Running head: OCCUPATIONAL PROFILE AND INTERVENTION PLAN

Occupational Profile and Intervention Plan

Tiffany Poon
Touro University Nevada

Occupational Profile
The patient is a 31 year old female. She lives in Las Vegas, Nevada with her husband,
who she has been married to for five years. She recently gave birth to their new baby boy. They
moved here several years ago from Nigeria, Africa. Her husbands family currently lives in Las
Vegas; however, the patients family still resides in Nigeria. She works as a custodian at the
MGM Grand Hotel and Casino, while her husband is a valet driver for the same hotel. The
patient and her husband currently live in a single story one bedroom and one bathroom home in
South Las Vegas. She has not been home with her newborn son since his birth.
The patient checked into Spring Valley Hospital when she felt initial labor contractions.
She went into labor at 36 weeks. One week prior to going into labor, the patient came to the
emergency room because she had been having constant diarrhea for over five days. She was
prescribed anti-diarrheal medication, but the diarrhea did not stop and she sought no further
medical help. On the day of labor, the patient was not able to give birth vaginally, and had a

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cesarean section. During labor, doctors confirmed she was infected with Clostridium difficile (Cdiff). Her son was taken to the newborn intensive care unit in precaution. The patient was
admitted to the intensive care unit (ICU) due to complications. The complications included high
fever, tachycardia, diarrhea, abdominal pain, and fluid retention. The client has no prior medical
history and was a healthy young woman before the infection. She was independent in all areas of
occupations and was living a meaningful life.
The patient is seeking services based on her newly acquired complications inhibiting her
from engaging in her desired occupations. She demonstrates high motivation to get better in
order to return home to her son. The patients current concerns are related to her fluid retention
causing complications such as overwhelming edema in both of her lower extremities. Also,
because she has minimized mobility and is unable to breast feed her son, she cannot lose the
weight in her abdominal area. These complications decrease her endurance, strength, and balance
while engaging in occupations such as grooming, dressing, and toileting. She also expresses
concern in managing her pain. She hopes to return home to her son as soon as possible, but states
that she just does not know how she will be able to take care of herself and her son
independently.
The patient is able to dress her upper body, feed, and eat independently. However, these
occupations are completed as the patient is seated, requiring increased time and rest breaks. She
is unable to bathe, toilet, perform grooming and hygiene activities, dress her lower body, and
functionally transfer and ambulate without assistance. She is unable to independently participate
in these occupations based on her decreased balance, decreased strength, decreased endurance,
and increased pain.
In the ICU environment, the patient is able to participate in many of her occupations but
the setting does prevent her from generalizing the skills into her natural environment. In the ICU
room, meals are brought in daily and the bathroom is located ten feet from the edge of her bed.

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She is able to eat her meals on a tray and perform hygiene and grooming activities seated in a
chair. She receives intravenous therapy for pain management and diuretics for fluid retention.
However, due to her tachycardia, she was taken off diuretics. Nurses come into her room
frequently to check on her health and to administer more medication as necessary. Her husband
stays with her overnight and well into the day. He has not gone to work for two weeks. The
patient seems to become less motivated as her stay in the ICU prolongs.
Due to the patient being only 31years old and just having a newborn son, she has a lot of
life to live and look forward to. She is young and strong enough to overcome her complications,
infection, and acute pain. She shows potential in pain management and edema management to
live a fully functional and independent life. The patient will not be immediately returning to
work due to being on maternity leave and her current health condition. The patient will be able to
focus on her overall health and taking care of her baby when discharged home. The patient also
states that she has a great support system from her family.
The patient has been pregnant and was on maternity leave when she was admitted to the
hospital. She previously worked five days a week, 40 hours a week. As a custodian, she was
required to perform standing, bending, and walking tasks. During her maternity leave, her day
normally consisted of doing housework, running errands, spending time with friends and family,
and cooking for her husband. She also stated that she enjoyed reading books and preparing for
her sons birth. She spoke fondly of her son and how she cannot wait to get home to him. Asking
about her son, both her and her husband beamed with joy and shared stories about the babys
hair, personality, and health.
The patients main priority is to return home as quickly as possible to take care of her
son. She showed desire to be independent in all areas of occupations again, but wants to focus on
transfers, toileting, lower extremity dressing, and grooming and hygiene. However, she states
that she does not feel strong or have enough endurance to complete these occupations at the

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moment without assistance. She also desires to keep her pain at a manageable level and eliminate
all edema in her lower extremities, and in her abdominal area. She states she is afraid of the pain
she may feel once she is no longer on high doses of medication. She participates in occupational
therapy interventions with maximum encouragement. She states she is willing to do whatever it
takes to be in her own home with her husband and baby.
Occupational Analysis
The setting in which occupational therapy services took place was on the ICU floor at
Spring Valley Hospital. The initial evaluation occurred in the patients hospital room with an
occupational therapist (OT), physical therapist (PT), and a nurse present. In the hospital room,
the toilet and bathroom sink are ten feet from the patients hospital bed. Also in the room, there is
numerous hospital equipment and most are connected with lines to the patient. There is limited
space within the hospital room making therapy sessions slightly difficult with several members
of the interdisciplinary team present.
The patient participated in the evaluation by answering questions about her prior level of
functioning and her current home. After the interview, the patient participated in activities such
as bed mobility, lower body dressing, functional ambulation, and toileting. The patient was
supine in bed upon entering the room. She had difficulty moving from supine to sitting edge of
bed. The OT helped the patient roll to her side by instructing her to grab onto the bed rails. The
PT stood in front of the patient and moderately assisted her to sit up and ensured the patient
maintained sitting balance. Then the OT provided the patient with hospital socks and asked if the
patient could don the socks independently. The patient was unable to reach farther than her knees
due to fluid retention in her abdominal area and lower extremities. The patient also stated she felt
weak and tired. The OT then donned the patients socks. Afterwards, the PT moderately assisted
the patient to stand utilizing a front wheel walker for balance. Using the front wheel walker, the

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patient functionally ambulated to the toilet with minimum assistance, increased time, and rest
breaks. At the toilet, the OT moderately assisted the patient onto and off the toilet. The patient
required maximum assistance to clean her perineal area.
While observing the patient, there were many inhibiting factors affecting her
performance. The patient was unable to sit upright without support from a therapist and support
from one of her upper extremities due to lack of strength and balance in her trunk. The patient
was unsuccessful in donning socks. She was unable to lift her legs and reach down to her feet
because of her enlarged abdominal area and extremely swollen lower extremities. The patient
needed assistance to stand due to decreased strength in her lower extremities and excess weight
in her body from her pregnancy and fluid retention. The patient required a front wheel walker to
ambulate to the toilet and moderate assistance. At the toilet, the patient required assistance to
lower and rise from the toilet and to clean her perineal area due to the same complications
aforementioned.
The patients main diagnosis, and reasoning for being in the ICU, is due to complications
from being infected with C-diff during and after labor. The patient has not been discharged
because of her fluid retention, tachycardia, pain, and being diagnosed with colitis one and a half
weeks into her stay. With her current health condition, the patient is unable to perform various
occupations, such as activities of daily living (ADLs). Participating in occupations is vital to
allow her to live a satisfying life.
There are multiple client factors which impact the patients ability to successfully engage
in occupations. The patient values her family and wishes to get better to return home to them as
soon as possible. She also believes that things happen for a reason, and that a higher power is
taking care of her. Specific body functions impacting the patient include significant pain,
decreased strength and endurance, decreased energy and sleep, limited range of motion, and
impaired gait patterns. While observing the patient interact and move within her environment,

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her slight inability to align and stabilize herself impacted her performance. Motor skills she is
unable to perform include bending the trunk, transferring, ambulating safely and independently,
and enduring through an activity. These skills directly relate to her inability to perform
occupations. Process skills and social interaction skills were not affected.
The patient fulfills the roles of a wife, daughter, friend, and mother. These identified roles
enable her to find importance in life and increases her motivation to improve her health
condition. She desires to return back to her daily routine such as daily household chores and
returning to work. However, she states that she would like to create a new routine in taking care
of her son and herself when she returns home. This routine would include the occupations of
child rearing and health management. Prior to hospitalization, the patients daily activities were
active and productive. An obstacle for the patient to overcome presently, is working through pain
and fatigue, both mentally and physically.
Problem List
Problem Statement One
Client requires max (A) to perform edema management in bilateral LE due to strength,
balance, & pain.
Problem Statement Two
Client requires mod (A) in functional toilet transfers due balance & strength.
Problem Statement Three
Client requires max (A) in pain management due to pain tolerance, dependence on
pain medications, & motivation.
Problem Statement Four
Client requires max (A) in LE dressing activities due to ROM, strength, & balance.

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Problem Statement Five

Client requires min (A) in grooming & hygiene due to strength & balance.
Justification
The above problem list is ranked in sequential order with the highest priority item being
listed first. The patient must be educated in edema management. The fluid retention in her
abdominal area and lower extremities are impacting her participation in occupations. By
educating the patient in edema management, the patient can continuously utilize these techniques
and speed the recovery process. The next problem identified is her current inability to transfer to
the toilet independently. The skills gained in toilet transfers can easily be generalizable to other
occupations. Next, the patient is highly reliant on medication given through intravenous therapy.
The patient shows low tolerance of pain due to a decrease in motivation and heightened anxiety.
By addressing pain management, the patient will gain skills needed to manage her pain without
the reliance on medication when she returns home. The patients inabilities to independently
dress her lower extremities and perform grooming and hygiene activities are also areas of
concern. These problems are listed in order of importance to the patient, but are also listed in a
way that each problem will assist in the accomplishment of the next problem area.
Intervention Plan and Outcomes
Long Term Goal
Client will perform daily edema management in bilateral LE (I) within 1 wk.
Short term goal 1a. Client will don ted hose stockings on bilateral LE c min (A) & will
wear for duration of 6 hours/day within 4 days.
Short term goal 1b. Client will perform edema management techniques c SPV within 4
days.
Long Term Goal

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Client will perform functional toilet transfers c mod (I) using FWW in hospital room
within 1 wk.
Short term goal 2a. Client will functionally ambulate to toilet in hospital room c mod (I)
using a FWW within 4 days.
Short term goal 2b. Client will stand-to-sit & sit-to-stand from toilet in hospital room c
mod (I) using grab bars & FWW within 4 days.
Intervention 1a
Provide education on edema management through the use of training and demonstrating
of donning and doffing ted hose stocking. Both the husband and the patient will be educated on
the significance of keeping the stockings on for as long as possible. While the patient is laying
supine in the hospital bed, the OT will dress one lower extremity with the stocking while
teaching strategies to both the husband and the patient. One strategy includes a simplified way to
initially put the stockings on. Another strategy include breathing techniques for the patient while
the stockings are being put on to manage pain. Then, the husband will utilize the strategies and
the observed skill from the OT to dress his wifes other lower extremity. Then, in collaboration,
the therapist and patient will set a goal of how long the stockings will stay on for the day. Assign
the patient to keep track of how long the stockings stayed on for that day. The end goal will be
having the patient tolerate the stockings for six consecutive hours. With the stockings on, the
patient can participate in other meaningful occupations to distract from the pain. Activities can
include brushing hair or applying makeup and working on the photo album for her son. Lastly,
inform the nurse that the patient should be wearing the ted hose stockings for the majority of the
day.
The most appropriate intervention approach is prevent (disability prevention). By
addressing the edema in her lower extremities, the patient will have more success leading to

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independence in the near future. By wearing the ted hose stockings, there will be prevention of
further complications relating to edema. This will then also allow an increase in overall health
and wellness.
A study done by Partsch, Winiger, and Lun (2004) investigated compression pressure to
prevent further leg swelling. Twelve participants lower legs were measured in the morning and
then after seven hours of wearing compression stockings. This procedure was carried out for four
days. Each day, the participants wore different compression levels on only one leg in a random
order. The study concluded that compression stockings with a pressure range between 11 to 21
millimeters of mercury reduced or totally prevented further evening edema. (Partsh et al., 2004).
The main outcome of this intervention is participation. Currently, the patient is unable to
participate in her desired occupations due to the overwhelming edema in her lower extremities.
Because of the patients decreased tolerance of pain, this intervention focuses on goal setting for
the duration of wearing the stockings. By utilizing ted hose stockings, her swelling will decrease
and her participation in meaningful occupations will increase.
Intervention 1b
The patient must comply with several edema management techniques. This is the
patients first experience of excessive fluid retention and overwhelming swelling that inhibits her
participation in many occupations. The intervention focuses on educating the patient on edema
management techniques for the lower extremities, modifications in her diet, and selfmanagement skills. The patient will receive skilled instruction on techniques to help alleviate her
edema such as elevating her legs in bed by always having a pillow rested under her legs.
Additional techniques include sitting in a chair to be in a reclined position or keeping the legs
elevated with a stool or leg rest. Also, education of gentle massage would be useful to the patient
and her husband. The therapist will then educate the patient in simple diet modifications such as
reducing her salt intake and maintaining a healthy diet rich in fruits and vegetables which can all

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reduce inflammation. Lastly, the patient will be educated in self-management skills in edema
management. The patient must feel confident to carry out instructions for the prescribed diet and
medical management. The patient may practice these skills throughout her stay in the hospital.
The more redundant and normal these skills become for her, it is more likely that she will retain
the skills at discharge. After thoroughly educating the patient, she will demonstrate her learned
skills while also participating in a meaningful occupation such as grooming. The husband can
also participate in gentle massaging of the patients legs. The therapist will then ask the patient to
state appropriate food choices for lunch that day to ensure diet modification. The therapist will
provide immediate feedback. The therapist will also have the patient record edema management
techniques she felt were most successful. This activity will encourage self-management skills.
The approach to this intervention is establish, restore (remediation, restoration). The
patient will be establishing new skills to manage her edema. With these skills, the patient will be
able to prevent further disability and complications related to her fluid retention.
The article by Ely, Osheroff, Chambliss, and Ebell (2006) provided clinically oriented
recommendations for the management of leg edema in adults. This article included multiple
causes and types of leg edema and provided a brief, focused review of each type. The review
describes management of each particular edema. Each review emphasized the importance of
utilizing edema reducing techniques, such as elevating the leg, wearing compression stockings,
and modifying diet even when on prescribed diuretics (Ely et al., 2006).
The main outcome achieved is participation; however, improvement in occupational
performance, quality of life, and prevention is also appropriate. By providing the patient with
skills to self-manage her edema, she will be able to implement the learned techniques into her
daily routine. This implementation will allow the patient to fully participate in occupations.
Intervention 2a
One of the patients main desires is to be able to transfer and use the toilet without the
assistance of others. Prior to being admitted to the hospital, the patient was independent in

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toileting and would like to return to normal function as soon as possible. The patients ability to
functionally ambulate to the toilet safely is a concern while in the hospital and when the patient
is discharged home. She has never utilized a front wheel walker to ambulate; however, the
patient shows quick skill retention in appropriately using the walker. Although the patient shows
motivation in this activity, the patient requires verbal cues to slow down and to watch her step. In
this intervention, the patient will transfer from edge of bed to standing with the front wheel
walker for assistance. Once her standing balance is stabilized, the therapist will assist the patient
in ambulating to the toilet. The therapist will also utilize a wheelchair, following behind the
patient, for safety and rest breaks. During this intervention, the therapist will provide client
education such as energy conservation techniques including deep breathing and taking frequent
rest breaks. Therapist will also provide education to the husband and include some suggestion for
home modifications.
The intervention approach is establish, restore (remediation, restoration). Due to the
patients complications, she is unable to get to the toilet in a timely manner without having an
accident. This causes the patient a tremendous amount of stress and frustration. This intervention
will restore her ability to ambulate safely and in a timely manner to the restroom.
Harris and Shadid (2014) studied the positive effects of early mobilization of patients in
the ICU. They determined that early mobilization is a safe and cost-effective strategy to improve
patient outcomes. Having the patient participate in early mobilization such as functionally
ambulating to the bathroom is a safe activity if not over-challenging the patient (Harris &
Shadid, 2014).
The patients ability to functionally ambulate to the restroom will be improved through
the implementation of this intervention. Improvement in her occupational performance is one
expected outcome. Participation in a desired occupation is also an expected outcome. This
intervention will provide ways to enhance the patients participation in toileting independently.

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By addressing functional ambulation within the restroom, the patient will be able to participate in
toileting as well as other desired activities.
Intervention 2b
The patients inability to raise and lower herself onto the toilet seat is another area of
concern. Due to her complications such as excessive fluid retention in her abdominal area and
extremely swollen legs, she experiences lack of strength, balance, and endurance. She requires
assistance in this area based on the stated deficits. The patient will participate in raising and
lowering herself on and off the toilet with the therapists guidance and/or assistance as needed.
Before beginning the activity, the therapist will educate the patient in strategies such as proper
techniques to use when sitting and standing. Then demonstration of the proper use of the grab
bars and the walker while lowering herself down onto the toilet seat will be shown to the patient.
Also, the therapist will remind the patient about the energy conservation techniques utilized in
previous activities. The patient can then practice utilizing the strategies, energy conservation
techniques, and walker to lower herself onto a regular chair. Once the patient is ready to practice
on the toilet or actually needs to use the toilet, the therapist will have the patient ambulate to the
restroom or either be pushed in a wheelchair. This will depend on the patients current activity
tolerance. Using a wheelchair to get to the restroom will give the patient a sufficient amount of
energy to safely and appropriately transfer onto the toilet. Education will also be provided to the
husband to ensure his understanding and ability to aid the patient in transfers following
discharge.
The approach of this intervention is establish, restore (remediation, restoration). This
intervention will restore the patients ability to raise and lower herself onto the toilet seat.
Another appropriate approach to this intervention is modify (compensation, adaptation). The
patient utilized modifications such as grab bars and a front wheel walker to provide balance and

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support. By modifying the patients environment, her performance in this activity will increase
and she will find more satisfaction in her performance.
Blair (1999) studied the effects of self-care ADLs on self-esteem in nursing home
residents. The participants were cognitively and physically intact and able to perform ADLs.
Group one received a combination of regular nursing care, an educative and supportive system of
care, and environment modifications. The next treatment included the regular routine nursing
care. Following a two-week baseline period, the groups were compared on their self-care ADLs
and self-esteem. Group one did significantly more self-care activities and had significantly
higher self-esteem (Blair, 1999). This study shows by providing more education and support
such as the specialized instructions of occupational therapy, the patient will have increased selfesteem. With an increase in self-esteem, the patient will increase their participation of important
occupations such as toileting.
Restoring the patients ability to raise and lower herself onto the toilet seat will most
greatly affect her quality of life. Being independent in toileting and back to normalcy, the patient
will have hope and realize that she can reach a goal even after all the hardships she has recently
encountered. Being independent in this occupation will improve the patients overall life
satisfaction and well-being.
Precautions and Contraindications
Precautions related to edema management include patients health literacy and
motivation. Because of the patients cultural background, her health literacy is affected.
However, having the therapist continue to emphasize the importance of participating in the above
interventions is beneficial. Also, addressing and re-explaining medical complications will also be
beneficial for the patient and her husband. The therapist and the patient must work together to
ensure effective communication. The patient must also take an active role in her health related
decisions and develop strong health information skills. Having the therapist utilize the teach-

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back technique can help with developing effective health communication skills. Another
precaution relating to the patients edema management is her motivation. The patient has begun
to feel less motivated to return back to health due to her decrease in pain tolerance. This inhibits
her from participating in edema management techniques.
During toilet transfers, there are several precautions. Some precautions include pain and
activity tolerance. If the patient is experiencing a high level of pain while performing any part of
the toilet transfer, the activity should be terminated. The patient should then be returned to bed
and be given a bed pan, if needed. The patients vital signs should also be assessed and reported
back to the nurse due to the patients status in the ICU. However, utilizing clinical judgment, the
patient can be instructed to take a short rest break and utilize breathing techniques instead of
returning straight to bed. The therapist can also provide more assistance to have the patient be
successful in completing the activity.
Frequency and Duration
The client will be seen daily in her hospital room located on the ICU floor. Occupational
therapy treatment will last between 30 to 45 minutes a day. The amount of time for the
intervention will vary based on the patients ability to participate in activities that day. Being in
the ICU, the patients negative health status is difficult to approximate and will take clinical
judgment to assess when first arriving in the patients hospital room. The expected length of stay
is approximately two weeks, or until the treating physician allows discharge.
Grading Up and Grading Down
Functionally ambulating to and from the toilet is an activity that can be graded up and
down in a variety of ways. A method to grade this activity up is to have the patient ambulate to a
restroom that is outside of her hospital room. This would require the patient to have increased
activity tolerance, increased balance and stability, and the ability to maneuver through more
obstacles. This would also require the patient to have more skill and practice utilizing the front
wheel walker. In the restroom, the toilet may be different than the toilet in the hospital room

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which will have the patient utilize her generalizing skills. The therapist will still provide
assistance as necessary.
To grade this activity down, the patient will complete this activity in her hospital room.
The therapist can provide a wheelchair for the patient if she suddenly feels too tired and needs a
rest break. Another method of grading down is having the patient ambulate to the toilet, but then
be pushed back from the toilet in the wheelchair. The therapist can also provide increased verbal
and physical cues. Whether choosing to grade the activity up or down, the therapist must find the
just right challenge. The activity must not be too simple where there is no new learning.
However, the patient must not over exert herself and become frustrated in the activity.
Primary Framework
The primary framework that is utilized to guide this intervention plan is the PersonEnvironment-Occupational-Performance Model (PEOP). The PEOP model takes into account the
patients intrinsic factors, extrinsic factors and overall occupational performance and
participation in the interventions. During the above interventions, the patients intrinsic factors
were addressed through her psychological functioning. This was done by making sure the patient
could be successful in completing an intervention. The patients cognitive functioning was
addressed by having the interventions both explained and demonstrated to assure the patient
understood the correct way to perform an activity. The patients physiological functioning was
addressed when implementing breathing techniques when the patient felt shortness of breath or
fatigue during an activity. Her physical limitations were addressed when completing the toilet
transfers and utilizing compensatory strategies to overcome her temporary weakness.
The extrinsic factors of the patient were addressed through consideration of the
environmental factor related to the patient. There were modifications made to the patients
current environment in her hospital room. A modification included having a stool in front of a
chair to have the patient continuously self-practice edema management techniques. Also a bed

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pan was placed on a bedside table just in case she had no assistance to toilet transfer. The
therapist also provided suggestions to modify the patients home environment to allow for more
accessibility and safety upon discharge.
The interventions are aimed to directly assist the patients ability to participate in the
related occupations. Participating in occupations such as health management and toilet transfers,
and being successful in the activities better prepare the patient for discharge. Upon and after
discharge, the patient will be able to participate in any additional meaningful activities. The
interventions above are patient-centered, taking the patients view of her problems as the primary
concern. Her perception of her own occupational performance issues is the cornerstone of the
interventions.
Training and Education
Both the patient and husband will receive individualized instruction and education about
the patients complications. Skilled instruction about edema management will be reviewed. Also
the patients ability to safely and efficiently use the toilet will be addressed. Training and
education will be provided throughout the therapy session. This is provided through instruction
and demonstration of all interventions. A specific technique for patient education is utilizing the
teach-back method. Because the patient had no prior illnesses and begins to find it difficult to
stay motivated, providing frequent feedback throughout interventions is crucial. Feedback will
be given during the patients participation in activities to ensure she is performing it correctly
and appropriately. Continuously educating the patient and the husband will enhance her recovery
and participation in meaningful occupations.
Clients Response
When the initial evaluation was conducted, the patient was assessed using the Functional
Independence Measure (FIM). The patients abilities to participate in toilet transfers and toileting
were observed and given a FIM score. After a therapy session where toilet transfers were
addressed, a new FIM score was given based on the patients performance. Comparing the initial

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FIM score to the current FIM score upon discharge, will show a direct indication of the patients
gains. For edema management, the patients edema in her lower extremities can be measured
using the two different methods. One is volumetry and the other is assigning a pitting grade for
the edema. Both methods are effective ways to track and measure edema after treatment sessions.

References
American Occupational Therapy Association. (2014). Occupational therapy practice framework:
Domain and process (3rd ed.). American Journal of Occupational Therapy, 68 (Suppl. 1),
S1-S48. doi: 10.5014/ajot.2014.682006
Blair, C. (1999). Effect of self-care ADLs on self-esteem of intact nursing home residents.
Issues in Mental Health Nursing, 20(6), 559-570. doi: 10.1080/016128499248367
Ely, J., Osheroff, J., Chambliss, L., & Ebell, M. (2006). Approach to leg edema of unclear
Etiology. Journal of the American Board of Family Medicine, 19(2), 148-160. doi:
10.3122/jabgm.19.2.148

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Harris, C., & Shahid, S. (2014). Physical therapy-driven quality improvement to promote early
mobility in the intensive care unit. Proceedings (Baylor University, Medical Center),
27(3), 203-207. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059563/
Partsch, H., Winiger, J., & Lun, B., (2004). Compression stockings reduce occupational leg
swelling. Dermatologic Surgery, 5, 737-743. doi: 10.1111/j.1524-4725.2004.30204.x