技能（Fine motor skills），進而嚴重影響了日常生活活動（ADL）的獨立性，如烹飪開瓶與穿衣扣鈕扣。職能治療師（Occupational Therapist, OT）的專長正是協助病患透過生活環境改造、動作適應訓練及客製化輔助器具（如大握柄餐具、拉鍊輔助器）來重獲獨立生活的技能。選項B的物理治療師（PT）主要處理大肌肉群的問題（Gross motor skills），如轉位、步態訓練與下肢肌力；選項C社工師處理社會資源與補助；選項A營養師規劃飲食配方，皆不直接解決手部精細動作與輔具使用的障礙。
The client’s difficulty with fine motor tasks and activities of daily living due to rheumatoid arthritis deformities requires specialized intervention. An occupational therapist is best suited to teach compensatory techniques and provide adaptive devices to help the client regain independence in daily activities.
台美在 OT 與 PT 的臨床分工完全一致，OT (職能) 著重於上半身、精細動作及 ADL 輔助；PT (物理) 著重下半身、大肌肉及步態。美國在保險給付上極度依賴嚴格的字面定義來分工。