A systematic review and narrative synthesis of occupational therapy-led interventions for individuals with anxiety and stress-related disorders

Occupational therapy and stress-related exhaustion - a scoping review

BACKGROUND

Sick leave due to long-term stress is increasing in Finland and other Western countries. Occupational therapists might contribute to the prevention of and/or recovery from stress-related exhaustion.

AIMS/OBJECTIVES

To describe what is known about occupational therapy for stress-related exhaustion.

MATERIAL AND METHODS

A five-step scoping review included papers published in six databases from 2000 to 2022. Extracted data was summarized to show the occupational therapy contribution within the literature.

RESULTS

There were 29 papers meeting the inclusion criteria, of which a limited number described preventive interventions. Most articles described recovery-oriented occupational therapy with group interventions. The occupational therapists contributed with prevention measures, mostly targeting recovery in multi-professional interventions in terms of stress reduction or return-to-work.

CONCLUSIONS

Occupational therapy involving stress management both prevents stress and supports recovery from stress-related exhaustion. Occupational therapists internationally use craft, nature activities or gardening as stress management measures.

SIGNIFICANCE

Occupational therapy appears to be a potential treatment option for stress-related exhaustion internationally in conditions that could also work in Finland, for example in occupational healthcare.

Characteristics of Occupational Therapy Interventions for Community-Dwelling Adults With Anxiety: Protocol for a Scoping Review

BACKGROUND

Anxiety is linked to decreased life quality and well-being. Living with an anxiety disorder results in higher personal and societal financial expenditure. Occupational therapists work with people living with anxiety in a variety of settings. A preliminary database search was conducted, and no current or underway systematic or scoping reviews on the topic were identified. Developing an overview of studies of occupational therapy interventions for people with anxiety is a necessary first step to understanding the existing knowledge and to increase the impact of future interventions. This scoping review will build on the findings of a previously conducted systematic review.

OBJECTIVE

This scoping review will identify the following: (1) what occupational therapy interventions exist for adults with anxiety and (2) the intervention characteristics including outcomes used and impact observed.

METHODS

This protocol was reviewed by an occupational therapist as part of a patient and public involvement consultation. The review will consider all studies and publications of occupational therapy that include community-dwelling adults with a diagnosis of anxiety who are aged 18 years and older and diagnosed with an anxiety disorder (Diagnostic and Statistical Manual of Mental Disorders [DSM-5-TR] criteria). Databases to be searched are MEDLINE, CINAHL, Cochrane Library, Science Direct, PsycArticles, Psychology & Behavioural Sciences Collection, Embase, PubMed, TRIP, Proquest, Social Care Online, JBI EBP database, OpenGrey, and OALster. Titles and abstracts will be screened against the inclusion criteria using Rayyan Qatar Computing Research Institute. Potentially relevant studies will be retrieved in full and assessed against the inclusion criteria. Articles published in English will be included. No date limiters will be used. Study selection will be completed by 2 independent reviewers. Data will be extracted using a data extraction tool.

RESULTS

Data will be charted using the Template for Intervention Description and Replication (TIDieR) checklist in alignment with the review objectives. The scoping review will be reported in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols statement.

CONCLUSIONS

This scoping review will produce valuable information about community-based interventions used to improve participation, life quality, and well-being for adults with anxiety to support the development of occupational therapy interventions. The findings will be disseminated through professional and National Health Service bodies, employer organizations, conferences, and research articles. The findings will be of value to health care professionals and researchers working to improve the lives of people living with anxiety.

TRIAL REGISTRATION

Open Science Framework DOI 10.17605/OSF.IO/JS549; https://osf.io/js549/.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/41230.

Occupational performance issues in a longitudinal perspective in people with depression and/or anxiety on sick leave, returning to work or working

BACKGROUND

People with depression and anxiety disorder may experience occupational performance issues (OPIs). Further knowledge about these issues longitudinally and about potential differences between people is valuable.

AIM

To explore experienced OPIs longitudinally in a sample living with depression and/or anxiety disorder participating in occupational therapy and varying in terms of their work situation.

MATERIAL AND METHODS

The Canadian occupational performance measure (COPM) was completed by 54 participants with depression and/or anxiety at four measure-points from baseline to one-year after participation in occupational therapy. The participants constituted three groups: continuously on sick leave (SL), returned to work within a year and continuing working. Descriptive and non-parametric analysis was used.

RESULTS

Participants in all groups identified OPIs in all occupational areas in the COPM. All groups increased their occupational performance and satisfaction with their occupational performance in the area socialisation. Each group also made improvements in relation to other occupational areas, varying between the groups.

CONCLUSIONS

OPIs and improvements were identified among the participants regardless of them being on SL, returning to work or working.

SIGNIFICANCE

The diverse nature of OPIs and improvements in the clients indicate the relevance of occupational therapy.

A study protocol of the photo-supported conversations about the well-being intervention (Be Well™) for people with stress related disorders

BACKGROUND

Stress-related illnesses constitute a huge problem in society. The primary care services in Sweden form the first line of care whose role is to coordinate interventions for reducing symptoms, as well as health-promoting interventions. There is lack of knowledge concerning health-promoting interventions for these illnesses. The aim of this study is to evaluate whether photo-supported conversations about well-being (Be Well™) as an intervention, in addition to care as usual within the primary care services, improves health and well-being for patients with stress-related illnesses. The intervention will be compared to a control group, who receive care as usual. A further aim is to conduct a process evaluation.

METHODS/DESIGN

This ongoing project has a quasi-experimental design, using quantitative and qualitative methods, and includes patients from primary care centres in two Swedish counties. Seventy patients, 20-67 years, with stress-related illnesses will be recruited. They constitute an intervention group, which receive the intervention together with care as usual, and a control group, which receive care as usual. The intervention, photo-supported conversations about well-being, involves 12 sessions. Care as usual entails medication, occupational therapy, physiotherapy and/or psychotherapy. Data collection is carried out at baseline, and outcomes are assessed directly after the intervention, as well as six months after completion of the intervention. The outcomes are evaluated based on factors related to health, well-being and everyday occupations. Furthermore, data concerning experiences of well-being and perceptions of the intervention will be collected in interviews. The therapists will also be interviewed about their experiences of performing the intervention. Data will be analysed with non-parametric statistics, and qualitative methodology.

DISCUSSION

The project is based on the concept that focusing on well-being despite living with stress-related illness may positively impact health and well-being as well as activity-related aspects, and that photo-supported conversations about well-being can contribute a complement to other treatment and rehabilitation. A strength is the use of a wide range of methods: such as quantitative measures, photographs, and qualitative interviews with participants and therapists. The results will thus provide knowledge about potential effects of this health-promoting intervention. Trial registration Clinical Trials.gov: NCT04832295; retrospectively registered 2nd April 2021 https://clinicaltrials.gov/ct2/show/NCT04832295.

A feasibility study of the Redesigning Daily Occupations (ReDOTM-10) programme in an Irish context

BACKGROUND

Despite high demand, mental health services in primary care in Ireland are underdeveloped. People with mild/moderate anxiety, depression and unspecified psychological distress are frequently seen in primary care settings, mostly by general practitioners (GPs). Occupational therapists have the potential to contribute to service-provision with interventions specially designed for the targeted group e.g. the Redesigning Daily Occupations programme (ReDO-10).

AIMS/OBJECTIVES

This study aimed to explore the feasibility of a future RCT of the ReDO-10 programme in Ireland and the contextual factors that would influence future implementation.

MATERIAL AND METHODS

Using a multi-phase, mixed-method design, qualitative and quantitative data were gathered from key stakeholders: ReDO-10 participants (n = 10), GPs (n = 9) and occupational therapists (n = 2). Acceptability, satisfaction, cultural fit and demand were explored, as well as methodological issues such as appropriateness of recruitment methods, outcome measures and randomization.

RESULTS

ReDO-10 was acceptable to participants who reported improvements in their occupational patterns and valued the group-based format. GPs and occupational therapists welcomed the intervention, but acknowledged the limitations of time and resources in the Irish primary care context.

CONCLUSIONS

ReDO-10 is feasible to explore in a future RCT in Ireland and this study provides important context for future implementation and/or research.

The experiences of veterans with mental health problems participating in an occupational therapy and resilience workshop intervention: an exploratory study

Introduction

Occupational therapy has long had a strong presence in military mental healthcare. Today’s veterans have complex needs and can face challenges reintegrating into civilian life. This exploratory study investigated whether veterans receiving mental health treatment who participated in a bespoke occupational therapy and resilience workshop intervention improved their perceived participation in everyday life.

Method

An interpretivist hermeneutic phenomenological approach was used to explore veterans’ perspectives. Ten participants took part in two semistructured focus groups. Thematic analysis was used to identify and analyse patterns within the data.

Findings

Most participants developed occupational goals and started to make lifestyle changes; participants developed an appreciation of the value of occupation; participants developed insight into their recovery journeys; and value was placed on the ‘healing power’ of the group.

Conclusion

This exploratory study provides preliminary evidence to suggest occupational therapy was influential in helping participants understand the impact of occupation on health and start making lifestyle changes. Participants also reflected on their recovery journeys. The benefits of doing this within a group environment appear to have been particularly therapeutic. Original occupational therapy research in this specialism is sparse. This novel study provides insight that can further discussion and enhance understanding about what the profession can offer this client group.