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Jespersen AE, Lumbye A, Mariegaard J, Damgaard V, Glenthøj LB, Nordentoft M, Mikkelsen C, Didriksen M, Ostrowski SR, Vinberg M, Wæhrens EE, Miskowiak KW. Cognition Assessment in Virtual Reality (CAVIR): Associations with neuropsychological performance and activities of daily living in patients with mood or psychosis spectrum disorders. J Affect Disord 2024:S0165-0327(24)01795-6. [PMID: 39447982 DOI: 10.1016/j.jad.2024.10.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 09/27/2024] [Accepted: 10/20/2024] [Indexed: 10/26/2024]
Abstract
BACKGROUND More ecologically valid tools are needed to better capture daily-life cognitive impairments in patients with mood or psychosis spectrum disorders in clinical settings and cognitive treatment trials. We developed the Cognition Assessment in Virtual Reality (CAVIR) test, which assesses daily-life cognitive skills in an immersive virtual reality kitchen scenario. This study investigated the validity and sensitivity of CAVIR, including its association with activities of daily living (ADL) ability. METHODS 70 symptomatically stable patients with mood or psychosis spectrum disorders and 70 healthy controls completed CAVIR and standard neuropsychological tests and were rated for clinical symptoms, functional capacity, and subjective cognition. In addition, patients' ADL ability was evaluated with the Assessment of Motor and Process Skills (AMPS). RESULTS Higher global CAVIR performance correlated moderately with better global neuropsychological test scores (rs(138) = 0.60, p < 0.001) and showed a weak to moderate association with better ADL process ability in patients (r(45) = 0.40, p < 0.01), also after adjusting for sex and age (ps ≤ 0.03). In comparison, neuropsychological performance, interviewer- and performance-based functional capacity, and subjective cognition were not significantly associated with ADL process ability (ps ≥ 0.09). Further, CAVIR was sensitive to cognitive impairments in patients and was able to differentiate between patients with and without the ability to undertake regular employment. LIMITATIONS The modest sample size and concomitant medication. CONCLUSION Our results indicate that CAVIR is a sensitive measure of daily-life cognitive skills in patients with mood or psychosis spectrum disorders.
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Affiliation(s)
- Andreas E Jespersen
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Denmark.
| | | | - Johanna Mariegaard
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Denmark.
| | - Viktoria Damgaard
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Denmark.
| | - Louise B Glenthøj
- Department of Psychology, University of Copenhagen, Denmark; Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Denmark.
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
| | - Sisse Rye Ostrowski
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
| | - Maj Vinberg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Mental Health Services, Denmark.
| | - Eva E Wæhrens
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Kamilla W Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Denmark.
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Kissow H, Hill B, Hansen AØ. Danish translation, cultural adaptation and psychometric testing of the Brachial Assessment Tool (BrAT), designed to assess activity limitation in adults with traumatic brachial plexus injuries. Disabil Rehabil 2024:1-6. [PMID: 39225107 DOI: 10.1080/09638288.2024.2398144] [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: 02/20/2024] [Revised: 08/26/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To translate and cross-culturally adapt The Brachial Assessment Tool (BrAT) into Danish and assess its content validity and reproducibility in adults with traumatic brachial plexus injury (BPI). MATERIAL AND METHODS Translation followed international guidelines. BrAT(DK) were cognitive tested with 19 adults with traumatic BPI to evaluate cross-cultural understanding, relevance, comprehensiveness and comprehensibility. Content validity and reproducibility were evaluated following the COnsensus-based Standards for the selection of health Measurement INstruments guideline. Participants were recruited from an outpatient hand clinic. Test-retest reliability was assessed using intra-class-correlation coefficient (ICC) and the smallest detectable change (SDC). Internal consistency was evaluated using Cronbach's alpha. RESULTS Minor cultural differences were observed in the content validity analysis of BrAT(DK). Cognitive testing revealing no significant issues. All participants found the items relevant and important. 63 participants with traumatic BPI were recruited; 49 completed the retest. ICC values for the sub-scales and the total score ranged from 0.91 to 0.95 (95% CI 0.85 to 0.97). Internal consistency ranged from 0.87 to 0.98. SDC ranged from 4.16 to 9.63 for subscales and 16.01 for the total score. CONCLUSION BrAT(DK) appeared to be content valid and reliabel as a measure of activity limitation in adults with traumatic BPI.
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Affiliation(s)
- Helene Kissow
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense C, Denmark
| | - Bridget Hill
- Epworth Monash Rehabilitation Medicine Unit, Epworth HealthCare, Richmond, Victoria, Australia
| | - Alice Ørts Hansen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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Ransby TB, Jacobsen NS, Hansen AØ. Are occupational therapists in hand therapy working in an occupation-centered way? A cross sectional survey. HAND THERAPY 2024; 29:124-134. [PMID: 39246568 PMCID: PMC11378532 DOI: 10.1177/17589983241268188] [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: 12/19/2023] [Revised: 05/30/2024] [Accepted: 06/20/2024] [Indexed: 09/10/2024]
Abstract
Introduction The dominance of the biomedical approach has previously caused a limited focus on occupation within hand therapy. This study aimed to investigate the rehabilitation offered to patients with a hand-related disorder (HRD) in Denmark including to determine the extent to which occupation-focused and/or occupation-based assessments and interventions are used and to identify barriers against their use. Methods A cross-sectional survey with 45 questions was conducted among members of the Danish Association for Hand Therapy. Data were analysed with descriptive statistics. Categorical variables were reported with frequency and percentage, and continuous variables with average and standard deviation. Results One hundred and six occupational therapists working as hand therapists (n = 106) completed the survey. They reported common use of assessments measuring range of motion, pain, edema, and occupational performance. Occupational performance was assessed by non-standardized occupation-focused assessments, such as informal conversations. Exercise, pain management, and occupation-focused informal conversations were reported as the most frequently used interventions. Out of 82 respondents, 74 (91.4%) reported that they used interventions focused on body function and structures to the extent they wanted. Only 41 (50.0%) used occupation-focused or occupation-based interventions to the extent they wanted. Discussion Assessments and interventions reporting body function and structure were used most frequently whereas assessments and interventions reporting activity and participation were used to a lesser extent. Occupation-focused assessments and interventions were used more commonly than occupation-based. Hand therapists considered occupation-based assessments and interventions to be important in rehabilitation after HRD, despite using them with few patients. Several barriers were reported regarding the implementation of an occupation-centered approach: habit, workload, time constraints, and setting.
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Affiliation(s)
- Thea Birch Ransby
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark
| | | | - Alice Ørts Hansen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Hagelskjær V, Wæhrens EE, von Bülow C, Nielsen KT. Qualitative realist evaluation of an occupational therapy intervention programme (ABLE), addressing ability to perform activities of daily living among persons with chronic conditions. BMC Health Serv Res 2024; 24:9. [PMID: 38172780 PMCID: PMC10765686 DOI: 10.1186/s12913-023-10498-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Chronic conditions are associated with problems related to performance of activities of daily living (ADL) stressing a need to develop and evaluate intervention programmes addressing such problems. Hence, the ABLE programme was developed, and its feasibility evaluated. Implementing intervention programmes in community-based rehabilitation settings requires understanding of how the programme works in various contexts. Applying a realist evaluation approach, the aim of this study was to identify and evaluate interactions between contexts, mechanisms, and outcomes in the ABLE 2.0, to confirm, refine, or reject aspects of the initial programme theory. METHODS Realist evaluation using qualitative data collected in the ABLE 2.0 randomised controlled trial (n = 78). Based on the ABLE 2.0 initial programme theory, qualitative realist interviews were conducted among receivers (n = 8) and deliverers (n = 3) of the ABLE 2.0 in a Danish municipality. Transcripts were coded, and context-mechanism-outcome configurations were extracted and grouped into contiguous themes. Results were then held up against the initial programme theory. RESULTS Four contiguous themes were identified including a total of n = 28 context-mechanism-outcome configurations: building a foundation for the entire intervention; establishing the focus for further intervention; identifying and implementing relevant compensatory solutions; and re-evaluating ADL ability to finalise intervention. Overall, the ABLE 2.0 initial programme theory was confirmed. The evaluation added information on core facilitating mechanisms including active involvement of the client in the problem-solving process, a collaborative working relationship, mutual confidence, and a consultative occupation-based process using compensatory solutions. Several contextual factors were required to activate the desired mechanisms in terms of supportive management, referral procedures encouraging the problem-solving process, delivery in the client's home, skilled occupational therapists, and clients feeling ready for making changes. CONCLUSIONS The ABLE 2.0 represents a coherent problem-solving occupational therapy process, applicable across sex, age, and diagnoses with the potential to enhance ADL ability among persons with chronic conditions, when delivered as part of community-based rehabilitation services. Knowledge about the interactions between contextual factors, mechanisms, and outcomes in the ABLE 2.0 is central in case of future implementation of the programme in community-based rehabilitation settings. TRIAL REGISTRATION The trial was prospectively registered on www. CLINICALTRIALS gov (registration date: 05/03/2020; identifier: NCT04295837 ) prior to data collection that occurred between August 2020 and October 2021.
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Affiliation(s)
- Vita Hagelskjær
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark.
- Department of Occupational Therapy, VIA University College, Holstebro, Denmark.
| | - Eva Ejlersen Wæhrens
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Cecilie von Bülow
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Tomra Nielsen
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
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Nielsen KT, Bang MB, Pilegaard MS, Hagelskjær V, Wæhrens EE. Perspectives on content and delivery of the ABLE 1.0 intervention programme. Scand J Occup Ther 2024; 31:2394644. [PMID: 39180385 DOI: 10.1080/11038128.2024.2394644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 07/28/2024] [Accepted: 08/15/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND The occupational therapy intervention programme ABLE 1.0 was designed to enhance the ability to perform activities of daily living in persons living with chronic conditions. There is a need to determine if content and delivery of the ABLE 1.0 are acceptable among occupational therapists (OTs) and clients after having delivered or received the programme, respectively. OBJECTIVES The paper reports on evaluation of content and delivery of the ABLE 1.0 among OTs and clients. This, in terms of acceptability of intervention in principle, and perceived value, benefits, harms, or unintended consequences of the intervention. MATERIAL AND METHODS Qualitative semi-structured interviews were conducted with OTs having delivered and clients having received ABLE 1.0 in a Danish municipality. Content analysis was performed. FINDINGS Two OTs and three clients participated. Analyses revealed six categories related to content and delivery; 'Overall perception of the programme'; 'Potential for implementation'; 'Evaluation, goal setting and clarification of reasons for ADL task performance problems'; 'Intervention: compensatory solutions'; 'Format and duration' and 'Preconditions for delivery'. CONCLUSIONS AND SIGNIFICANCE The findings provided valuable information used for further development of the ABLE programme.
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Affiliation(s)
- Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-Based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Marie Bangsgaard Bang
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
| | - Marc Sampedro Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Gødstrup Hospital, Herning, Denmark
| | - Vita Hagelskjær
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-Based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Occupational Therapy, VIA University College, Holstebro, Denmark
| | - Eva Ejlersen Wæhrens
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-Based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Nielsen SS, Skou ST, Larsen AE, Polianskis R, Arendt-Nielsen L, Østergaard AS, Kjær-Staal Petersen K, Vægter HB, Søndergaard J, Christensen JR. Changes in pain, daily occupations, lifestyle, and health following an occupational therapy lifestyle intervention: a secondary analysis from a feasibility study in patients with chronic high-impact pain. Scand J Pain 2024; 24:sjpain-2023-0043. [PMID: 38037749 DOI: 10.1515/sjpain-2023-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES This study explored changes in pain-related parameters, occupational function, occupational balance, lifestyle factors, and self-perceived health status in adults with chronic high-impact pain participating in an occupational therapy lifestyle intervention. METHODS This one-group longitudinal feasibility study was performed in three continuous feasibility rounds. The occupational therapists-led intervention targeted meaningful occupations, regular physical activity, and a healthy diet. The intervention contained individual and group sessions and was added to the standard multidisciplinary chronic pain treatment. Outpatients (n=40, 85 % females, 46.6 ± 10.9 years old) participated in the study between April 2019 and December 2021. The analysis includes data for 31 participants. Analysis of pre-post changes assessed after each feasibility round were performed for the outcomes: pain intensity, pain sensitivity and pain modulation (pressure pain threshold and tolerance, temporal summation of pain and conditioned pain modulation), pain self-efficacy, pain catastrophizing, motor and process skills, occupational balance, daily wake-time movement, daily walking steps, body mass index, waist circumference, blood pressure, and self-perceived health status. RESULTS Improvements in motor skills (assessment of motor and process skills score=0.20 (1.37; 1.57), 95 % CI 0.01; 0.38) and temporal summation of pain (-1.19 (2.86; -1.67), 95 % CI -2.16; -0.22), but a decrease in pain tolerance (-7.110 (54.42; 47.32), 95 % CI -13.99; -0.22) were observed. Correlation analysis suggested moderate-to-very strong statistically significant relationships in several outcomes related to pain, health, pain coping, occupational balance, occupational functioning, body anthropometrics, and pain sensitivity. CONCLUSIONS This study suggested that the lifestyle intervention would benefit motor skills while effects on other outcomes were unclear in adults with chronic pain. To confirm the findings, a randomized trial evaluating effectiveness is needed. Ethical committee number: SJ-307 Reg. Clinicaltrials.gov: NCT03903900.
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Affiliation(s)
- Svetlana Solgaard Nielsen
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse & Ringsted Hospitals, Slagelse, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse & Ringsted Hospitals, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Anette Enemark Larsen
- Department of Therapy and Midwifery Studies, Faculty of Health Sciences, University College Copenhagen, Copenhagen, Denmark
| | - Romanas Polianskis
- Multidisciplinary Pain Centre, Department of Anesthesiology, Naestved Hospital, Naestved, Denmark
| | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Skov Østergaard
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Henrik Bjarke Vægter
- Pain Research Group/Pain Centre, Department of Anesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jeanette Reffstrup Christensen
- Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- User Perspectives, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
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Hansen T, Rasmussen SAF, Fabricius J, Grove LMD, Simpelaere I. Measuring mealtime performance in older adults with suspected oropharyngeal dysphagia: an updated systematic review of psychometric properties. Disabil Rehabil 2023:1-15. [PMID: 36790118 DOI: 10.1080/09638288.2023.2178033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
PURPOSE To update a previous review of psychometric properties of performance-based outcome measurement instruments (PerFOMs) for task performance in the context of meal activity of older adults (≥65 years) with suspected oropharyngeal dysphagia (OD). MATERIALS AND METHODS Systematic searches were conducted in PubMed, CINAHL, EMBASE, SCOPUS, and Web of Science. Studies on PerFOMs that covers items reflecting skills in the pre-oral, oral, and pharyngeal stages of ingestion during meals were included. Two review authors independently screened, extracted, and evaluated the methodological rigour and quality of the reported psychometric properties in the included studies using the guidelines of the COnsensus-based Standards for the Selection of health Measurement INstruments (COSMIN). RESULTS Twenty-three articles featuring nine original PerFOMs and five translated versions were included. PerFOM development and content validity were rated with inadequate or doubtful methodological quality across all studies. The quality of the evidence across the additional psychometric properties of the PerFOMs was very low for two, ranged from very low to moderate for six, and from very low to high for five. CONCLUSIONS There is limited evidence of the psychometric properties of available PerFOMs for measuring task performance during meals in older adults with OD, and further validation is warranted.Implication for rehabilitationAssessing the mealtime performance of older adults with oropharyngeal dysphagia (OD) provides important information.Performance-based outcome measurement instruments (PerFOMs) need to be valid and reliable.Clinicians need to be careful when choosing PerFOMs to assess the mealtime performance of older adults with OD as there is insufficient evidence on the quality of available instruments.Established guidelines and standards should be used when developing and investigating psychometric properties of PerFOMs assessing mealtime performance of older adults with OD.
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Affiliation(s)
- Tina Hansen
- Department of Occupational and Physical Therapy, Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - Sophia Alberte Fisker Rasmussen
- Department of Occupational and Physical Therapy, Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - Jesper Fabricius
- Department of Clinical Medicine, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Linda-Maria Delgado Grove
- Department of Clinical Medicine, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Ingeborg Simpelaere
- Department of Paramedical Professions, VIVES University of Applied Sciences, University of Louvain, Brugge, Louvain-la-Neuve, Belgium
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8
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Nielsen KT, Andersen U, Wæhrens EE, von Bülow C. Quality of ADL task performance in persons with schizophrenia: Looking beyond independence. Scand J Occup Ther 2023:1-10. [PMID: 36635973 DOI: 10.1080/11038128.2023.2165541] [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: 01/14/2023]
Abstract
BACKGROUND Persons with schizophrenia may experience decreased ability to perform activities of daily living (ADL) indicated by need for assistance in everyday life. Others are independent, but their quality of ADL task performance in terms of effort and efficiency may still be impacted. AIMS/OBJECTIVES The overall purpose of this study was to explore the quality of ADL task performance in subgroups with schizophrenia (independent/needing assistance). MATERIALS AND METHODS Participants were in- and outpatients at a Psychiatric Hospital diagnosed with schizophrenia (n = 83). Their quality of ADL task performance was evaluated using the Assessment of Motor and Process Skills (AMPS). Evaluations were conducted at the hospital. Two subgroups (A: independent and B: needing assistance) were created based on AMPS ADL ability measures. RESULTS The majority in both subgroups had AMPS ADL ability measures within the risk zones. Further, the majority in subgroup A had ADL ability measures within age expectations but below mean for well persons of the same age. Both ineffective motor and process skills were identified in both subgroups. CONCLUSIONS/SIGNIFICANCE Occupational therapy is indicated for persons with schizophrenia, both for independent persons and for persons needing assistance. This is to prevent decline in or to enhance ADL ability.
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Affiliation(s)
- Kristina Tomra Nielsen
- The Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Andersen
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,The Department of Occupational Therapy, Copenhagen University College, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, Occupational Science, User Perspectives and Community-Based Research, University of Southern Denmark, Odense, Denmark
| | - Cecilie von Bülow
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Stewart V, Judd C, Wheeler AJ. Practitioners' experiences of deteriorating personal hygiene standards in people living with depression in Australia: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1589-1598. [PMID: 34240491 DOI: 10.1111/hsc.13491] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/29/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Functional impairment in people diagnosed with depression is common, although the domain of personal hygiene and grooming has received limited attention in the scholarly literature. While issues concerning personal hygiene and grooming by those experiencing depression have been reported in personal narratives, they are rarely included in symptom lists or treatment guidelines, or as an outcome indicator in research studies. The aim of this research was to better understand how mental health practitioners assessed, understood and worked with, service users diagnosed with depression who had previously exhibited declining personal hygiene and grooming standards. In-depth interviews (n = 16) explored the views of professionals experienced in this area of mental health practice. A qualitative descriptive methodology was utilised. Findings indicated that for some service users, personal hygiene and grooming issues were an integral aspect of their depression, which negatively impacted recovery, particularly in areas concerned with overall functioning, mood, social and vocational engagement, motivation, self-worth and esteem, and engagement with treatment. Study results supported the benefits of a person-centred approach to assess, engage with and intervene effectively when a decline in personal hygiene and grooming was noted. However, lack of pertinent research is a barrier to appropriately assessing specific skill or performance difficulties when declining standards are observed. This impedes the provision of interventions which might support the person to develop and maintain of personal hygiene routines, which conform to socially acceptable standards. Difficulties with personal hygiene and grooming presented both a barrier to recovery and an opportunity for timely and salient intervention. Further investigation is needed to build the research evidence needed to develop appropriate and acceptable interventions, and to inform effective treatment strategies.
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Affiliation(s)
- Victoria Stewart
- School of Human Services and Social Work, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Christine Judd
- School of Human Services and Social Work, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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10
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Garcia C, Collins R, McCabe D, Galvin R, Boland P. Impact of visual field loss post-stroke on activities of daily living: a prospective cohort study. Neuropsychol Rehabil 2022:1-16. [PMID: 35679176 DOI: 10.1080/09602011.2022.2081219] [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: 10/18/2022]
Abstract
This study investigated the ADL performances of people with VFL after an acute stroke using an observation-based evaluation of ADL skills, the Assessment of Motor and Process Skills. The AMPS was administered on initial assessment and at ≥11 weeks follow-up on 58 adults with a mild stroke, with (n = 16) and without VFL (n = 42), over a 13-month period. The AMPS guidelines on clinically relevant difference of 0.30 logits were used to determine the differences of the groups' ADL performance on initial assessment and follow-up. The study found that the ADL motor and process scores did not differ significantly on initial assessment. The study observed no clinically relevant difference between the ADL motor and process scores of between the VFL and non-VFL on initial assessment and follow-up but demonstrated clinically relevant improvements in ADL motor and process scores of both groups from initial assessment to follow-up. VFL does not have an additional negative impact on ADL performance of those with a mild stroke and does not impede improvement of ADL performance over time.
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Affiliation(s)
| | | | - Djh McCabe
- Tallaght University Hospital, Dublin, Ireland.,Vascular Neurology Research Foundation, Dept of Neurology, and Stroke Services, Tallaght University Hospital, Dublin, Ireland.,Department of Clinical Neurosciences, Royal Free Campus, UCL Queen Square Institute of Neurology, London, UK.,Academic Unit of Neurology School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Pauline Boland
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Schwarz R, Decker L, Seeberg I, Miskowiak KW, Kessing LV, Vinberg M. Affective disorders: eliminate WArning signs and REstore functioning-AWARE-a randomised controlled multimodule intervention study, presentation of design and intervention. BMJ Open 2022; 12:e058839. [PMID: 35618335 PMCID: PMC9137330 DOI: 10.1136/bmjopen-2021-058839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/02/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Affective disorders are associated with impaired overall functioning and quality of life (QoL). Despite different medical and psychological treatment options, the prognosis remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting patient groups with impaired functioning. This study aims to improve functioning and QoL in patients with affective disorders using a comprehensive 360° intervention. METHODS AND ANALYSIS Affective disorders: eliminate WArning signs And REstore (AWARE) functioning is a randomised, controlled, parallel-group design study. Participants will be 120 outpatients, men or women, aged 18-65 years, with a diagnosis of bipolar disorder or major depressive disorder. Inclusion requires an objectively rated impaired functioning defined as a score ≥11 according to the Functioning Assessment Short Test. Participants will be randomised to 6-month AWARE intervention or treatment as usual (TAU). The AWARE intervention is a 360° multimodal intervention based on the International Classification of Functioning Brief Core Set for bipolar and unipolar disorder targeting functioning.The primary outcome is improvement of observation-based activities of daily living (ADL) ability using Assessment of Motor and Process Skills. Secondary outcomes are changes from baseline to endpoint in functioning, QoL, stress, cognition and physical health.Our hypothesis is that the AWARE treatment in comparison with TAU will improve observed ability to perform ADL, patients self-perceived level of functioning and QoL.Status: currently recruiting patients. ETHICS AND DISSEMINATION Ethical approval has been obtained from The Regional Ethics Committee in the Capital Region of Denmark. All patients will be provided oral and written information about the trial before informed consent is obtained. The study results will be disseminated by peer-review publications. If the present AWARE intervention shows beneficial effects, the goal is to use it as a template for future interventions addressing disability in patients with affective disorders as well as for patients within other diagnostic categories. TRIAL REGISTRATION NUMBER NCT04701827; Clinicaltrials.gov.
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Affiliation(s)
- Rasmus Schwarz
- Research Unit, North Zealand Psychiatric Center, Hillerod, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Lone Decker
- Department of Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
| | - Ida Seeberg
- Department of Dialectical Behavior Therapy, North Zealand Psychiatric Center, Hillerod, Denmark
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maj Vinberg
- Research Unit, North Zealand Psychiatric Center, Hillerod, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
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12
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Hagelskjær V, Nielsen KT, von Bulow C, Oestergaard LG, Graff M, Wæhrens EE. Evaluating a complex intervention addressing ability to perform activities of daily living among persons with chronic conditions: study protocol for a randomised controlled trial (ABLE). BMJ Open 2021; 11:e051722. [PMID: 34836902 PMCID: PMC8628341 DOI: 10.1136/bmjopen-2021-051722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The need to develop and evaluate interventions, addressing problems performing activities of daily living (ADL) among persons with chronic conditions, is evident. Guided by the British Medical Research Council's guidance on how to develop and evaluate complex interventions, the occupational therapy programme (A Better everyday LifE (ABLE)) was developed and feasibility tested. The aim of this protocol is to report the planned design and methods for evaluating effectiveness, process and cost-effectiveness of the programme. METHODS AND ANALYSIS The evaluation is designed as a randomised controlled trial with blinded assessors and investigators. Eighty participants with chronic conditions and ADL problems are randomly allocated to ABLE or usual occupational therapy. Data for effectiveness and cost-effectiveness evaluations are collected at baseline (week 0), post intervention (week 10) and follow-up (week 26). Coprimary outcomes are self-reported ADL ability (ADL-Interview (ADL-I) performance) and observed ADL motor ability (Assessment of Motor and Process Skills (AMPS)). Secondary outcomes are perceived satisfaction with ADL ability (ADL-I satisfaction); and observed ADL process ability (AMPS). Explorative outcomes are occupational balance (Occupational Balance Questionnaire); perceived change (Client-Weighted Problems Questionnaire) and general health (first question of the MOS 36-item Short Form Survey Instrument). The process evaluation is based on quantitative data from registration forms and qualitative interview data, collected during and after the intervention period. A realist evaluation approach is applied. A programme theory expresses how context (C) and mechanisms (M) in the programme may lead to certain outcomes (O), in so-called CMO configurations. Outcomes in the cost-effectiveness evaluation are quality-adjusted life years (EuroQool 5-dimension) and changes in ADL ability (AMPS, ADL-I). Costs are estimated from microcosting and national registers. ETHICS AND DISSEMINATION Danish Data Protection Service Agency approval: Journal-nr.: P-2020-203. The Ethical Committee confirmed no approval needed: Journal-nr.: 19 045 758. Dissemination for study participants, in peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER NCT04295837.
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Affiliation(s)
- Vita Hagelskjær
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Occupational Therapy, VIA University College, Holstebro, Denmark
| | - Kristina Tomra Nielsen
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Aalborg, Denmark
| | - Cecilie von Bulow
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
- DEFACTUM, Department of Public Health and Rehabilitation, Central Denmark Region, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Maud Graff
- Department of Rehabilitation & Scientific Institute for Quality of Care Research, Radboud University Medical Center, Nijmegen, Netherlands
| | - Eva Ejlersen Wæhrens
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
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13
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Measuring self-reported ability to perform activities of daily living: a Rasch analysis. Health Qual Life Outcomes 2021; 19:243. [PMID: 34663347 PMCID: PMC8522042 DOI: 10.1186/s12955-021-01880-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022] Open
Abstract
Background Since the number of persons diagnosed with multi-morbidity is increasing, there is a need for generic instruments to be able to assess, measure and compare ADL ability across diagnoses. Accordingly, the ADL-Interview (ADL-I) was developed to be used in rehabilitation research and clinical practice. The aim of this study was to investigate if the ADL-I can be used to provide valid and reliable ADL ability measures across gender and diagnostic groups. Methods ADL-I data were extracted from an existing research database on persons with chronic conditions including medical, rheumatological, oncological, neurological, geriatric and psychiatric diagnoses. Data were analysed based on Rasch Measurement methods to examine: the psychometric properties of the rating scale; ADL item and person fit to the Rasch model; if the difficulty of the ADL tasks differs across gender and diagnostic groups, and if the ADL-I provides precise and reliable measures of ADL ability. Results Data on n = 2098 persons were included in the final analysis. Initial evaluation of the 0–3 rating scale revealed threshold disordering between categories 1 and 2. After removal of 16 underfitting items, the variance explained by the Rasch dimension increased from 54.3 to 58.0%, thresholds were ordered, but the proportion of persons with misfitting ADL-I measures increased slightly from 8.7 to 9.1%. The person separation index improved slightly from 2.75 to 2.99 (reliability = 0.90). Differential test function analysis, however, supported that the 16 underfitting items did not represent a threat to the measurement system. Similarly, ADL items displaying differential item functioning across gender and diagnoses did not represent a threat to the measurement system. The ADL items and participants were well distributed along the scale, with item and person measures well targeted to each other, indicating a small ceiling effect and no floor effect. Conclusions The study results overall suggest that the ADL-I is producing valid and reliable measures across gender and diagnostic groups among persons within a broad range of ADL ability, providing evidence to support generic use of the ADL-I. Trial registration N/A.
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14
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Hagelskjær V, Nielsen KT, von Bülow C, Graff M, Wæhrens EE. Occupational therapy addressing the ability to perform activities of daily living among persons living with chronic conditions: a randomised controlled pilot study of ABLE 2.0. Pilot Feasibility Stud 2021; 7:122. [PMID: 34116727 PMCID: PMC8192272 DOI: 10.1186/s40814-021-00861-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ABLE intervention was developed to enhance the ability to perform activities of daily living (ADL) tasks among persons living with chronic conditions. ABLE is a generic, home-based, individualised, 8-week occupational therapy intervention program, developed to be delivered in Danish municipalities. In a previous study, the feasibility of ABLE was evaluated in terms of content and delivery. In this pilot study, the remaining feasibility aspects of a randomised controlled trial including (i) trial procedures (recruitment and retention), (ii) randomisation, (iii) adherence to program, (iv) feasibility of additional outcome measurements, and (iv) access to information on usual occupational therapy were evaluated. METHODS The study was conducted in a Danish municipality, using a two-armed parallel randomised controlled design, planning a recruitment strategy including 20 persons living with one/more chronic conditions and experiencing problems performing ADL. The following progression criteria were used to determine if a future full-scale randomised controlled trial was feasible: (i) recruitment (50% met the eligibility criteria) and retention (80%), (ii) randomisation (80% accepted randomisation, procedure was executed as planned), (iii) adherence to program (100% followed the treatment protocol), (iv) outcome measurements (80% of the participants delivered relevantly and fully answered questionnaires), and (v) usual occupational therapy (extraction of needed information was successful). RESULTS Due to the COVID-19 pandemic, the study was truncated resulting in limited but sufficient data to answer most of the study questions. (i) Eighteen of 37 eligible persons (48.6%) were recruited; of those treated (n = 6), all remained (100%); (ii) 18 accepted randomisation (100%), and procedure was effective; (iii) ABLE was delivered with adherence (100%); (iv) 92.3-100% of the participants gave relevant and complete answers in two of three questionnaires; and (v) needed information on usual occupational therapy was extractable in seven of nine aspects. CONCLUSIONS Proceeding to full-scale trial is recommendable; however, a few adjustments on outcome measurements, inclusion criteria and extraction of information on usual occupational therapy are needed. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (Identifier: NCT04295837 ) on December 5th, 2019. Retrospectively registered.
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Affiliation(s)
- Vita Hagelskjær
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark. .,Occupational Science & Occupational Therapy, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark. .,Department of Occupational Therapy, VIA University College, Holstebro, Denmark.
| | - Kristina Tomra Nielsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
| | - Cecilie von Bülow
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Occupational Science & Occupational Therapy, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Maud Graff
- Department of Rehabilitation & Scientific Institute for Quality of Care Research, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Occupational Science & Occupational Therapy, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
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15
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Zera SM, Preissner K, Fischer H, Stoffel A. Cognitive orientation to daily occupation group in the adult day rehabilitation setting: A feasibility study. Br J Occup Ther 2021. [DOI: 10.1177/03080226211008713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction The Cognitive Orientation to daily Occupational Performance (CO-OP) ApproachTM is a leading approach in occupational therapy. Implementing the CO-OP ApproachTM in a group format in day rehabilitation has not yet been explored. Method In day rehabilitation, a barrier to implementing the CO-OP ApproachTM is the group model. To address these challenges, this feasibility study involved the development, implementation, and evaluation of a CO-OP group for adults. Four patients participated in six group sessions. Pre- and post-measures included the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Subjective data were collected to reflect the participant’s experiences during the group. Results 80% of participants recruited completed the group. All participants demonstrated improvement in goals addressed within the group and goals not addressed within the group on the COPM. AMPS findings were inconclusive. Subjective findings indicated participants appreciated the group learning environment, valued the CO-OP process, were motivated to participate, and would have liked more groups. Conclusion To our knowledge, this is the first adult CO-OP group in a clinical setting. Results support the feasibility of a CO-OP group in day rehabilitation and the need for further examination of the effectiveness of this intervention.
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Affiliation(s)
- Sarah M Zera
- Occupational Therapy Program, Midwestern University, USA
| | - Kathy Preissner
- Occupational Therapy Program, University of Illinois at Chicago, USA
| | - Heidi Fischer
- Occupational Therapy Program, University of Illinois at Chicago, USA
| | - Ashley Stoffel
- Occupational Therapy Program, University of Illinois at Chicago, USA
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16
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Nielsen KT, Klokker L, Wæhrens EE. Self-reported quality of activities of daily living task performance in four diagnostic groups with chronic conditions. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims To design intervention programmes addressing activities of daily living task performance problems in individuals with chronic conditions, more knowledge about the types of challenges these individuals experience is needed. The aim of this study was to examine the types of activities of daily living tasks, as well as the types of problems related to the quality of task performance, that individuals with chronic conditions report and determine similarities and differences in four diagnostic sub-groups. Methods Data on self-reported quality of activities of daily living task performance were collected among 593 individuals with rheumatological disease, incurable cancer, chronic obstructive pulmonary disease and schizophrenia, using the ADL-Interview. Activities of daily living tasks most frequently reported as problematic were identified within each sub-group. Sub-group profiles were generated to identify similarities and differences in quality of performance. Results Participants reported problems performing similar types of activities of daily living tasks across diagnostic sub-groups, especially within instrumental activities of daily living. Moreover, participants mainly reported a decreased quality of performance in terms of using extra time and/or increased physical effort while performing personal activities of daily living. Conclusions As individuals across four chronic conditions reported somewhat similar problems related to activities of daily living task performance, generic activities of daily living interventions addressing these problems seem appropriate, especially interventions addressing problems related to use of extra time and increased effort.
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Affiliation(s)
- Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
- The ADL Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark
| | - Louise Klokker
- The Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- The ADL Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark
- Occupational Science and Occupational Therapy, User Perspectives and Community-based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
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17
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Nielsen KT, Guidetti S, von Bülow C, Klokker L, Wæhrens EE. Feasibility of ABLE 1.0-a program aiming at enhancing the ability to perform activities of daily living in persons with chronic conditions. Pilot Feasibility Stud 2021; 7:52. [PMID: 33602338 PMCID: PMC7891027 DOI: 10.1186/s40814-021-00790-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 02/04/2021] [Indexed: 12/31/2022] Open
Abstract
Background The “A Better everyday LifE” (ABLE) intervention was developed to accommodate the need of a program addressing ability to perform activities of daily living (ADL) in persons with chronic conditions living at home. During intervention development, it is necessary to evaluate relevant aspects of the feasibility of a program. Thus, the aim was to evaluate the feasibility of content and delivery of ABLE version 1.0. Methods A one group pre- and post-test design was applied. Thirty persons with chronic conditions, two occupational therapists (OTs), and five occupational therapy students (OTSs) participated. ABLE 1.0 is an 8-week program consisting of ADL evaluation (session 1); goal setting and reasons for ADL problems (session 2); intervention (sessions 3–7); and re-evaluation (final session), conducted in the clients’ home-setting and local area. Sessions 1–4 and the final session was mandatory. To evaluate the feasibility of content and delivery, the OTs, after each session, reported on applied intervention component(s), time-use, needed equipment, adjustments, meaningfulness, confidence, progress toward goal attainment, and side effects using registration forms. The clients reported on progress toward goal attainment, meaningfulness, and satisfaction. Clinically relevant improvements in ADL ability were identified using the ADL-Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS). Goal attainment was evaluated using the Goal Attainment Scaling (GAS). Results Twenty clients (67%) completed ABLE 1.0 and received four sessions (median = 4, range 4–7) each lasting between 30 and 94 min. Most frequently applied component was “Changing habits related to task performance”. Generally, OTs reported having the needed equipment. Deviations from the manual were made by omission of GAS and AMPS and less than mandatory number of sessions per client. The OTs reported confidence in delivering the program and the clients perceived the program as meaningful and satisfying, and experienced progress toward goal attainment. Goal attainment was found in 52% of the goals. Sixteen (80%) clients obtained clinically relevant improvements in self-reported or observed ADL ability. Conclusions The content and delivery of ABLE 1.0 was feasible. However, the study revealed a need to adjust the recruitment procedure and make minor changes in the intervention manual. A pilot randomized controlled trial (RCT) study is recommended. Trial registration The study was registered at ClinicalTrials.gov with registration no. NCT03335709 on November 8, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00790-7.
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Affiliation(s)
- Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Selma Lagerløfs vej 2, DK-9220, Aalborg Ø, Denmark. .,The ADL Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark. .,The Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), J.B. Winsløwsvej 9, DK-5000, Odense, Denmark.
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden
| | - Cecilie von Bülow
- The ADL Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark.,The Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), J.B. Winsløwsvej 9, DK-5000, Odense, Denmark
| | - Louise Klokker
- The Musculoskeletal Statistics Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark
| | - Eva Ejlersen Wæhrens
- The ADL Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark.,The Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), J.B. Winsløwsvej 9, DK-5000, Odense, Denmark
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Kaptain RJ, Helle T, Patomella AH, Weinreich UM, Kottorp A. New Insights into Activities of Daily Living Performance in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:1-12. [PMID: 33447024 PMCID: PMC7802487 DOI: 10.2147/copd.s264365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/11/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose There have been calls for more knowledge of activities of daily living (ADL) performance in order to address interventions in pulmonary rehabilitation effectively. Everyday technology (ET) has become an integrated dimension of ADL, impacting the ways in which ADL is performed. To improve everyday functioning and quality of life, the use of ADL and ET use needs to be evaluated and addressed effectively in interventions. Therefore, the aim of this study was twofold: 1) to explore the quality of ADL performance, and 2) to investigate the relationship between observation and self-reported ADL performance and ability to use everyday technologies in people living with COPD. Methods This cross-sectional study involved 84 participants aged 46–87 years. Participants were recruited through healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were collected using standardized assessments that investigated different ADL perspectives: self-reported ADL tasks and ET use, observed motor and process ability, and need for assistance. Data were analysed and presented using descriptive statistics and Pearson’s correlation coefficient. Results The most affected ADL tasks were mobility within or outside the home, lower dressing, bathing, pedicuring, cooking, shopping, cleaning and washing clothes. New insights into the quality of ADL performance in people living with COPD were presented in terms of detailed ADL motor skills and ADL process skills, as well as the predicted need for support to function in the community. Moreover, new insights into the relationship between observation and self-reported ADL performance (r=0.546, p<0.01; r=0.297, p<0.01) and between ADL performance and self-perceived ability to use ET (r=0.524, p<0.01; r=0.273, p<0.05; r=0.044, p=0.692) were presented. Conclusion Overall, the knowledge from the present study is valuable for focusing interventions that address challenging ADL performance and ET use through relevant and realistic activities. The ability to use ET is important to evaluate and target pulmonary rehabilitation.
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Affiliation(s)
- Rina Juel Kaptain
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Tina Helle
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Ann-Helen Patomella
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark.,The Clinical Institute, Aalborg University, Aalborg, Denmark
| | - Anders Kottorp
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Health and Society, Malmö University, Malmö, Sweden
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19
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Wæhrens EE, Brandt Å, Peoples H, Cour K. Everyday activities when living at home with advanced cancer: A cross‐sectional study. Eur J Cancer Care (Engl) 2020; 29:e13258. [DOI: 10.1111/ecc.13258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 01/13/2020] [Accepted: 04/16/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Eva Ejlersen Wæhrens
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- Department of Rheumatology The ADL Unit The Parker Institute Copenhagen University Hospitals Bispebjerg – Frederiksberg Frederiksberg Denmark
| | - Åse Brandt
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- The National Board of Social Services Center for Disability and Mental Vulnerability Odense Denmark
| | - Hanne Peoples
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
| | - Karen Cour
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
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20
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Ransby TB, Hansen AØ, Rolving N. Psychometric properties of the Assessment of Motor and Process Skills in patients undergoing rehabilitation following hand-related disorders. HAND THERAPY 2020. [DOI: 10.1177/1758998320912761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Assessment of Motor and Process Skills (AMPS) has been proven to be a suitable measurement tool for assessing performance-based ADL ability; however, its reliability and validity have not been tested on patients with hand-related disorders. Methods Patients referred for outpatient hand rehabilitation were assessed with AMPS, The Canadian Occupational Performance Measure (COPM), dynamometer and goniometer at baseline and after eight weeks of hand therapy. Construct validity and responsiveness of AMPS were assessed by hypothesis testing. Construct validity was assessed by correlating the baseline score of AMPS with the baseline score of the other measurement tools. Responsiveness was assessed by correlating the change scores of each measurement tool with a Global Rating Scale. Results Fifty-one patients were recruited. The construct validity of AMPS indicated that the various measurement tools captured different aspects to functioning from the AMPS, as the correlations between AMPS and the other measurement tools were generally weak to low (r < 0.25 to 0.49). AMPS was less responsive than COPM when correlated with the GRS. The correlation between COPM and GRS was r = 0.62 compared with the AMPS motor, r = 0.45 and AMPS process, r = 0.33. Relative responsiveness of AMPS is similar to that of the dynamometer (r = 0.39) and goniometer (r = –0.34). Discussion In a sample of 51 patients, this study found that the construct validity of AMPS seemed to be moderate, while the responsiveness of AMPS seemed to be poor. However, due to the small sample size no conclusions can be made, and should be further assessed in larger studies.
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Affiliation(s)
- Thea Birch Ransby
- Department of Physical and Occupational Therapy, Diagnostic Center Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Alice Ørts Hansen
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nanna Rolving
- Department of Physical and Occupational Therapy, Diagnostic Center Silkeborg Regional Hospital, Silkeborg, Denmark
- DEFACTUM, Central Denmark region, Aarhus, Denmark
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Sampedro Pilegaard M, la Cour K, Brandt Å, Lozano-Lozano M, Gregersen Oestergaard L. Impact of pain, fatigue and dyspnoea on occupational performance in people with advanced cancer: A longitudinal study. Scand J Occup Ther 2019; 27:507-516. [PMID: 31729272 DOI: 10.1080/11038128.2019.1690042] [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: Pain, fatigue and dyspnoea are symptoms commonly experienced by people with advanced cancer, which may impact on their occupational performance. It is not known whether these symptoms impact their occupational performance over time.Objective: To examine correlation between pain, fatigue and dyspnoea and occupational performance and the impact of such symptoms on occupational performance over time in people with advanced cancer.Material and Methods: A longitudinal study was conducted including 242 participants assessed at baseline and after six and 12 weeks. Spearman's rank-order test and mixed linear models were performed.Results: The correlation between pain, fatigue and dyspnoea and occupational performance at baseline spanned from trivial to moderate (Spearman's rho: -0.004 to 0.34). Only pain had a statistically significant impact on activities of daily living (ADL) motor ability over time (p = 0.01). Participants with no pain problems had the largest decrease in ADL motor ability (-0.24 logits (95%-CI: -0.37 to -0.12)), but the observed decrease was not clinically relevant (≥-0.30).Conclusion: Pain, fatigue and dyspnoea did not seem to highly correlate with occupational performance or impact occupational performance over time of people with advanced cancer.
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Affiliation(s)
- Marc Sampedro Pilegaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.,Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Denmark
| | - Karen la Cour
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Åse Brandt
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Mario Lozano-Lozano
- The Department of Physical Therapy, University of Granada, Granada, Spain.,The "Cuídate", Support Unit for Oncology Patients (UAPO), Granada, Spain.,Department of Physical and Occupational Therapy, The Sport and Health Joint University Institute (IMUDS), Granada, Spain
| | - Lisa Gregersen Oestergaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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22
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Axmon A, Ekstam L, Slaug B, Schmidt SM, Fänge AM. Detecting longitudinal changes in activities of daily living (ADL) dependence: Optimizing ADL staircase response choices. Br J Occup Ther 2019. [DOI: 10.1177/0308022619853513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anna Axmon
- Epidemiology, Population studies, and Infrastructures at Lund University, Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Lisa Ekstam
- Department of Health Sciences, Lund University, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Sweden
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Brekke MF, la Cour K, Brandt Å, Peoples H, Wæhrens EE. The Association between ADL Ability and Quality of Life among People with Advanced Cancer. Occup Ther Int 2019; 2019:2629673. [PMID: 31531007 PMCID: PMC6745094 DOI: 10.1155/2019/2629673] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/09/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Occupational therapy and occupational science are founded on the theoretical core assumption that occupation and quality of life (QoL) are closely related. However, such theoretical core assumptions must be supported through empirically based research. OBJECTIVE To investigate the association between QoL and occupation, here self-reported and observed ADL abilities as a part of occupation, among people with advanced cancer, including determining whether self-reported or observed ADL ability had the stronger association with QoL. METHODS The study was nested in a cross-sectional study. The association between ADL ability and QoL among 108 people with advanced cancer was investigated using the ADL Interview (ADL-I), the Assessment of Motor and Process Skills (AMPS), and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30). RESULTS AND CONCLUSIONS Results showed that high observed ADL motor ability was associated with high QoL. In contrast, observed ADL process ability and self-reported ADL ability were not significantly associated with QoL. Oppositely expected, observed ADL ability had a stronger association with QoL than self-reported ADL ability. Thereby, the study to some extent contributes knowledge confirming the theoretical core assumptions about the relation between occupation, here performance of ADL, and QoL.
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Affiliation(s)
- Mette Falk Brekke
- Department of Occupational Therapy, University College Absalon, Næstved, Denmark
| | - Karen la Cour
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
- The Danish Knowledge Center for Rehabilitation and Palliative Care, REHPA, Vestergade 17, 5800 Nyborg, Denmark
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
| | - Åse Brandt
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense, Denmark
| | - Hanne Peoples
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Faculty of Health Sciences, Health Sciences Research Center, University College Lillebaelt, Odense, Denmark
| | - Eva Ejlersen Wæhrens
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- The Parker Institute, Copenhagen University Hospital Bispebjerg & Frederiksberg, Copenhagen, Denmark
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24
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Hansen AØ, Knygsand-Roenhoej K, Ardensø K. Danish version of the Patient-Rated Wrist/Hand Evaluation questionnaire: Translation, cross-cultural adaptation, test–retest reliability and construct validity. HAND THERAPY 2018. [DOI: 10.1177/1758998318807238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction In Denmark, there is a growing need for valid, reliable and standardized patient-rated outcome measures for use in clinical practice and research. The Patient-Rated Wrist/Hand Evaluation (PRWHE) is a self-reported assessment of hand-related disorders that measures pain and functional difficulties in activities of daily living. The purpose of this study was to: (1) translate and cross-culturally adapt the PRWHE into Danish and (2) assess the reliability and construct validity of the Danish version in patients with hand-related disorders. Methods The PRWHE was translated and cross-culturally adapted into Danish using the dual-panel approach. A total of 97 patients with diverse hand-related disorders and a mean age of 52.6 years (SD 15.2) participated in the psychometric testing. They were assessed on two occasions. Test–retest reliability was assessed using the Intraclass Correlation Coefficient (ICC2.1) to assess test–retest, Cronbach’s alpha to assess internal consistency and a Bland–Altman plot to estimate measurement error. Construct validity was investigated by evaluating the relationship between the Danish PRWHE (PRWHE-DK) and the Danish validated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Results Psychometric testing demonstrated an excellent test–retest reliability (ICC2.1 = 0.94) and internal consistency (alpha = 0.96). A systematic error of 1.5 and a measurement error of ± 16.1 were found. Furthermore, a strong correlation was found between PRWHE-DK and DASH ( r = 0.71). Conclusions The PRWHE-DK is a reliable, valid instrument for patients with different kinds of hand-related disorders, and can be used in clinical practice and multi-cultural research studies to measure pain and functional disability.
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Affiliation(s)
- Alice Ørts Hansen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopaedic Surgery, Odense University Hospital, Odense, Denmark
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
| | - Karin Knygsand-Roenhoej
- Department of Occupational Therapy and Physiotherapy, Aarhus University Hospital, Aarhus, Denmark
| | - Kecia Ardensø
- Department of Occupational Therapy and Physiotherapy, Zealand University Hospital, Køge, Denmark
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25
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Guidetti S, Nielsen KT, von Bülow C, Pilegaard MS, Klokker L, Wæhrens EE. Evaluation of an intervention programme addressing ability to perform activities of daily living among persons with chronic conditions: study protocol for a feasibility trial (ABLE). BMJ Open 2018; 8:e020812. [PMID: 29780029 PMCID: PMC5961614 DOI: 10.1136/bmjopen-2017-020812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION The number of persons living with a chronic condition is increasing worldwide. Conditions are considered chronic when lasting 1 year or more and requiring ongoing medical attention and/or limiting activities of daily living (ADL). Besides medical treatment, physical exercise to improve body functions is recommended and prescribed. However, improvements in body functions do not necessarily improve ability to perform ADL. Thus, it is necessary to develop interventions aiming directly at enhancing ADL ability. As a part of the research programme 'A Better Everyday Life', the first version of the ABLE intervention programme was developed. METHODS AND ANALYSIS This feasibility study examine the perceived value and acceptability of the ABLE programme by evaluating the fidelity, reach, dose and potential outcomes using a pretest and post-test design involving 30 persons living with chronic conditions. Qualitative interviews among occupational therapists delivering and participants receiving the ABLE programme will be conducted to explore aspects affecting the intervention. ETHICS AND DISSEMINATION The results will form the base for refinement of the ABLE programme and planning of a large-scale randomised controlled trial investigating the effect of the programme on self-reported and observed ADL ability. Dissemination will include peer-reviewed publications and presentations at national and international conferences. PROTOCOL VERSION 7 November 2017: v ersion 1.0. 19 February 2018: v ersion 2.0. TRIAL REGISTRATION NUMBER NCT03335709; Pre-results.
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Affiliation(s)
- Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Stockholm, Sweden
| | - Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Aalborg, Denmark
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
| | - Cecilie von Bülow
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
| | - Marc Sampedro Pilegaard
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
| | - Louise Klokker
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
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26
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Nielsen KT, Klokker L, Guidetti S, Wæhrens EE. Identifying, organizing and prioritizing ideas on how to enhance ADL ability. Scand J Occup Ther 2018; 26:382-393. [PMID: 29322869 DOI: 10.1080/11038128.2018.1424235] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is a need to develop evidence-based occupational therapy programs aiming at enhancing the ability to perform Activities of Daily Living (ADL) among persons living with chronic conditions. Information from different sources is to be integrated in the development process. Thus, it is necessary to engage both occupational therapists and persons living with chronic conditions in suggesting ideas on how to enhance the ADL ability. OBJECTIVE To identify, organize and prioritize ideas on how to enhance ability to perform ADL in persons with chronic conditions. MATERIAL AND METHOD Group Concept Mapping, involving brainstorming, sorting, labeling, rating and validation of ideas, was applied among persons with chronic conditions (n = ≤ 18) and occupational therapists (n = ≤ 23). Multidimensional scaling analysis and cluster analyzes were applied. RESULTS 149 ideas were identified and organized into seven clusters related to applying new adaptational strategies, personal factors, social surroundings and relevant services and opportunities. Each cluster contained ideas of high priority to persons with chronic conditions and/or occupational therapists. CONCLUSION A span of highly relevant themes, illustrated the complexity of enhancing ADL ability. This should be considered in the development of interventions aiming at enhancing ADL ability in persons with chronic conditions.
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Affiliation(s)
- Kristina Tomra Nielsen
- a The Occupational Therapy Department , University College of Northern Denmark , Aalborg , Denmark.,b The Parker Institute , Bispebjerg og Frederiksberg Hospital, Copenhagen University Hospital , Frederiksberg , Denmark.,c The Research Initiative for Activity Studies and Occupational Therapy (FiA), The Research Unit of General Practice , University of Southern Denmark , Odense , Denmark
| | - Louise Klokker
- b The Parker Institute , Bispebjerg og Frederiksberg Hospital, Copenhagen University Hospital , Frederiksberg , Denmark
| | - Susanne Guidetti
- d Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden
| | - Eva Ejlersen Wæhrens
- b The Parker Institute , Bispebjerg og Frederiksberg Hospital, Copenhagen University Hospital , Frederiksberg , Denmark.,c The Research Initiative for Activity Studies and Occupational Therapy (FiA), The Research Unit of General Practice , University of Southern Denmark , Odense , Denmark
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Toglia J, Askin G, Gerber LM, Taub MC, Mastrogiovanni AR, O'Dell MW. Association Between 2 Measures of Cognitive Instrumental Activities of Daily Living and Their Relation to the Montreal Cognitive Assessment in Persons With Stroke. Arch Phys Med Rehabil 2017; 98:2280-2287. [PMID: 28478128 DOI: 10.1016/j.apmr.2017.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/28/2017] [Accepted: 04/08/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To explore the relation between a computer adaptive functional cognitive questionnaire and a performance-based measure of cognitive instrumental activities of daily living (C-IADL) and to determine whether the Montreal Cognitive Assessment (MoCA) at admission can identify those with C-IADL difficulties at discharge. DESIGN Prospective cohort study. SETTING Acute inpatient rehabilitation unit of an academic medical center. PARTICIPANTS Inpatients (N=148) with a diagnosis of stroke (mean age, 68y; median, 13d poststroke) who had mild cognitive and neurological deficits. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Admission cognitive status was assessed by the MoCA. C-IADL at discharge was assessed by the Executive Function Performance Test (EFPT) bill paying task and Activity Measure of Post-Acute Care (AM-PAC) Applied Cognition scale. RESULTS Greater cognitive impairment on the MoCA was associated with more assistance on the EFPT bill paying task (ρ=-.63; P<.01) and AM-PAC Applied Cognition scale (ρ=-.43; P<.01). This relation was nonsignificant for higher MoCA scores and EFPT bill paying task scores. The AM-PAC Applied Cognition scale and the EFPT bill paying task had low agreement in classifying functional performance (Cohen's κ=.20). A receiver operating characteristic curve identified optimal MoCA cutoff scores of 20 and 21 for classifying EFPT bill paying task status and AM-PAC Applied Cognition scale status, respectively. For values above 20 and 21, sensitivity increased whereas specificity decreased for classifying functional deficits. Approximately one third of the participants demonstrated C-IADL deficits on at least 1 C-IADL measure at discharge despite having a MoCA score of ≥26 at admission. CONCLUSIONS Questionnaire and performance-based methods of assessment appear to yield different estimates of C-IADL. Low MoCA scores (<20) are more likely to identify those with C-IADL deficits on the EFPT bill paying task. The results suggest that C-IADL should be assessed in those who have mild or no cognitive difficulties at admission.
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Affiliation(s)
- Joan Toglia
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY; Department of Rehabilitation Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY.
| | - Gulce Askin
- Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, NY
| | - Linda M Gerber
- Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, NY
| | | | - Andrea R Mastrogiovanni
- Department of Rehabilitation Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY
| | - Michael W O'Dell
- Department of Rehabilitation Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY; Weill Cornell Medicine, New York, NY
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Experiences of people with a personality disorder or mood disorder regarding carrying out daily activities following discharge from hospital. Br J Occup Ther 2017. [DOI: 10.1177/0308022617697995] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction People with a diagnosed personality or mood disorder can experience challenges to participating in everyday life. Having a relapse of symptoms and an admission to hospital can further disrupt daily life. The aim of this study is to explore the experiences of people with a personality or mood disorder regarding carrying out everyday activities following discharge from hospital. Method Semi-structured interviews were carried out with 16 service users, by a researcher with lived experience of mental health problems and admissions to hospital. Findings Five themes were identified: The cumulative effect of multiple admissions on activities of daily living; the consequences of long admissions on daily living; reduced activities caused by social isolation in the first few months post-discharge; activities that people would like to do better post-discharge from hospital and longer term goals. Conclusion The findings of this study identified challenges people with a personality or mood disorder experience post-discharge from hospital regarding developing a daily routine, managing their home environment and participating in social activities. This indicates the importance of occupational therapy provision following discharge from hospital.
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Träger C, Decker L, Wæhrens EE, Knorr U, Miskowiak K, Vinberg M. Influences of patient informed cognitive complaints on activities of daily living in patients with bipolar disorder. An exploratory cross-sectional study. Psychiatry Res 2017; 249:268-274. [PMID: 28135597 DOI: 10.1016/j.psychres.2016.12.058] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/24/2016] [Accepted: 12/27/2016] [Indexed: 11/27/2022]
Abstract
Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of impaired occupational and psychosocial functioning. However, knowledge of how these deficits impact the patients' ability to perform Activities of Daily Living (ADL), tasks related to self-care and domestic life is limited. We explored the relation between impaired cognitive function and the ability to perform ADL in patients with BD. A total of 42 outpatients (mean age 36 years (range 19.0-58.0 years), 69% women) with BD in remission and with subjective cognitive complaints (≥ 13 on the Cognitive Complaints in Bipolar Disorder Rating Assessment questionnaire (COBRA)) were included. Objective neurocognitive function was evaluated with a short comprehensive cognitive test battery and ADL ability was evaluated with the performance-based Assessment of Motor and Process Skills (AMPS) in the homes of the patients. Our findings indicate that low processing speed correlated with decreased ADL ability, and processing speed as measured by the cognitive test battery thus seems to be significantly related to patients' ability to live independently in the community. Overall, adding a performance based test to assess ADL ability in patients with BD home-surroundings seems to provide new insights regarding the effect of cognitive impairment in patients with BD.
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Affiliation(s)
- Conny Träger
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lone Decker
- Department of Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Copenhagen University Hospital-, Bispebjerg and Frederiksberg, Frederiksberg, Denmark; Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ulla Knorr
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kamilla Miskowiak
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maj Vinberg
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
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30
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Decker L, Vinberg M. Ability to perform Activities of Daily Living among patients with bipolar disorder in remission. ACTA ACUST UNITED AC 2017. [DOI: 10.5348/d05-2017-33-oa-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Berg B, Atler K, Fisher AG. Is it possible to develop a cross-country test of social interaction? Scand J Occup Ther 2016; 24:421-430. [PMID: 27809634 DOI: 10.1080/11038128.2016.1250813] [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: 10/20/2022]
Abstract
OBJECTIVE The Evaluation of Social Interaction (ESI) is used in Asia, Australia, North America and Europe. What is considered to be appropriate social interaction, however, differs amongst countries. If social interaction varies, the relative difficulty of the ESI items and types of social exchange also could vary, resulting in differential item functioning (DIF) and test bias in the form of differential test functioning (DTF). Yet, because the ESI scoring criteria are designed to account for culture, the ESI should be free of DIF and DTF. The purpose, therefore, was to determine whether the ESI demonstrates DIF or DTF related to country. METHODS A retrospective, descriptive, cross-sectional study of 9811 participants 2-102 years, 55% female, from 12 countries was conducted using many-facet Rasch analyses. DIF analyses compared paired item and social exchange type values by country against a critical effect size (±0.55 logit). DTF analyses compared paired ESI measures by country to 95% confidence intervals. RESULTS All paired social exchange types and 98.3% of paired items differed by less than ±0.55 logit. All persons fell within 95% confidence intervals. CONCLUSIONS Minimal DIF resulted in no test bias, supporting the cross-country validity of the ESI.
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Affiliation(s)
- Brett Berg
- a Occupational Therapy Department , Colorado State University , Fort Collins , CO , USA
| | - Karen Atler
- a Occupational Therapy Department , Colorado State University , Fort Collins , CO , USA
| | - Anne G Fisher
- a Occupational Therapy Department , Colorado State University , Fort Collins , CO , USA.,b Department of Community Medicine and Rehabilitation, Division of Occupational Therapy , Umeå , Sweden
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32
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Johansson MM, Marcusson J, Wressle E. Development of an instrument for measuring activities of daily living in persons with suspected cognitive impairment. Scand J Occup Ther 2016; 23:230-9. [DOI: 10.3109/11038128.2016.1139621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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