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Ekbladh E, Yngve M, Melin J. Initial evaluation of measurement properties of the Work Environment Impact Questionnaire (WEIQ) - using Rasch analysis. Health Qual Life Outcomes 2024; 22:43. [PMID: 38816864 PMCID: PMC11140878 DOI: 10.1186/s12955-024-02260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/21/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND To provide both preventive and rehabilitative conditions in a workplace, one must understand how employees experience work demands. Such an understanding can be obtained from each individual with valid and quality-assured questionnaires. The Work Environment Impact Questionnaire (WEIQ) is a new questionnaire for measuring employees' self-perceived work ability in relation to their specific workplace environment. The purpose of this study was to assess the measurement properties in terms of construct validity of the WEIQ. METHODS A cross-sectional survey study was conducted with 288 respondents from three different workplaces involving assisted living personnel, vocational rehabilitation personnel and personnel at a research institute. The measurement properties of the WEIQ were assessed according to Rasch Measurement Theory (RMT), including assessment of item-to-sample targeting, threshold ordering, item fit statistics, unidimensionality and reliability. RESULTS Item fit, i.e., fit residuals, item characteristic curves (ICC) and chi square values, were all satisfactory, and no disordered thresholds were present after collapsing the lowest response categories. However, issues with local dependent (LD) item correlations was present in 7.6% cases, four items showed statistically significant differential item functioning (DIF), where 11% of the respondents had person fit residuals outside the recommended range of ± 2.5 and the t-test for unidimensionality did not meet the criterion of 5%. Scale-to-sample targeting and reliability (0.92) were good. LD could be resolved with testlets and at the same time maintaining fit and improving dimensionality, but then the reliability decreased to 0.82. CONCLUSIONS This study provides an initial validation of the WEIQ to be used for assessing employees' self-perceived work ability. Most measurement properties were acceptable, but further exploration of LD, DIF and unidimensionality in additional work settings and with larger sample sizes is warranted. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Elin Ekbladh
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, 601 74, Sweden.
| | - Moa Yngve
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, 601 74, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jeanette Melin
- Division Safety & Transport, Department Measurement Science and Technology, RISE Research Institutes of Sweden, Gothenburg, Sweden
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2
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Mitterfellner R, D'Cunha NM, Isbel S. Occupation-Based Interventions to Improve Occupational Performance Among Older Adults Living in Long-Term Care: A Systematic Review. Am J Occup Ther 2024; 78:7801205140. [PMID: 38231082 DOI: 10.5014/ajot.2024.050441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
IMPORTANCE Evidence for the positive effects of occupation-based interventions on occupational performance is increasing; however, little is known about the impacts of occupation-based interventions on older adults living in long-term care. OBJECTIVE To consolidate the evidence on the effectiveness of occupation-based interventions for improving occupational performance among older adults living in long-term care. DATA SOURCES MEDLINE, CINAHL, PsycINFO, SCOPUS, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from journal-database inception to February 2023. STUDY SELECTION AND DATA COLLECTION This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles were peer-reviewed studies published in English that evaluated occupation-based interventions for older adults living in long-term care and used validated tools to measure occupational performance. FINDINGS Seventeen articles, with 2,974 participants, were identified. The reviewed studies included 6 Level 1b randomized controlled trials, 5 Level 2b studies of various study designs, and 5 Level 3b studies with quasi-experimental designs. Across studies, heterogeneous measures were used to assess occupational performance. All studies implemented client-centered, occupation-based interventions designed and/or delivered by occupational therapists. Interventions were tailored to residents' goals, interests, or abilities to improve occupational performance and participation, and inconsistent effects were reported. CONCLUSIONS AND RELEVANCE Moderate evidence supports the use of occupation-based interventions tailored to individual residents and incorporation of physical activities for improving the occupational performance of older adults living in long-term care. Currently, evidence for care partner involvement and multilevel occupation-based interventions is limited. Plain-Language Summary: This study adds to the evidence base indicating that occupation-based interventions have the potential to promote the occupational performance of older adults living in long-term care. High-quality randomized controlled trials with longer term follow-up and assessment of clinically meaningful outcomes are critical for developing the evidence base in this practice setting.
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Affiliation(s)
- Rachael Mitterfellner
- Rachael Mitterfellner, MOT, BMedSc, is Occupational Therapist, Canberra Health Services, and Professional Associate, Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia. At the time of this research, Mitterfellner was Postgraduate Research Student, School of Exercise and Rehabilitation Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Nathan M D'Cunha
- Nathan M. D'Cunha, PhD(Health), BHumNutr(Hons), is Assistant Professor, Human Nutrition, School of Exercise and Rehabilitation Sciences, Faculty of Health, and Theme Lead (Dementia and Cognition), Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Stephen Isbel
- Stephen Isbel, HScD, MOT, MHA, BAppSc(OT), GCTE, is Professor, Occupational Therapy, School of Exercise and Rehabilitation Sciences, Faculty of Health, and Theme Lead (Innovative Care Models), Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia;
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Gately ME, Metcalf EE, Waller DE, McLaren JE, Chamberlin ES, Hawley CE, Venegas M, Dryden EM, O’Connor MK, Moo LR. Caregiver Support Role in Occupational Therapy Video Telehealth: A Scoping Review. TOPICS IN GERIATRIC REHABILITATION 2023; 39:253-265. [PMID: 37901356 PMCID: PMC10601380 DOI: 10.1097/tgr.0000000000000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Caregiver involvement may facilitate patient participation in occupational therapy (OT) video telehealth. However, little is known about the extent to which caregivers participate and what they do. This scoping review aims to, 1) describe the caregiver role supporting patient participation in OT video telehealth, and, 2) identify barriers and facilitators to caregiver involvement. Findings reveal caregiver involvement in a range of OT evaluation and intervention processes, with details on what caregivers did overall lacking. Barriers and facilitators are also described. This study underscores the need for clear and robust descriptions of caregiver participation to increase best practices in video telehealth.
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Affiliation(s)
- Megan E. Gately
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Boston University School of Medicine, Department of Medicine, Division of Geriatrics, Boston, MA, USA
| | - Emily E. Metcalf
- VA Palo Alto Health Care System, National Center for PTSD, Dissemination and Training Division, Menlo Park, CA, USA
| | - Dylan E. Waller
- VA Portland Health Care System, Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR, USA
| | - Jaye E. McLaren
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
| | - Elizabeth S. Chamberlin
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- VA Bedford Health Care System, VISN 1 Mental Illness Research, Education, and Clinical Center (MIRECC), Bedford, MA, USA
| | - Chelsea E. Hawley
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Boston University School of Medicine, Department of Medicine, Division of Geriatrics, Boston, MA, USA
| | - Maria Venegas
- Boston University School of Medicine, Department of Medicine, Division of Geriatrics, Boston, MA, USA
- VA Bedford Health Care System, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, MA, USA
| | - Eileen M. Dryden
- VA Bedford Health Care System, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, MA, USA
| | - Maureen K. O’Connor
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Boston University School of Medicine, Neurology Department, Boston, MA, USA
| | - Lauren R. Moo
- VA Bedford Health Care System, New England Geriatric Research Education and Clinical Center (GRECC), Bedford, MA, USA
- Massachusetts General Hospital, Cognitive Behavioral Neurology Unit, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
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4
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Alegre-Ayala J, Vela-Desojo L, Fernández-Vázquez D, Navarro-López V, Macías-Macías Y, Cano-de-la-Cuerda R. Occupational performance skills in Parkinson's disease: relationship with health-related quality of life and caregiver burden. Rev Neurol 2023; 77:3-11. [PMID: 37365719 PMCID: PMC10663802 DOI: 10.33588/rn.7701.2023097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION The progression of Parkinson's disease (PD) results in a loss of ability to performance activities of daily living and health-related quality of life. The objectives of this study were to establish the relations between occupational performance skills and health-related quality of life, and the degree of caregiver burden in PD patients. PATIENTS AND METHODS Forty-nine patients at different stages of PD according to the Hoehn and Yahr scale participated in the study. Patients were assessed using the Parkinson's Disease Questionnaire (PDQ-39), the EuroQoL (EQ-5D), the Assessment of Motor and Process Skills (AMPS), and the Zarit Caregiver Burden Interview (ZCBI). RESULTS Strong correlations were found between the motor skills section of the AMPS scale and the PDQ-39 (r = -0.76; p = 0.001), and the EQ-5D questionnaires (r = 0.72; p = 0.001), while moderate correlations were found with the process skills. AMPS process skills were moderately correlated with mobility and activities of daily living. The ZCBI was only weakly correlated with the AMPS motor skills (r = -0.34; p = 0.02). CONCLUSION Declining scores on the AMPS scale are closely related to the loss of health-related quality of life in PD patients, and, to a lesser extent, with the degree of caregiver burden.
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Affiliation(s)
| | - L Vela-Desojo
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, España
| | | | | | - Y Macías-Macías
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, España
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Mahmoodkhani M, Aminmansour B, Shafiei M, Hasas M, Tehrani DS. Citicoline on the Barthel Index: Severe and moderate brain injury. Indian J Pharmacol 2023; 55:223-228. [PMID: 37737074 PMCID: PMC10657618 DOI: 10.4103/ijp.ijp_570_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is a paramount factor in mortality and morbidity. The clinical trials conducted to investigate the efficacy of neuroprotective agents, such as citicoline, as a therapeutic alternative for TBI have presented divergent findings. Therefore, this study aimed to evaluate and compare citicoline's effect on the Barthel Index in patients with severe and moderate brain injury. MATERIALS AND METHODS The study is a randomized clinical trial. Patients in the case group (35 patients) were treated with citicoline and the control group (34 patients) received a placebo. Data were analyzed using SPSS 16 software. RESULTS The results showed that changes in the Glasgow Coma Scale, changes in quadriceps muscle force score, Barthel Index score changes, achieving the status without intubation, and spontaneous breathing in patients treated with citicoline were not a statistically significant difference in the two groups (P > 0.05). CONCLUSION Findings revealed that citicoline did not impact the recovery process of severe and moderate TBI patients.
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Affiliation(s)
- Mehdi Mahmoodkhani
- Department of Neurosurgery, School of Medicine, Neurosciences Research Center, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Aminmansour
- Department of Neurosurgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Shafiei
- Department of Neurosurgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Hasas
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
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Fabricius J, Huynh MNM, Pedersen AR, Sampedro Pilegaard M. Predicting length of stay with assessment of motor and process skills in subjects with acquired brain injury. Brain Inj 2023; 37:1-6. [PMID: 36597272 DOI: 10.1080/02699052.2022.2163291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/30/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The Functional Independence Measure (FIM) is a well-established predictor of length of stay (LOS) for rehabilitation. The Assessment of Motor and Process Skills (AMPS) is a more in-depth construct for measuring activities of daily living (ADL) and may therefore be a valuable adjunct when predicting LOS. This paper aimed to investigate AMPS as a candidate predictor of LOS in a statistical model including FIM. METHODS A cohort study of 647 patients with acquired brain injuries admitted for rehabilitation. LOS was analyzed in a multiple regression model with the motor and process/cognitive domains of AMPS and FIM. RESULTS Independence in ADL process ability and FIM cognition were associated with 31% (p < 0.001) and 38% (p < 0.001) shorter LOS, respectively, relative to patients needing total assistance. Independence in ADL motor ability was associated with a 26% (p = 0.002) shorter LOS, whereas FIM motor was not a predictor. CONCLUSIONS The AMPS predicts LOS for rehabilitation at a level that is at least as good as that of FIM. Conducting the AMPS early in the course of inpatient rehabilitation provides clinicians and managers with valuable information for planning LOS.
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Affiliation(s)
- Jesper Fabricius
- Department of Research, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Martin Nhut Minh Huynh
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Asger Roer Pedersen
- Department of Research, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Marc Sampedro Pilegaard
- Department of Social Medicine and Rehabilitation, Gødstrup Hospital, Denmark
- DEFACTUM, Central Region Denmark, Aarhus, Denmark
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7
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Kehrer AL, Barkocy B, Downs B, Rice S, Chen SW, Stark S. Interventions to promote independent participation among community-dwelling middle-aged adults with long-term physical disabilities: a systematic review. Disabil Rehabil 2022; 44:7739-7750. [PMID: 34757870 DOI: 10.1080/09638288.2021.1998668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE People aging with long-term physical disabilities (PAwLTPD) are aging at an accelerated rate beginning in middle-age. They face age-related challenges in conjunction with their existing disabilities; thus, maintaining independence as they age is often difficult. The aim of this systematic review was to examine the effectiveness of rehabilitation interventions for middle-aged PAwLTPD to participate independently in the home and community. MATERIALS AND METHODS We searched four databases - MEDLINE, CINAHL, Web of Science, and EMBASE - for studies published from January 2005 to December 2020. Information from included studies was extracted using a critical appraisal form. Studies were categorized based on common themes, assigned level of evidence, and assessed for risk of bias. RESULTS Fourteen articles were included. Common themes derived were fall risk reduction, functional capacity, community mobility, and function within the home. The strongest evidence supports wheelchair skills training programs (WSTPs) among manual wheelchair users and targeted paretic limb exercise post-stroke. Moderate evidence supports exercise and multicomponent interventions for those with multiple sclerosis, adaptive strategy training and WSTPs to improve satisfaction with mobility for power wheelchair users, and home modifications/assistive technology for mobility-impaired individuals. CONCLUSION Interventions with strong and moderate evidence should be routinely offered for middle-aged PAwLTPD. Future research should focus on developing evidence-based interventions for middle-aged PAwLTPD.IMPLICATIONS FOR REHABILITATIONMiddle-aged PAwLTPD face the same aging-related challenges as people without disabilities but will experience additional difficulties due to compounding effects of long-term health conditions and aging.Current effective interventions to promote participation for middle-aged PAwLTPD have been measured over a wide range of outcomes, and many interventions should be used by clinicians on a case-by-case basis.Wheelchair skills training was found to have the strongest evidence and is recommended for use with middle-aged PAwLTPD who use manual and power wheelchairs.
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Affiliation(s)
- Abigail L Kehrer
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Brianna Barkocy
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Britney Downs
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan Rice
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Szu-Wei Chen
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan Stark
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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8
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Omura KM, Augusto de Araujo Costa Folha O, Moreira PS, da Silva Bittencourt E, Seabra AD, Cardoso MM. Energy conservation, minimum steps, and adaptations when needed: A scoping review. Hong Kong J Occup Ther 2022; 35:125-136. [PMCID: PMC9716468 DOI: 10.1177/15691861221137223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background/objective Although many therapeutic approaches use energy conservation, only a few effectively report the steps involved. Thus, it is intended to identify energy conservation practices to be organized in flexible and adaptable stages. Methods A scoping review was carried out, whose search strategies were applied in seven databases (CINAHL, Cochrane Library, Portal BVS, PsycINFO, PubMed, Scopus, and Web of Science) following guidelines by Arksey and O’Malley on the Rayyan software. Searches were carried out from January 2010 to December 2020. Inclusion of refered publications with different study designs, participation of adults with or by demands of energy conservation, joint protection, and control of fatigue and/or pain. Exclusion of productions without an occupational therapist or involving merely pharmacological or surgical therapeutic strategies. Results 653 articles were identified, after the selection and eligibility steps, 30 articles were full review, 18 articles were included and 635 excluded. Energy conservation studies have been increasingly focusing on neurological and systemic diseases, especially regarding symptoms of fatigue and pain. The findings were arranged in six strategies whose interventions are essentially based on guidelines and setting goals for patients, client-centered approach. Merely supervised interventions are less frequent. The number of sessions is closed, but the duration of treatment is not yet. Conclusions The signs of pain and fatigue are confirmed as indicators of energy conservation strategies, this delivery can be condensed from planning and organization, priorities, activity analysis, balance between activity and rest, outsourcing of tasks and physical/environmental adaptation. Trial Registration, OSF https://osf.io/rsyq4.
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Affiliation(s)
| | | | | | | | | | - Marcelo Marques Cardoso
- Marcelo Marques Cardoso, Faculty of Physiotherapy and Occupational Therapy, Universidade Federal do Pará, Instituto de Ciências da Saúde – Faculdade de Fisioterapia e Terapia Ocupacional (UFPA, ICS – FFTO), Rua Augusto Corrêa, 01 – Guamá, CEP 66075-110. Belém, Pará – Brasil.
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Marston C, Koye DN, Goonan R, Lim K, Juj G, Klaic M. Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study. Aust Occup Ther J 2022; 69:536-545. [PMID: 35502588 DOI: 10.1111/1440-1630.12808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Delivering high-intensity occupational therapy can improve functional outcomes for patients and reduce length of stay. However, there is little published evidence of this in the aged rehabilitation setting. This study aims to explore the association between intensity of occupational therapy interventions and functional outcomes in geriatric rehabilitation inpatients. METHODS A prospective cohort study was conducted with adult inpatients admitted to a geriatric rehabilitation program. The intervention was the intensity of occupational therapy measured as high (≥30 minutes per day) versus low (<30 minutes per day). The primary outcome measured was change in functional performance, defined as a minimum of half a point improvement in the Katz Index of Activities of Daily Living (ADL) and/or the Lawton and Brody Scale of Instrumental ADL (IADL) at admission to rehabilitation, discharge and 3months post-discharge. RESULTS A total of 693 patients were included in the analysis. The mean age was 82.2 years (standard deviation [SD] = 7.9), 57% were females, and 64% had cognitive impairment. Patients (n = 210) who received greater than or equal to 30 minutes of occupational therapy daily were more likely to have clinically relevant functional improvements.; for both ADL (odds ratio [OR] = 1.87, 95% confidence interval [CI]: 1.24-2.83) and IADL (OR = 3.00, 95% CI: 1.96-4.61), after adjusting for age, sex, severity of function (ADL ≤ 2) at admission, frailty and cognitive impairment. Improvements in ADL and IADL were maintained for at least 3 months following discharge. CONCLUSION This study found that geriatric rehabilitation inpatients who received higher intensity of occupational therapy interventions were more likely to functionally improve than those who received lower intensity. Further research is required to determine if other factors, such as therapy type, influence functional outcomes.
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Affiliation(s)
- Celia Marston
- Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Digsu N Koye
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,MISCH (Methods and Implementation Support for Clinical Health research platform), Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rose Goonan
- Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kwang Lim
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Genevieve Juj
- Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Marlena Klaic
- Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Knightbridge L, Bourke-Taylor HM, Hill KD. Healthy ageing through participation in community situated activities: A scoping review of assessment instruments to support occupational therapy practice. Aust Occup Ther J 2022; 69:493-509. [PMID: 35445413 PMCID: PMC9546241 DOI: 10.1111/1440-1630.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/24/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Introduction The occupational therapy profession has an essential role to play in healthy ageing that includes enabling participation, a construct that according to The International Classification of Functioning, Disability and Health (ICF), incorporates an environmental context. Environmental barriers and enablers of participation in community‐situated activities for people over the age of 65 have been identified. To support practice, occupational therapists require assessments with demonstrated content validity including comprehensive coverage of the construct. The purpose of this scoping review study was to investigate what instruments are available to assess community participation for people over the age of 65 that included environmental factors. Methods A scoping review of the literature was conducted, utilising the Joanna Briggs Institute (JBI) scoping review methodology. The evidence source was review articles and inclusion criteria were that they reviewed instruments to assess participation that could be used for people over the age of 65. Items extracted from included instruments were evaluated against a preset list of community‐participation and environment categories that had been developed from the ICF. Results Twenty‐three review studies met inclusion criteria and from these 240 instruments were extracted. Twenty instruments were retained after exclusions and from these, 540 instrument items were extracted. Of these, 280 (47%) were coded as community‐participation, and only 20 (3.4%) as environment items. Fourteen of the instruments included no environment items. Conclusions No instrument was identified that comprehensively assessed community participation including the related environmental factors. Such an instrument is required to enable occupational therapy practitioners to support healthy ageing. The development of such an instrument will strengthen the profession's capacity to develop new ways of delivering services to older adults in line with emerging ways that aged care will be delivered and to advance its essential role in healthy ageing.
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Affiliation(s)
- Lisa Knightbridge
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Frankston, VIC, Australia
| | - Helen M Bourke-Taylor
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Frankston, VIC, Australia
| | - Keith D Hill
- School of Primary and Allied Health Care, Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Faculty Medicine Nursing and Health Sciences, Monash University (Peninsula Campus), Frankston, VIC, Australia
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11
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Williams S, Morrissey AM, Steed F, Leahy A, Shanahan E, Peters C, O'Connor M, Galvin R, O'Riordan C. Early supported discharge for older adults admitted to hospital with medical complaints: a systematic review and meta-analysis. BMC Geriatr 2022; 22:302. [PMID: 35395719 PMCID: PMC8990486 DOI: 10.1186/s12877-022-02967-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Early supported discharge (ESD) aims to link acute and community care, allowing hospital inpatients to return home and continue to receive the necessary input from healthcare professionals that they would otherwise receive in hospital. The concept has shown reduced length of stay and improved functional outcomes in stroke patients. This systematic review aims to explore the totality of evidence for the use of early supported discharge in older adults hospitalised with medical complaints. METHODS A literature search of CINAHL in EBSCO, Cochrane Central Register of Controlled Trials in the Cochrane Library (CENTRAL), EMBASE and MEDLINE in EBSCO was carried out. Randomised controlled trials or quasi-randomised controlled trials were included. The Cochrane Risk of Bias Tool 2.0 was used for quality assessment. The primary outcome measure was hospital length of stay. Secondary outcomes included mortality, function, health related quality of life, hospital readmissions, long-term care admissions and cognition. A pooled meta-analysis was conducted using RevMan software 5.4.1. RESULTS Five studies met the inclusion criteria. All studies were of some concern in terms of their risk of bias. Statistically significant effects favouring ESD interventions were only seen in terms of length of stay (REM, MD = -6.04, 95% CI -9.76 to -2.32, I2 = 90%, P = 0.001). No statistically significant effects favouring ESD interventions were established in secondary outcomes. CONCLUSION ESD interventions can have a statistically significant impact on the length of stay of older adults admitted to hospital for medical reasons. There is a need for further higher quality research in the area, with standardised interventions and outcome measures used.
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Affiliation(s)
- Susan Williams
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ann-Marie Morrissey
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Fiona Steed
- Department of Medicine, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Aoife Leahy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.,Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Elaine Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Catherine Peters
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Margaret O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland.,School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cliona O'Riordan
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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12
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Newnham HH. Acting on better data for general medical care will help solve our acute hospital access crisis. Med J Aust 2022; 216:116-118. [PMID: 35073599 PMCID: PMC9306513 DOI: 10.5694/mja2.51385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022]
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13
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Self-reported quality of life following stroke: a systematic review of instruments with a focus on their psychometric properties. Qual Life Res 2021; 31:329-342. [PMID: 34247327 DOI: 10.1007/s11136-021-02944-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the psychometric properties of common health-related quality-of-life instruments used post stroke and provide recommendations for research and clinical use with this diagnostic group. METHODS A systematic review of the psychometric properties of the five most commonly used quality-of-life measurement tools (EQ-5D, SF-36, SF-6D, AQoL, SS-QOL) was conducted. Electronic searches were performed in MEDLINE, CINAHL, and EMBASE on November 27th 2019. Two authors screened papers against the inclusion criteria and where consensus was not reached, a third author was consulted. Included papers were appraised using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist and findings synthesized to make recommendations. RESULTS A total of n = 50,908 papers were screened and n = 45 papers reporting on 40 separate evaluations of psychometric properties met inclusion criteria (EQ-5D = 19, SF-36 = 16, SF-6D = 4, AQoL = 2, SS-QOL = 4). Studies reported varied psychometric quality of instruments, and results show that psychometric properties of quality-of-life instruments for the stroke population have not been well established. The strongest evidence was identified for the use of the EQ-5D as a quality-of-life assessment for adult stroke survivors. CONCLUSIONS This systematic evaluation of the psychometric properties of self-reported quality-of-life instruments used with adults after stroke suggests that validity across tools should not be assumed. Clinicians and researchers alike may use findings to help identify the most valid and reliable measurement instrument for understanding the impact of stroke on patient-reported quality of life.
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Bowen-Salter H, Kernot J, Baker A, Posselt M, Boshoff K. Self-reported outcome measures for adults with post-traumatic stress disorder: towards recommendations for clinical practice. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.1893615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Holly Bowen-Salter
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Military and Emergency Services Health Australia, The Hospital Research Foundation, Glenside, Australia
| | - Jocelyn Kernot
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Amy Baker
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Miriam Posselt
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Kobie Boshoff
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Psychometric properties of measures of upper limb activity performance in adults with and without spasticity undergoing neurorehabilitation-A systematic review. PLoS One 2021; 16:e0246288. [PMID: 33571238 PMCID: PMC7877653 DOI: 10.1371/journal.pone.0246288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction This systematic review appraises the measurement quality of tools which assess activity and/or participation in adults with upper limb spasticity arising from neurological impairment, including methodological quality of the psychometric studies. Differences in the measurement quality of the tools for adults with a neurological impairment, but without upper limb spasticity, is also presented. Methods 29 measurement tools identified in a published review were appraised in this systematic review. For each identified tool, we searched 3 databases (Medline, Embase, CINAHL) to identify psychometric studies completed with neurorehabilitation samples. Methodological quality of instrument evaluations was assessed with use of the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) checklist. Synthesis of ratings allowed an overall rating of the psychometric evidence for each measurement tool to be calculated. Results 149 articles describing the development or evaluation of psychometric properties of 22 activity and/or participation measurement tools were included. Evidence specific to tool use for adults with spasticity was identified within only 15 of the 149 articles and provided evidence for 9 measurement tools only. Overall, COSMIN appraisal highlighted a lack of evidence of measurement quality. Synthesis of ratings demonstrated all measures had psychometric weaknesses or gaps in evidence (particularly for use of tools with adults with spasticity). Conclusions The systematic search, appraisal and synthesis revealed that currently there is insufficient measurement quality evidence to recommend one tool over another. Notwithstanding this conclusion, newer tools specifically designed for use with people with neurological conditions who have upper limb spasticity, have emergent measurement properties that warrant further research. Systematic review registration PROSPERO CRD42014013190.
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16
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Anderson L, Moran C, Liew S, Kimmel LA. Patients from residential aged care with hip fractures-Does discharge destination from acute care affect outcomes? Australas J Ageing 2020; 39:e522-e528. [PMID: 33161645 DOI: 10.1111/ajag.12824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 05/16/2020] [Accepted: 05/20/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to describe the demographics of patients from residential aged care facilities (RACFs) who underwent fixation of hip fracture and to compare 12-month functional and mortality outcomes for those returning to their RACF with those admitted to a subacute facility (SAF) following their acute hospital stay. METHODS A retrospective review was undertaken of all patients from a RACF with high-level care needs admitted to Alfred Hospital, Melbourne, for fixation of hip fracture in 2014-2015. Data including demographic and hospital event details, length of stay (LOS), discharge destination and 12-month functional outcomes measured by the Glasgow Outcome Scale-Extended (GOS-E), were collected. Factors related to discharge destination and outcomes were analysed. RESULTS Ninety patients from a RACF were included in this study, with 68 patients (76%) returning to their RACF and 22 (24%) admitted to a SAF after acute hospital stay. Those discharged to a SAF had an average LOS at this facility of 20.79 days (SD 8.02). The SAF group also had a longer acute LOS (7 days IQR 5-10, compared to 6 days IQR 4-7.5) but there was no difference between groups at 12 months in terms of mortality or function, with 50% of all patients deceased at this time point (n = 40) and the remaining 40 patients (50%) reporting a poor functional outcome. CONCLUSIONS Mobility status during acute and subacute stay, and 12-month functional and mortality outcomes were similar in both groups irrespective of discharge destination, with the influence of cognition and concomitant medical issues currently unknown. Further research is required to evaluate the efficacy of current hip fracture models of care, the factors that influence clinician discharge planning decision-making and to interrogate new models of care that support rehabilitation and complex medical management in RACFs.
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Affiliation(s)
- Lara Anderson
- Physiotherapy Department, The Alfred, Melbourne, Victoria, Australia
| | - Chris Moran
- Department of Medicine, Peninsula Health and Monash University, Melbourne, Victoria, Australia.,Alfred Health, Melbourne, Victoria, Australia
| | - Susan Liew
- Department of Orthopaedic Surgery, The Alfred, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Lara A Kimmel
- Physiotherapy Department, The Alfred, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Yam N, Murphy A, Thew M. Occupational Therapy for South Asian Older Adults in the United Kingdom: Cross-Cultural Issues. Br J Occup Ther 2020. [DOI: 10.1177/0308022620933207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction There is limited understanding of the cultural needs of diverse Black and Minority Ethnic populations such as South Asian older adults, which may be perpetuating occupational injustices and health inequalities faced by these groups. Although cultural considerations are intrinsic to person-centred occupational therapy and increasingly relevant to the changing landscape of health and social care, the profession is criticised for its western-centric focus. This study aimed to gain understanding of the current cross-cultural issues in supporting South Asian older adults in the UK, as perceived by occupational therapists. Method A constructivist qualitative design supported by thematic analysis was used, involving seven occupational therapists in the United Kingdom who participated in semi-structured interviews via Skype/telephone. Findings Cross-cultural issues were illustrated through the following themes: ‘when the barriers go down’ – cultural mismatch in individualist vs. collectivist worldviews; ‘invasion of the family home’ – cultural inappropriateness of standard interventions; and ‘I go into every assessment assuming nothing’ – recognition of and response to challenges. Conclusion This study provides insight into cross-cultural issues in occupational therapy for South Asian older adults, revealing a gap between theory and practice in integrating cultural humility. It highlights the need for a more inclusive, person-centred approach to support culturally diverse populations.
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Affiliation(s)
- Nichole Yam
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Angela Murphy
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Miranda Thew
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, UK
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18
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Hansen T, Kjaersgaard A. Item analysis of the Eating Assessment Tool (EAT-10) by the Rasch model: a secondary analysis of cross-sectional survey data obtained among community-dwelling elders. Health Qual Life Outcomes 2020; 18:139. [PMID: 32404203 PMCID: PMC7222581 DOI: 10.1186/s12955-020-01384-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/28/2020] [Indexed: 01/19/2023] Open
Abstract
Background The Eating Assessment Tool (EAT-10) is increasingly used to screen for self-perceived oropharyngeal dysphagia (OD) in community-dwelling elders. A summated EAT-10 total score ranges from 0 to 40, with a score ≥ 3 indicative of OD. When using cut-points of a summated score, important requirements for the measurements are specific objectivity, validity, and reliability. Analysis by the Rasch model allows investigation of whether scales like EAT-10 satisfy these requirements. Currently, a few studies have found that EAT-10 responses from clinical populations with OD do not adequately fit the Rasch model. Purpose The aim of this study was to determine whether measurements by EAT-10 fit the Rasch model when applied in screening self-perceived OD in non-clinical populations. Methods Secondary analysis was conducted on data from a cross-sectional survey of community-dwelling elders living in a municipal district of Tokyo, Japan, in which 1875 respondents completed the Japanese version of EAT-10 (J-EAT-10). Data were cleaned and recoded for the purpose of the analysis in this study, which resulted in inclusion of J-EAT-10 responses from 1144 respondents. Data were analyzed using RUMM2030 and included overall model fit, reliability, unidimensionality, threshold ordering, individual item and person fits, differential item functioning, local item dependency, and targeting. Results The analysis identified that the response categories from zero to four were not used as intended and did not display monotonicity, which necessitated reducing the five categories to three. Considerable floor effect was demonstrated and there was an inappropriate match between items’ and respondents’ estimates. The person separation reliability (PSI = 0.65) was inadequate, indicating that it is not possible to differentiate between different levels of OD. Several items displayed misfit with the Rasch model, and there were local item dependency and several redundant items. Conclusions J-EAT-10 performed less than optimally and exhibited substantial floor effect, low reliability, a rating scale not working as intended, and several redundant items. Different improvement strategies failed to resolve the identified problems. Use of J-EAT-10 in population-based surveys cannot therefore be recommended. For such purpose, alternative screening tools of self-perceived OD should be chosen or a new one should be developed and validated.
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Affiliation(s)
- Tina Hansen
- Division of Occupational Therapy, Faculty of Health and Technology, Copenhagen University College, Sigurdsgade 26, 2200, N Copenhagen, Denmark.
| | - Annette Kjaersgaard
- Department for Education, Hammel Neurorehabilitation Centre and University Research Clinic, Voldbyvej 15, 8450, Hammel, Denmark
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19
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Abstract
The on-road driving test is considered a ‘gold standard’ evaluation; however, its validity and reliability have not been sufficiently reviewed. This systematic review aimed to map out and synthesize literature regarding on-road driving tests using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. Cochrane Library, PubMed, CINAHL, and Web of Science databases were searched from initiation through February 2018. All articles addressing reliability or validity of on-road driving tests involving adult rehabilitation patients were included. The search output identified 513 studies and 36 articles, which were included in the review. The Washington University Road Test/Rhode Island Road Test, performance analysis of driving ability, test ride for investigating practical fitness-to-drive, and K-score demonstrated high reliability and validity in regard to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. The Washington University Road Test/Rhode Island Road Test and test ride for investigating practical fitness-to-drive were analyzed based on Classical Test Theory techniques, and performance analysis of driving ability and K-score were analyzed based on Item Response Theory techniques. The frequency of studies were Washington University Road Test/Rhode Island Road Test (n=9), Test Ride for Investigating Practical fitness-to-drive (n=8), performance analysis of driving ability (n=4), and K-score (n=1). From the viewpoint of accuracy and generalization, the Washington University Road Test/Rhode Island Road Test, test ride for investigating practical fitness-to-drive, and performance analysis of driving ability were identified as highly qualified concerning on-road driving tests. However, the ability to assess real-world driving depends on various environmental conditions.
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20
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Kristensen LQ, Muren MA, Petersen AK, van Tulder MW, Gregersen Oestergaard L. Measurement properties of performance-based instruments to assess mental function during activity and participation in traumatic brain injury: A systematic review. Scand J Occup Ther 2019; 27:168-183. [PMID: 31725339 DOI: 10.1080/11038128.2019.1689291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Performance-based measures that focus primarily on the ability to engage in ADL are routinely used by occupational therapists to assess a client's cognitive abilities.Objective: To perform a systematic review to investigate measurement properties of performance-based instruments to assess mental function during activity and participation in individuals with traumatic brain injury.Material and methods: Pubmed, EMBASE, CINAHL, PsycINFO and OTseeker were searched. The Consensus-based Standards for the selection of health measurement instruments checklist was used to evaluate methodological quality of each included study. The quality criteria adapted by Terwee were applied to extract the results of each measurement property followed by a best evidence synthesis.Results: Twenty-eight articles, including 40 ratings of measurement properties, were included. The combination of the Functional Independence Measure and the Functional Assessment Measure showed moderate evidence of good internal consistency (Cronbach's alpha 0.99), but conflicting evidence of reliability (ICC 0.83) and poor evidence of construct validity. All other instruments showed limited or unknown evidence.Conclusions: This review provides an overview of measurement properties of performance-based instruments and contributes to such methodological considerations before choosing an instrument. Though, the results reveal a lack of high-quality evidence for any of the measurement properties, it is recommended to use tools with the highest possible evidence for positive ratings.Significance: This review contributes with psychometric evidence on instruments to use in occupational therapy practice and research.
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Affiliation(s)
- Lola Qvist Kristensen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Neurorehabilitation Skive, Hammel Neurorehabilitation Centre and University Research Clinic, Skive, Denmark
| | - Marie Almkvist Muren
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Annemette Krintel Petersen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital and Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Maurits W van Tulder
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Health Sciences and the EMGO + Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital and Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,Department of Public Health, The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
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21
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Heldmann P, Werner C, Belala N, Bauer JM, Hauer K. Early inpatient rehabilitation for acutely hospitalized older patients: a systematic review of outcome measures. BMC Geriatr 2019; 19:189. [PMID: 31288750 PMCID: PMC6617943 DOI: 10.1186/s12877-019-1201-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/02/2019] [Indexed: 01/11/2023] Open
Abstract
Background Selecting appropriate outcome measures for vulnerable, multimorbid, older patients with acute and chronic impairments poses specific challenges, which may have caused inconsistent findings of previous intervention trials on early inpatient rehabilitation in acutely hospitalized older patients. The aim of this review was to describe primary outcome measures that have been used in randomized controlled trials (RCTs) on early rehabilitation in acutely hospitalized older patients, to analyze their matching, and to evaluate the effects of matching on the main findings of these RCTs. Methods A systematic literature search was conducted in PubMed, Cochrane CENTRAL, CINAHL, and PEDro databases. Additional studies were identified through reference and citation tracking. Inclusion criteria were: RCT, patients aged ≥65 years, admission to an acute hospital medical ward (but not to an intensive medical care unit), physical exercise intervention (also as part of multidisciplinary programs), and primary outcome measure during hospitalization. Two independent reviewers extracted the data, assessed the methodological quality, and analyzed the matching of primary outcome measures to the intervention, study sample, and setting. Main study findings were related to the results of the matching procedure. Results Twenty-eight articles reporting on 24 studies were included. A total of 33 different primary outcome measures were identified, which were grouped into six categories: functional status, mobility status, hospital outcomes, adverse clinical events, psychological status, and cognitive functioning. Outcome measures differed considerably within each category and showed a large heterogeneity in their matching to the intervention, study sample, and setting. Outcome measures that specifically matched the intervention contents were more likely to document intervention-induced benefits. Mobility instruments seemed to be the most sensitive outcome measures to reveal such benefits. Conclusions This review highlights that the selection of outcome measures has to be highly specific to the intervention contents as this is a key factor to reveal benefits attributable to early rehabilitation in acutely hospitalized older patients. Inappropriate selection of outcome measures may represent a major cause of inconsistent findings reported on the effectiveness of early rehabilitation in this setting. Trial registration PROSPERO CRD42017063978. Electronic supplementary material The online version of this article (10.1186/s12877-019-1201-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Heldmann
- Network Aging Research (NAR), Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany.
| | - Christian Werner
- Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Heidelberg, Germany.,Center for Geriatric Medicine, Heidelberg University, Heidelberg, Germany
| | - Nacera Belala
- Network Aging Research (NAR), Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Jürgen M Bauer
- Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Heidelberg, Germany.,Center for Geriatric Medicine, Heidelberg University, Heidelberg, Germany
| | - Klaus Hauer
- Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Heidelberg, Germany
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Efficacy of botulinum toxin in modifying spasticity to improve walking and quality of life in post-stroke lower limb spasticity - a randomized double-blind placebo controlled study. BMC Neurol 2019; 19:96. [PMID: 31078139 PMCID: PMC6511142 DOI: 10.1186/s12883-019-1325-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 05/03/2019] [Indexed: 01/01/2023] Open
Abstract
Background Post-stroke lower limb spasticity (PSLLS) has a prevalence of 28–37%. PSLLS can cause difficulty in walking and reduce quality of life (QOL). Post stroke spasticity impairs the ability to intervene to improve walking ability. Botulinum Toxin A (BT) is an effective intervention for focal spasticity, but its use is currently restricted in many countries by their reimbursement system stating that the evidence for improvement in walking and quality of life (QOL) is not robust for treatment in the lower limb. This randomized control trial (RCT) will investigate the effectiveness of BT in modifying spasticity, and improving functioning (mobility, walking, activities of daily living (ADL’s) and QOL. Methods/design A double-blind placebo-controlled trial injection will assess the effect of BT compared with a placebo (normal saline) in a sample of n = 94 patients. Following treatment of spasticity measured by Modified Ashworth Scale (MAS), the primary outcome of gait velocity will be measured by i) Gait Rite (Electronic Walkway); ii) walking by 2 Min Walk Test; iii) balance by Berg Balance Scale; mobility by iv) Timed Up and Go (TUG); v) lower limb function by ABILICO; vi) patient related goal by Goal Attainment Scale (GAS); vii) QOL by SF 12 (Rand version); viii) activities of daily living by the Functional Autonomy Measurement System (SMAF). There will be an associated health economic analysis. Discussion The study methodology is based on our systematic review 2026 studies, which concluded the evidence for improving mobility following use of BT to reduce spasticity was not robust. The results of this study could establish the use of BT in improving gait and lower limb function in PSLLS. This study could provide the evidence needed for reimbursement schemes to consider and changes to its funding policy for BT in PSLLS. Trial registration The trial is registered with the Australia New Zealand Clinical Trails Registry (ANZCTR)-ANZCTRN12617001603303. Registered 07/12/2017.
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23
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Sattar S, Kenis C, Haase K, Burhenn P, Stolz-Baskett P, Milisen K, Ayala AP, Puts MTE. Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper. J Geriatr Oncol 2019; 11:1-7. [PMID: 30956135 DOI: 10.1016/j.jgo.2019.03.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/21/2019] [Accepted: 03/27/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Falls are a major health issue in older adults and are of greater concern among those with cancer due to effects of cancer and its treatments. This paper provides an overview of current literature on fall screening/assessment and interventions and a succinct summary of recommendations for oncology nurses to support this vulnerable population. METHODS A comprehensive search for literature reviews on falls was conducted in Medline and CINAHL. A comprehensive Internet search was also performed for known guidelines on fall prevention and/or management published within the past 10 years. Search results were compared, contrasted, and summarized to develop clinical recommendations for nurses working with older adults with cancer. Levels of evidence were reported based on the Oxford Centre for Evidence-based Medicine. RESULTS Six guidelines and 17 systematic reviews were identified. Having a history of falls was the most commonly identified fall risk factor/predictor. Multifactorial intervention and exercise appear to be the most commonly recommended. No fall assessment tools were consistently recommended as a reliable means of identifying those at risk for falls. CONCLUSION Assessing older patients for falls and fall risks is an important first step to identify those who may require further follow-up and intervention. Oncology nurses play a key role in optimizing health outcomes of older adults with cancer - through the use of evidence-based information, such as presented in this publication - and have the capacity to help reduce fall risks during and after treatment through information provision, advocacy, support, and promotion of physical activity.
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Affiliation(s)
- Schroder Sattar
- College of Nursing, University of Saskatchewan, Regina, Canada.
| | - Cindy Kenis
- University Hospitals Leuven, Leuven, Belgium
| | - Kristen Haase
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | | | | | - Koen Milisen
- Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Ana Patricia Ayala
- Gerstein Information Science Centre, University of Toronto Libraries, Toronto, Canada
| | - Martine T E Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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24
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Sunkersing D, Martin FC, Reed J, Woringer M, Bell D. What do care home managers believe constitutes an 'assessment for frailty' of care home residents in North-West London? A survey. BMC Geriatr 2019; 19:62. [PMID: 30823874 PMCID: PMC6397475 DOI: 10.1186/s12877-019-1083-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/21/2019] [Indexed: 11/20/2022] Open
Abstract
Background Frail individuals are at risk of significant clinical deterioration if their frailty is not identified and managed appropriately. Research suggests that any interaction between an older person and a health or social care professional should include an assessment for frailty. Many older care home residents are frail when admitted, but we have little knowledge of whether or how this is assessed. The aim of this paper is to understand and establish the characteristics of the reported ‘assessments for frailty’ used in care homes with nursing (nursing homes) across North-West London. This will help understand what an ‘assessment for frailty’ of care home residents mean in practice in North-West London. Methods Telephone contact was made with every Care Quality Commission (CQC) (independent regulator of health and adult social care in England) regulated nursing home across North-West London [n = 87]. An online survey was sent to all that expressed interest [n = 73]. The survey was developed through conversations with healthcare professionals, based on literature and tested with academics and clinicians. Survey responses were analysed using descriptive statistics. The Mann-Whitney U test was used for statistical analyses. Results 24/73 nursing homes completed the survey (33%). Differences in the characteristics of reported ‘assessments for frailty’ across nursing homes were evident. Variation in high level domains assessed (physical, social, mental and environmental) was observed. Nurses were the most common professional group completing assessments for frailty, with documentation and storage being predominantly paper based. A statistically significant difference between the number of assessments used in corporate chain owned nursing homes (3.9) versus independently owned nursing homes (2.1) was observed (U = 21, p = .005). Conclusions Great variation existed in the characteristics of reported ‘assessments for frailty’ in nursing homes. Our study suggests that not all physical, social, mental and environmental domains of frailty are routinely assessed: it appears that frailty is still primarily viewed only in terms of physical health. The consequences of this could be severe for patients, staff and healthcare settings. Research illustrates that frailty is a broad, multifactorial health state and, as such, an overall ‘assessment for frailty’ should reflect this. Electronic supplementary material The online version of this article (10.1186/s12877-019-1083-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David Sunkersing
- NIHR CLAHRC North West London, 369 Fulham Road, London, SW10 9NH, UK. .,Department of Primary Care and Public Health, Imperial College London, W6 8RP, London, UK.
| | | | - Julie Reed
- NIHR CLAHRC North West London, 369 Fulham Road, London, SW10 9NH, UK.,Department of Primary Care and Public Health, Imperial College London, W6 8RP, London, UK
| | - Maria Woringer
- Department of Primary Care and Public Health, Imperial College London, W6 8RP, London, UK
| | - Derek Bell
- NIHR CLAHRC North West London, 369 Fulham Road, London, SW10 9NH, UK.,Department of Primary Care and Public Health, Imperial College London, W6 8RP, London, UK
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Romli MH, Wan Yunus F, Mackenzie L. Overview of reviews of standardised occupation-based instruments for use in occupational therapy practice. Aust Occup Ther J 2019; 66:428-445. [PMID: 30821362 DOI: 10.1111/1440-1630.12572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Using standardised instruments is one approach to support evidence-based practice. Referring to systematic reviews is an option to identify suitable instruments. However, with an abundance of systematic reviews available, therapists are challenged to identify an appropriate instrument to use. Therefore, this overview of reviews aimed to summarise relevant systematic review findings about standardised occupation-based instruments relevant for occupational therapy practice. METHODS An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). RESULTS A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play. DISCUSSION Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Farahiyah Wan Yunus
- Occupational Therapy Programme, Faculty of Health Sciences, Centre for Rehabilitation and Special Needs, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, Lidcombe, New South Wales, Australia
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Bravo G, Richards CL, Corriveau H, Trottier L. Converting Functional Autonomy Measurement System Scores of Patients Post-Stroke to FIM Scores. Physiother Can 2019; 70:349-355. [PMID: 30745720 DOI: 10.3138/ptc.2017-82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The Functional Independence Measure (FIM) is widely used to assess persons post-stroke. The Quebec government has selected the Functional Autonomy Measurement System (SMAF) for use in all care settings. In this article, we propose simple equations to convert SMAF scores to FIM scores for persons undergoing post-stroke rehabilitation. Method: Persons post-stroke (n=143) from three rehabilitation centres were assessed at admission and discharge using the FIM and SMAF. The sample was randomly split into derivation and validation data sets. Regression analysis was performed on the first data set to derive a conversion equation at each time point. The validity of the equations was measured using correlation coefficients, and differences between the observed and predicted FIM scores were computed from the second data set. Results: The relationship between the SMAF and FIM scores was linear at admission but quadratic at discharge. The proposed equations are, at admission, FIM=139-1.5×SMAF and, at discharge, FIM=118-0.018×SMAF2. The observed and predicted FIM scores were highly correlated in the validation data set (rs=0.92 and 0.93 at admission and discharge, respectively). Furthermore, the equations performed well in classifying stroke severity compared with a classification based on the observed FIM scores. Conclusions: SMAF scores can be reliably converted to FIM scores using the proposed equations, thus facilitating international trials in stroke rehabilitation.
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Affiliation(s)
- Gina Bravo
- Department of Community Health Sciences.,Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke
| | - Carol L Richards
- Department of Rehabilitation, Faculty of Medicine, Université Laval.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Que
| | - Hélène Corriveau
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke.,School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke
| | - Lise Trottier
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke
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Lockwood KJ, Harding KE, Boyd JN, Taylor NF. Predischarge home visits after hip fracture: a randomized controlled trial. Clin Rehabil 2019; 33:681-692. [PMID: 30642194 DOI: 10.1177/0269215518823256] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: The objective of this study is to investigate whether home assessment visits prior to hospital discharge for patients recovering from hip fracture reduce falls and prevent hospital readmissions, within the first 30 days and six months after discharge home. DESIGN: A randomized controlled trial was conducted. SETTING: The study setting included hospital wards and the community. PARTICIPANTS: The study included adults 50 years and over recovering from hip fracture ( n = 77). INTERVENTION: Both groups received inpatient rehabilitation and hospital-based discharge planning. In addition, the intervention group received a home assessment visit by an occupational therapist prior to discharge from hospital. MAIN MEASURES: Primary outcomes were falls and hospital readmissions. Secondary outcome measures included Functional Independence Measure, Functional Autonomy Measurement Scale, Nottingham Extended Activities of Daily Living Scale, EuroQol five dimension scale questionnaire and Falls Efficacy Scale-International. RESULTS: The intervention group had fewer hospital readmissions in the first 30 days compared to the control group (intervention n = 1, control n = 10; odds ratio (OR) 12.9, 95% confidence interval (CI) 1.5 to 99.2). The intervention group was observed to have fewer falls than controls in the 30 days after discharge (intervention n = 6, control n = 14; incidence rate ratio (IRR) = 0.41, 95% CI 0.15 to 1.11). Between-group differences favoured the intervention group for functional independence at six months (11.2 units, 95% CI 4.2 to 18.2). There were no other between-group differences. CONCLUSION: Home assessment visits by occupational therapists prior to hospital discharge for patients recovering from hip fracture reduced the number of readmissions to hospital, increased functional independence at six months and may have reduced the risk of falls in the first 30 days after discharge.
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Affiliation(s)
- Kylee J Lockwood
- 1 School of Allied Health, La Trobe University, Melbourne, VIC, Australia.,2 Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
| | - Katherine E Harding
- 1 School of Allied Health, La Trobe University, Melbourne, VIC, Australia.,2 Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
| | - Jude N Boyd
- 3 Department of Occupational Therapy, Eastern Health, Melbourne, VIC, Australia
| | - Nicholas F Taylor
- 1 School of Allied Health, La Trobe University, Melbourne, VIC, Australia.,2 Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
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Pike S, Lannin NA, Wales K, Cusick A. A systematic review of the psychometric properties of the Action Research Arm Test in neurorehabilitation. Aust Occup Ther J 2018; 65:449-471. [DOI: 10.1111/1440-1630.12527] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Shannon Pike
- School of Allied Health (Occupational Therapy); La Trobe University; Melbourne Australia
- Wagga Wagga Ambulatory Rehabilitation Service; Murrumbidgee Local Health District; Wagga Wagga New South Wales Australia
| | - Natasha A. Lannin
- School of Allied Health (Occupational Therapy); La Trobe University; Melbourne Australia
- Occupational Therapy Department; Alfred Health; Melbourne Australia
| | - Kylie Wales
- School of Health Sciences; Faculty of Health and Medicine; The University of Newcastle; Callaghan New South Wales Australia
| | - Anne Cusick
- Discipline of Occupational Therapy; The University of Sydney; New South Wales Australia
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29
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Perceptions of older people in Ireland and Australia about the use of technology to address falls prevention. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractFalls are common events with serious consequences for older people. With an ageing population and increasing health-care costs, information and communication technologies (ICT) will have a potential role in future health-care delivery. However, research on technology acceptance in health care for older people is limited and its application to falls prevention is unknown. The aims of this study were to explore and describe the perceptions of community-dwelling Australian and Irish older people about their current use of technology, and the potential use of technology for falls prevention. Qualitative data were collected from three focus groups conducted in and around Limerick in Ireland, and three in the Sydney area, Australia. A total of 35 older people participated. Data were analysed using thematic analysis. Four themes emerged from the data: (a) perceptions of vulnerability to falls, (b) preferences for exercise interventions, (c) participation in and ownership of technology, and (d) perceptions about applications of technology for falls prevention. As the use of technology is an instrumental activity of daily living, health professionals need to assess the capacity of older people to adopt these technologies, and provide falls prevention interventions to accommodate the technology skills of older people. Some participants were reluctant to embrace technology and barriers to the effective use of technology to assist in preventing falls may conflict with future health service trends.
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Unsworth CA, Timmer A, Wales K. Reliability of the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT). Aust Occup Ther J 2018; 65:376-386. [DOI: 10.1111/1440-1630.12476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Carolyn A. Unsworth
- School of Health, Medical and Applied Sciences; Central Queensland University; Melbourne Vic. Australia
| | - Amanda Timmer
- Donvale Rehabilitation Hospital-Ramsay Health Care; Donvale Vic. Australia
- School of Health, Medical and Applied Sciences; Central Queensland University; Rockhampton City Qld Australia
| | - Kylie Wales
- School of Health Sciences; University of Newcastle; Callaghan NSW Australia
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Yu STS, Yu ML, Brown T, Andrews H. Association between older adults’ functional performance and their scores on the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). IRISH JOURNAL OF OCCUPATIONAL THERAPY 2018. [DOI: 10.1108/ijot-07-2017-0020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The paper aims to investigate if the performance of older adults on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were associated or predictive of their functional performance in a geriatric evaluation and management (GEM) inpatient hospital setting. This will inform the occupational therapy assessment and management of older adults admitted to sub-acute GEM settings.
Design/methodology/approach
In all, 20 participants (11 men, 9 women, mean age 82 years, SD = 6.93) were recruited from a GEM ward in an Australian hospital. Participants’ cognitive abilities were assessed using the MMSE and MoCA, and their functional performance were assessed using the Functional Independence Measure (FIM). Spearman’s rho correlations and linear regression analyses were completed. Bootstrapping was applied to the regression analyses to accommodate the small study sample size.
Findings
No statistically significant correlations were obtained between the total and subscale scores of the MMSE and FIM or between the total and subscale scores of the MoCA and FIM. In other words, the cognitive and functional abilities of older adults admitted to a GEM setting were not significantly associated in this study.
Originality/value
The findings suggest that the MoCA and the MMSE were not predictive of participants’ functional performance as measure by the FIM in a sub-acute GEM setting. Occupational therapists should be cautious when interpreting participants’ MMSE, MoCA and FIM results and not depend solely on these results in the goal setting and intervention planning processes for clients on GEM wards. Further studies are recommended to confirm these findings.
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Makishima M, Fujino Y, Kubo T, Izumi H, Uehara M, Oyama I, Matsuda S. Validity and responsiveness of the work functioning impairment scale (WFun) in workers with pain due to musculoskeletal disorders. J Occup Health 2018; 60:156-162. [PMID: 29311438 PMCID: PMC5886883 DOI: 10.1539/joh.17-0166-oa] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To determine the convergent validity and responsiveness of the work functioning impairment scale (WFun) in workers with musculoskeletal disorder-related pain. Methods: Participants were extracted from an internet user study and prospectively examined using the pain intensity numerical rating scale (pain-NRS), the work ability numerical rating scale (productivity-NRS), and the WFun at baseline, 2 weeks, 6 weeks, and 3 months. The convergent validity and responsiveness of the WFun were examined by multilevel regression analysis. Results: A total of 786 workers participated and 593 completed all surveys. The WFun score gradually increased and decreased as the pain-NRS and the productivity-NRS increased, respectively. Changes in the WFun score steadily increased and decreased as changes in the pain-NRS and the productivity-NRS increased, respectively. Multilevel analyses showed that all linear associations were significant. Conclusions: The convergent validity and responsiveness of the WFun were consistent with the expected direction and magnitude.
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Affiliation(s)
- Misako Makishima
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health.,Department of Medical Affairs, Chugai Pharmaceutical Co., Ltd
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, University of Occupational and Environmental Health
| | - Tatsuhiko Kubo
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health
| | - Hiroyuki Izumi
- Department of Ergonomics, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health
| | | | | | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health
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Andreassen M, Öhman A, Larsson Ranada Å. Assessing occupational performance in special housing in Sweden. Scand J Occup Ther 2017; 25:428-435. [PMID: 28830285 DOI: 10.1080/11038128.2017.1367415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Assessing occupational performance is commonly done by occupational therapists [OTs] working in special housing in municipal elder care. Assessments should be relevant and evidence-based. Even so, we know little about how assessment of occupational performance is conducted in special housing. AIM The aim of this study was to identify OTs' use and perceptions of different methods to assess occupational performance for elderly clients living in special housing. METHOD An email questionnaire was sent to OTs working in special housing in Sweden. Data was analyzed using descriptive and parametric statistics. RESULTS The findings, based on data from 660 respondents, showed that OTs regularly assessed occupational performance but did not use standardized assessment instruments or structured methods to any great extent. In general, OTs reported that they were not pleased with their ability to assess their clients; however, OTs with higher education and with responsibility for fewer clients were more pleased with their assessments and stated that they had more knowledge about assessment methods. CONCLUSIONS To support OTs in using structured assessments of occupational performance in everyday practice, organization as well as structures in the work environment and educational development need to be taken into consideration.
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Affiliation(s)
- Maria Andreassen
- a Department of Social and Welfare Studies, Division of Occupational Therapy , Linköping University , Norrköping , Sweden
| | - Annika Öhman
- a Department of Social and Welfare Studies, Division of Occupational Therapy , Linköping University , Norrköping , Sweden
| | - Åsa Larsson Ranada
- a Department of Social and Welfare Studies, Division of Occupational Therapy , Linköping University , Norrköping , Sweden
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Wales K, Lannin NA, Clemson L, Cameron ID. Measuring functional ability in hospitalized older adults: a validation study. Disabil Rehabil 2017; 40:1972-1978. [PMID: 28482704 DOI: 10.1080/09638288.2017.1323021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine the internal consistency, construct validity and responsiveness of functional assessments tools when used with hospitalized older adults. MATERIALS AND METHODS The functional ability of 66 patients was assessed using a semi-structured interview scale (n = 16 tools). The assessment of motor and process skills was administered during hospital admission and again at three months post-discharge. RESULTS Tools showed poor-to-excellent internal consistency (α = 0.27-0.92). Of the tools that were internally consistent, only two demonstrated change: the Groningen activity restriction scale (GARS) (smallest detectable change [SDC] 11.68, effect size -1.59) and the modified reintegration to normal living scale (SDC 7.04, effect size -1.20). Validity was supported by strong correlations between the functional independence measure™ (FIM™) and the GARS, FIM™ and Sunnaas activity daily living (ADL) index. CONCLUSIONS Findings suggest that the GARS and the modified reintegration to normal living index (mRNLI) are internally consistent, valid and responsive to change over time when applied to a sample of hospitalized older adults. Further investigation of these tools in terms of inter and intra rater reliability in clinical practice is warranted. Implications for Rehabilitation Therapists and researchers need to choose standardized functional assessments carefully when working with hospitalized older adults, as not all assessments are reliable and valid in this population. The GARS and mRNLI are valid and responsive functional assessments for hospitalized older adults. Activity and participation have been viewed traditionally as only one component of function. Therapists and researchers can use standardized assessments of function that are activity or participation-based.
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Affiliation(s)
- Kylie Wales
- a Ageing Work and Health Research Unit , University of Sydney , Lidcombe , Australia
| | - Natasha A Lannin
- b Department of Occupational Therapy, Alfred Health , School of Allied Health, La Trobe University , Melbourne , Australia
| | - Lindy Clemson
- a Ageing Work and Health Research Unit , University of Sydney , Lidcombe , Australia
| | - Ian D Cameron
- c John Walsh Centre for Rehabilitation Research , University of Sydney , Sydney , Australia
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35
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Elgestad Stjernfeldt P, Wårdh I, Trulsson M, Faxén Irving G, Boström AM. Methods for objectively assessing clinical masticatory performance: protocol for a systematic review. Syst Rev 2017; 6:20. [PMID: 28122613 PMCID: PMC5267407 DOI: 10.1186/s13643-016-0403-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 12/20/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Chewing and masticatory function constitutes one of the most important oral health factors that affect quality of life, especially in older individuals. Little consensus currently exists regarding ways to objectively assess clinical masticatory performance (in this context, performance refers an individual's objective ability to mix or comminute food bolus). That said, many methods were developed to assess masticatory performance. Consequently, systematic review of the literature would be of great value when it comes to identifying various methods for objectively assessing clinical masticatory performance and for evaluating these methods. DESIGN This study protocol describes a systematic review that intends to (i) identify methods to objectively assess clinical masticatory performance and (ii) evaluate psychometric properties (such as validity and reliability) of the identified methods. A systematic literature search is required to do so in these sources: MEDLINE (Ovid), Embase (embase.com), Web of Science Core Collection (Thomson Reuters), Cochrane (Wiley), and Cinahl (Ebsco). INCLUSION CRITERIA studies in scientific, full-text articles; development articles; validation articles; studies of the general adult population, ages ≥18. EXCLUSION CRITERIA topics and article types that cover interview methods and self-reported questionnaires; methods/instruments that measure subjective masticatory performance; qualitative studies and case studies; opinion and editorial pieces; animal studies; studies of humans with severe oral health complications. DISCUSSION This systematic review will result in a comprehensive assessment of various methods designed to objectively measure clinical masticatory performance. This systematic review will rate these methods, assess their reliability and validity, and identify one or more methods that can be recommended for use in clinical and scientific environments. From what is currently known, no systematic evaluation of various methods for objectively assessing clinical masticatory performance has been published. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037700.
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Affiliation(s)
- Per Elgestad Stjernfeldt
- Dental Clinic of Medical Dental Care at Stockholms Sjukhem, Mariebergsgatan 22B, 112 19, Stockholm, Sweden. .,Akademiskt Centrum för Äldretandvård, Academic Center for Geriatric Dentistry, Stockholm, Sweden.
| | - Inger Wårdh
- Akademiskt Centrum för Äldretandvård, Academic Center for Geriatric Dentistry, Stockholm, Sweden.,Department of Dental Medicine, Division of Gerodontics, Karolinska Institute, Box 4064, 14104, Huddinge, Sweden
| | - Mats Trulsson
- Department of Dental Medicine, Karolinska Institute, Box 4064, 14104, Huddinge, Sweden
| | - Gerd Faxén Irving
- Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Karolinska Institute, Blickagången 6/Hälsovägen 7, 14157, Huddinge, Sweden
| | - Anne-Marie Boström
- Akademiskt Centrum för Äldretandvård, Academic Center for Geriatric Dentistry, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institute, Box 23300, 141 83, Huddinge, Sweden.,Department of Geriatric Medicine, Danderyd Hospital, SLSO, 182 87, Danderyd, Sweden.,Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway
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Pinto-Carral A, Fernández-Villa T, Molina de la Torre AJ. The Authors Respond. Arch Phys Med Rehabil 2016; 98:192-193. [PMID: 28010780 DOI: 10.1016/j.apmr.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/06/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Arrate Pinto-Carral
- School of Health Science, SALBIS Research Group, University of León, León, Spain
| | - Tania Fernández-Villa
- Research Group on Gene-Environment Interactions and Health (GIIGAS), University of León, León, Spain
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Nielsen LM, Kirkegaard H, Østergaard LG, Bovbjerg K, Breinholt K, Maribo T. Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department: implications for selection of clinical outcome measures. BMC Geriatr 2016; 16:199. [PMID: 27899065 PMCID: PMC5129645 DOI: 10.1186/s12877-016-0376-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 11/23/2016] [Indexed: 11/10/2022] Open
Abstract
Background Assessment of functional ability in elderly patients is often based on self-reported rather than performance-based measures. This study aims to compare self-reported and performance-based measures of functional ability in a population of elderly patients at an emergency department (ED). Methods Participants were 61 patients aged 65 years and above admitted to an ED. The self-reported measure used was the Barthel-20; the performance-based measures were Timed Up and Go (TUG); 30s-Chair Stand Test (30s-CST) and Assessment of Motor and Process Skills (AMPS) with the two scales; motor and process. Correlation analyses were conducted to examine the relationships between the self-reported and performance-based measures of functional ability. Results The correlation between the Barthel-20 and the TUG was moderate (r = −0.64). The correlation between the Barthel-20 and the AMPS motor was also moderate (r = 0.53). The correlation between the Barthel-20 and the 30s-CST was fair (r = 0.45). The correlation between Barthel-20 and the AMPS process was non-significant. The results were affected by high ceiling effect (Barthel-20). Conclusion Self-reported and performance-based measures seem to assess different aspects of functional ability. Thus, the two methods provide different information, and this highlight the importance of supplementing self-reported measures with performance-based measures when assessing functional ability in elderly patients. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0376-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise M Nielsen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark. .,School of Occupational Therapy at VIA University College, Aarhus N, Denmark.
| | - Hans Kirkegaard
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | - Lisa G Østergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark
| | - Karina Bovbjerg
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark
| | - Kasper Breinholt
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark
| | - Thomas Maribo
- MarselisborgCentret, DEFACTUM, Central Denmark Region, Department of Public Health, Aarhus University, Aarhus C, Denmark
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38
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Nielsen TL, Petersen KS, Nielsen CV, Strøm J, Ehlers MM, Bjerrum M. What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults’ occupational performance? A systematic review. Scand J Occup Ther 2016; 24:235-248. [DOI: 10.1080/11038128.2016.1245357] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tove Lise Nielsen
- Division of Rehabilitation, DEFACTUM, Central Denmark Region, Aarhus, Denmark
- VIA Department of Occupational Therapy, Aarhus, Denmark
| | | | - Claus Vinther Nielsen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Denmark
| | - Janni Strøm
- Division of Rehabilitation, DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Silkeborg Regional Hospital, Interdisciplinary Research Unit, Elective Surgery Center, Denmark
| | | | - Merete Bjerrum
- Division of Rehabilitation, DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Section for Nursing Science, Aarhus University, Denmark
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