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Changes in problematic activities of daily living in persons with COPD during 1 year of usual care.
Nakken, N, Janssen, DJA, Wouters, EFM, van den Bogaart, EHA, Muris, JWM, de Vries, GJ, Bootsma, GP, Gronenschild, MHM, Delbressine, JML, van Vliet, M, et al
Australian occupational therapy journal. 2020;(5):447-457
Abstract
INTRODUCTION Persons with chronic obstructive pulmonary disease (COPD) are often limited in performing their activities of daily living (ADLs). However, it remains unknown whether and to what extent problematic ADLs change over time and whether exacerbation-related hospitalisations affect problematic ADLs. Therefore, we investigated self-reported problematic ADLs of persons with COPD during 1 year of usual care (i.e. without a specific experimental intervention). METHODS Stable persons with moderate to very severe COPD (n = 137) were included in this longitudinal study (registered in the Dutch Trial Register [NTR 3941]). Participants were visited at home at baseline and after 1 year. Participants with an exacerbation-related hospitalisation during follow-up were visited additionally within 2 weeks after hospital discharge. During all visits, participants' personalised problematic ADLs were assessed using the Canadian Occupational Performance Measure (COPM), and perceived performance and satisfaction of important problematic ADLs were rated on a 10-point scale. RESULTS In total, 90% of the participants reported at least one new important problematic ADL after 1 year. In the subgroup of participants with an exacerbation-related hospitalisation (n = 31), 92% of the participants reported new problematic ADLs 2 weeks after discharge and 90% reported new problematic ADLs again after 1 year. Only the satisfaction score of problematic ADLs as mentioned during baseline improved after 1-year follow-up in all participants (p = .002) and in participants without an exacerbation-related hospitalisation (n = 106; p = .014). CONCLUSION Problematic ADLs changed during 1 year of usual care, which underlines the need for regular assessment of problematic ADLs and referral to treatment options like monodisciplinary occupational therapy and/or a comprehensive pulmonary rehabilitation programme.
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Occupational therapy to improve quality of life for colorectal cancer survivors: a randomized clinical trial.
Yang, SY, Wang, JD, Chang, JH
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2020;(3):1503-1511
Abstract
PURPOSE To determine the potential effects of a healthy lifestyle education provided by occupational therapists on quality of life (QoL), activities of daily living, and healthy lifestyle behavior in colorectal cancer (CRC) survivors. METHODS Sixty-eight participants were randomly assigned to either an occupational therapy (OT) intervention or a non-intervention group (in a 1:1 ratio). Participants in the OT intervention group were given an OT consultation based on a healthy lifestyle education handbook for CRC at discharge and at a 1-month and 3-month clinic follow-up; participants in the non-intervention group were given the same CRC education handbook only at discharge preparation without further consultation. The primary outcome was based on the QoL measured using the World Health Organization QoL-BREF (WHOOQOL-BREF). Outcomes were examined at discharge preparation as baseline and at a 1-month as well as 3-month clinic follow-up. RESULTS After controlling for demographic and income variables, we found statistically significant improvement in the scores on two items in the WHOQOL-BREF, including "overall quality of life" and "negative feelings" (p < 0.05) in the OT intervention group. CONCLUSIONS OT consultation sessions based on healthy lifestyle at discharge and in the first 3 months after discharge may improve the QoL of CRC survivors. TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT03521765?cond=Quality+of+Life+in+colorectal+cancer+survivors&rank=1.
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Adaptive Eating Device: Performance and Satisfaction of a Person with Parkinson's Disease.
Cavalcanti, A, Amaral, MF, Silva E Dutra, FCM, Santos, AVF, Licursi, LA, Silveira, ZC
Canadian journal of occupational therapy. Revue canadienne d'ergotherapie. 2020;(3):211-220
Abstract
BACKGROUND.: Individuals with Parkinson's disease (PD) can experience motor impairments related to their hand-use that restrict participation in daily activities. Feeding is one activity impacted by this health condition. The use of adapted utensils can improve performance and independence in this activity. PURPOSE.: To investigate if a locally designed and made eating-adaptive device helps a person with PD to improve their feeding performance. METHOD.: Single-case ABC-type experimental design. Performance and satisfaction of a 60-year-old man with PD were assessed during feeding tasks in 70 sequential days in three phases. Celeration Line, Two-Standard Deviation Band, and Visual Analysis were the methods used for data analysis. FINDINGS.: Performance and satisfaction increased significantly after the introduction of the adaptive eating device. The addition of weight also contributed to the increase in the participant's performance. IMPLICATIONS.: Adaptive eating device with low production costs and possibility of customized adjustments improves performance of people with PD.
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Effect of Enhanced Medical Rehabilitation on Functional Recovery in Older Adults Receiving Skilled Nursing Care After Acute Rehabilitation: A Randomized Clinical Trial.
Lenze, EJ, Lenard, E, Bland, M, Barco, P, Miller, JP, Yingling, M, Lang, CE, Morrow-Howell, N, Baum, CM, Binder, EF, et al
JAMA network open. 2019;(7):e198199
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Abstract
IMPORTANCE Enhanced medical rehabilitation (EMR) is a systematic and standardized approach for physical and occupational therapists to engage patients. Higher patient engagement in therapy might lead to improved functional recovery in rehabilitation settings, such as skilled nursing facilities (SNFs). OBJECTIVE To determine whether EMR improves older adults' functional recovery. DESIGN, SETTING, AND PARTICIPANTS A double-blind, parallel-group, randomized clinical trial was conducted from July 29, 2014, to July 13, 2018, in 229 adults aged 65 years or older admitted to 2 US SNFs. Participants were randomized to receive EMR (n = 114) vs standard-of-care rehabilitation (n = 115). Intention-to-treat analysis was used. INTERVENTIONS The intervention group received their physical and occupational therapy from therapists trained in EMR. Based on models of motivation and behavior change, EMR is a toolkit of techniques to increase patient engagement and therapy intensity. The control group received standard-of-care rehabilitation from physical and occupational therapists not trained in EMR. MAIN OUTCOMES AND MEASURES The primary outcome was change in function in activities of daily living and mobility, as assessed with the Barthel Index, which measures 10 basic activities of daily living or mobility items (scale range, 0-100), from SNF admission to discharge; secondary outcomes were gait speed for 10 m, 6-minute walk test, discharge disposition, rehospitalizations, and self-reported functional status at days 30, 60, and 90. To examine the rehabilitation process, therapists' engagement with patients and patient active time during therapy were measured for a sample of the sessions. RESULTS Of the 229 participants, 149 (65.1%) were women; 177 (77.3%) were white, and 51 (22.3%) were black; mean (SD) age was 79.3 (8.0) years. Participants assigned to EMR showed greater recovery of function than those assigned to standard of care (mean increase in Barthel Index score, 35 points; 95% CI, 31.6-38.3 vs 28 points; 95% CI, 25.2-31.7 points; P = .007). There was no evidence of a difference in the length of stay (mean [SD], 23.5 [13.1] days). However, there were no group by time differences in secondary outcome measures, including self-reported function after SNF discharge out to 90 days as measured on the Barthel Index (mean [SE] score: EMR, 83.65 [2.20]; standard of care, 84.67 [2.16]; P = .96). The EMR therapists used a median (interquartile range) of 24.4 (21.0-37.3) motivational messages per therapy session vs 2.3 (1.1-2.9) for nontrained therapists (P < .001), and EMR patients were active during a mean (SD) of 52.5 (6.6%) of the therapy session time vs 41.2 (6.8%) for nontrained therapists (P = .001). CONCLUSIONS AND RELEVANCE Enhanced medical rehabilitation modestly improved short-term functional recovery for selected older adults rehabilitating in SNFs. However, there was no evidence that the benefits persisted over the longer term. This study demonstrates the value of engaging and motivating older adults in rehabilitation therapy, but more work is needed to extend these benefits to longer-term outcomes after discharge home. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02114879.
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Occupational therapy intervention addressing weight gain and obesity in people with severe mental illness: A scoping review.
Conn, A, Bourke, N, James, C, Haracz, K
Australian occupational therapy journal. 2019;(4):446-457
Abstract
BACKGROUND Individuals diagnosed with severe mental illness have higher rates of obesity than the general population due to a range of factors, including: medication side effects, poor nutrition and reduced physical activity. Obesity is associated with increased mortality and reduced quality of life. Evidence suggests that lifestyle interventions can be effective in addressing this issue. While such interventions would appear to fit within the scope of practice of occupational therapy, there is no publication synthesising the existing literature regarding occupational therapy interventions addressing lifestyle factors associated with obesity. AIM: To determine what is known from the existing literature about occupational therapy interventions addressing weight gain and obesity in adults diagnosed with severe mental illness. METHODS A scoping review was conducted. Searches were performed in online databases, occupational therapy journals and grey literature databases. Thematic analysis occurred across all articles included in the review. RESULTS A total of 14 articles were included in the review. Analysis revealed a central theme of supporting occupational performance and participation in health promoting occupations. This central theme consisted of four categories; facilitating client-centred practice, addressing personal performance issues, addressing environmental barriers and providing the 'just right' challenge. CONCLUSION/SIGNIFICANCE These findings suggest occupational therapists are providing occupation focused interventions that are aligned with current clinical guidelines. However, more research is required to strengthen evidence-based occupational therapy practice in this important area.
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Psychosocial Benefits of Cooking Interventions: A Systematic Review.
Farmer, N, Touchton-Leonard, K, Ross, A
Health education & behavior : the official publication of the Society for Public Health Education. 2018;(2):167-180
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OBJECTIVES Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. METHODS A systematic review of the literature examined peer-reviewed research using Embase, PubMed, CINALH Plus, and PsychInfo with the following search terms: cooking, culinary, baking, food preparation, cookery, occupational therapy, mental health, mood, psychosocial, affect, confidence, self-confidence, self-esteem, socialization, and rehabilitation. Inclusion criteria were the following: adults, English, influence of cooking interventions on psychosocial outcomes. PRISMA guidelines were used. RESULTS The search yielded 377 articles; and 11 ultimately met inclusion criteria and were reviewed. Generally, the quality of the research was weak due to nonrandomization, unvalidated research tools, and small sample sizes. However, inpatient and community-based cooking interventions yielded positive influences on socialization, self-esteem, quality of life, and affect. CONCLUSIONS Finding benefits to cooking that extend beyond nutritional may be helpful in increasing motivation and frequency of cooking. This review suggests that cooking interventions may positively influence psychosocial outcomes, although this evidence is preliminary and limited. Further qualitative and rigorous quantitative research are needed to identify mechanisms by which cooking interventions may improve psychosocial outcomes.
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Effectiveness of Interventions for Weight Loss for People With Serious Mental Illness: A Systematic Review and Meta-Analysis.
Brown, C, Geiszler, LC, Lewis, KJ, Arbesman, M
The American journal of occupational therapy : official publication of the American Occupational Therapy Association. 2018;(5):7205190030p1-7205190030p9
Abstract
OBJECTIVE We examined the effectiveness of weight loss interventions in community-based settings for people with serious mental illness (SMI). METHOD Four databases were searched for randomized controlled trials published in 2008 or later that met the criteria for the research question and used weight loss as an outcome measure. Data were extracted, and weight loss was analyzed using a meta-analysis. Similarities and differences in interventions were analyzed qualitatively. RESULTS Seventeen studies and a total of 1,874 participants with various diagnoses of SMI were included in the meta-analysis. The various lifestyle-focused interventions had a significant effect on weight loss with an overall effect size of -0.308 (p < .001). CONCLUSION Community-based interventions for people with SMI are effective for weight loss. Occupational therapists can be involved in the provision of weight loss interventions and in the development and study of intervention components that are most effective.
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Prefeeding Oromotor Stimulation Program for Improving Oromotor Function in Preterm Infants - A Randomized Controlled Trial.
Arora, K, Goel, S, Manerkar, S, Konde, N, Panchal, H, Hegde, D, Mondkar, J
Indian pediatrics. 2018;(8):675-678
Abstract
OBJECTIVE To determine effect of Premature Infant Oral Motor Intervention program on oro-motor function and time to full independent wati spoon feeds in preterm infants. METHODS 30 preterm infants between 28-32 weeks of gestation on full gavage feeds of 150 mL/kg/day were randomized to receive either pre-feed oro-motor stimulation using Premature Infant Oral Motor Intervention (structured stimulation) or sham intervention (unstructured stimulation). RESULTS Improvement in mean (SD) Neonatal Oro-Motor Assessment Scale (NOMAS) over 7 days from baseline was significantly higher in the study group infants as compared to control group (9.25 (1.73) vs 4.79 (1.52), P=0.001). Infants in the study group reached full independent wati spoon feeds significantly earlier than the infants in control group (4.0 (0.8) d; vs 6.64 (1.0) d; P=0.001). There was significant increase in weight gain after enrolment in infants in study group compared to those in control group. CONCLUSION Oral stimulation program improves the oro-motor skills and growth velocity in 28-32 week preterm infants. There is decreased transition time from gavage to full independent feeds by mouth.
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Measuring personal recovery - psychometric properties of the Swedish Questionnaire about the Process of Recovery (QPR-Swe).
Argentzell, E, Hultqvist, J, Neil, S, Eklund, M
Nordic journal of psychiatry. 2017;(7):529-535
Abstract
BACKGROUND Personal recovery, defined as an individual process towards meaning, is an important target within mental health services. Measuring recovery hence requires reliable and valid measures. The Process of Recovery Questionnaire (QPR) was developed for that purpose. AIMS The aim was to develop a Swedish version of the QPR (QPR-Swe) and explore its psychometric properties in terms of factor structure, internal consistency, construct validity and sensitivity to change. METHODS A total of 226 participants entered the study. The factor structure was investigated by Principal Component Analysis and Scree plot. Construct validity was addressed in terms of convergent validity against indicators of self-mastery, self-esteem, quality of life and self-rated health. RESULTS A one-factor solution of QPR-Swe received better support than a two-factor solution. Good internal consistency was indicated, α = 0.92, and construct validity was satisfactory. The QPR-Swe showed preliminary sensitivity to change. CONCLUSIONS The QPR-Swe showed promising initial psychometric properties in terms of internal consistency, convergent validity and sensitivity to change. The QPR-Swe is recommended for use in research and clinical contexts to assess personal recovery among people with mental illness.
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The long-term (24-month) effect on health and well-being of the Lifestyle Matters community-based intervention in people aged 65 years and over: a qualitative study.
Chatters, R, Roberts, J, Mountain, G, Cook, S, Windle, G, Craig, C, Sprange, K
BMJ open. 2017;(9):e016711
Abstract
OBJECTIVES To assess the long-term effect on health and well-being of the Lifestyle Matters programme. DESIGN Qualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT). SETTING The intervention took place at community venues within two sites in the UK. PARTICIPANTS A purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2 years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being. INTERVENTION Lifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy. RESULTS Interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed. CONCLUSION The majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained. TRIAL REGISTRATION ISRCTN, ISRCTN67209155, post results.