Occupational therapy and cooking: A scoping review and future directions

BACKGROUND

Occupational therapy (OT) has historically used cooking as an intervention and assessment approach across settings. Current practices in OT and the emergence of the multidisciplinary field of culinary medicine highlight the relationship between cooking and health.

AIMS/OBJECTIVES

To map the current literature on OT and cooking and to identify key factors that may facilitate collaboration within culinary medicine.

MATERIALS AND METHODS

We conducted a scoping review using the Joanna Briggs Institute methodology to identify primary contexts and clinical settings. Publications were analysed using framework thematic analysis to identify OT themes and roles.

RESULTS

A total of 56 studies met the criteria for inclusion. The majority of studies (n = 29, 53%) represented home/community settings and brain injury was the largest clinical group (n = 15, 27%). Primary themes related to person (n = 47, 43%), occupation (n = 30 (28%), environment (n = 19, 17%), and psychosocial wellbeing (n = 13, 12%). The primary OT role identified was that of interventionist (n = 48, 86%).

CONCLUSIONS/SIGNIFICANCE

OT's holistic practice places cooking within a larger context that can help identify and overcome the barriers to participation. Findings support multiple pathways in which OT can contribute to cooking initiatives for health promotion and potentially expand OT practice in population health.

Effectiveness of IADL interventions to improve functioning in persons with Schizophrenia: A systematic review

BACKGROUND OF THE STUDY

Instrumental activities of daily living (IADL) are activities that are needed to live an independent life. Psychotic disorders are associated with deficits in everyday functioning, causing impairment/disability in activities of daily living. Activities play a crucial role to measure functional health or disability. People with Schizophrenia often present difficulties in social and occupational reintegration that may be associated with problems in performing daily activities, including independent living, education, working, and socializing. Activities of daily living and instrumental activities of daily living (life skills training) including leisure and social skills training intended to reintegrate the patient into the community to lead an everyday life.

AIM

The aim of this review was to identify the effect of skill-based interventions on independent functioning in persons with Schizophrenia.

METHODS

The authors conducted database searches of Google Scholar, PubMed, Science Direct, ProQuest, EBSCO from 1st January 1992 to 31st December 2020. The researcher extracted data, and the quality of included studies was rated by two authors independently. We used the Cochrane Risk of Bias (ROB) tool for assessing the quality of selected studies. The search identified nine studies that met the inclusion criteria with 655 participants. The outcome measure was independent functioning skills.

RESULTS

The interventions in the review were multifaceted with different combinations of psychoeducation, cognitive-behavioral methods, training in social skills, and IADL. The interventions resulted in significant improvement in functioning skills and reduction in relapse rates.

CONCLUSION

Results of this review have revealed moderate to strong evidence for skills training, either behavioral or social skills to improve social and independent functioning, reduce caregiver burden, and improve negative symptoms. The review also supported that interventions could be generalized across settings.

Randomised controlled trials of occupational therapy interventions for adults with a mental health condition or dementia: A systematic review of study methods and outcome measurement

Introduction

High-quality randomised controlled trials (RCTs) of interventions are essential for determining whether an intervention is effective. However, many RCTs that examine the effectiveness of occupational therapy interventions for adults with mental health conditions or dementia have methodological limitations that reduce confidence in their results. We aimed to systematically review the quality of methods and outcome measures used in RCTs of occupational therapy interventions for adults with a mental health condition or dementia. This will inform future research in this area and enable practitioners to appraise the evidence when selecting interventions.

Method

We searched peer-reviewed English language publications from 2000 to 2021 in MEDLINE, PsycINFO, ASSIA, CINAHL and e-thos, and hand-searched 12 journals. We included papers that met pre-specified inclusion criteria, appraised quality using a validated tool and extracted data. We conducted a narrative synthesis.

Results

Of thirty-three included papers, 26 reported full or pilot RCTs, two reported secondary analysis or secondary outcomes of included RCTs, three reported process evaluations and two reported economic evaluations. Methodological limitations were found in many studies and outcome measures varied in their psychometric quality.

Conclusion

High-quality RCTs of occupational therapy interventions are needed for adults with mental health conditions and dementia. Researchers should follow international guidelines for rigorously developing and evaluating interventions and reporting studies. Practitioners should critically apply RCT evidence when selecting occupational therapy interventions.

The relationship between Motivation for Occupation and Pattern of Occupation scores of the MOHOST and types of discharge placement from a mental health rehabilitation unit

Introduction

Model of Human and Occupational Screening Tool (MOHOST) is a scale used to assess occupational functioning in mental health inpatients which can inform suitable post-discharge placements. However, there is little research on the relationship between scores on Motivation for Occupation (MO) and Pattern of Occupation (PO) subscales of the MOHOST and types of discharge placement.

Method

The records of all patients discharged over a 2-year period from a male psychiatric rehabilitation unit were examined. All patients had undergone MOHOST assessments; however, these scores were not a factor in their discharge placement selection. Analyses were done on types of discharge placements (transfer to another psychiatric unit or community discharge) versus predischarge scores in MO and PO of MOHOST.

Results

N = 20 and average length of stay was 23 months. There was positive correlation between MO and PO scores and discharge placements (rs = 0.66, p = 0.002; rs = 0.67 and p = 0.001, respectively). Using ordinal logistic regression, for each unit increase of negative score in PO, there was 0.68 increase in the log odds of more restrictive discharge placements, p = 0.008.

Conclusion

The study suggests that MOHOST is a useful tool in determining suitable placements for patients being discharged or transferred from psychiatric rehabilitation units.

Food skills group value, meaning, and use with inpatients in a mental health setting

Introduction

Occupational therapists use food skills groups to support mental health recovery and engagement in meaningful occupation. Research examining participants’ experiences in these mental health groups is sparse.

Method

Researchers used a convergent parallel mixed methods design. Following participation in an inpatient food skills group, 60 participants completed a questionnaire, and 20 also participated in a semi-structured interview. The questionnaire data was analysed using descriptive and correlational statistics. The interview data was analysed using thematic analysis. Triangulation was used to combine and interpret findings from the different methods to gain a more complete understanding of the participants’ experiences.

Findings

Participants strongly agreed/agreed that they enjoyed participating, felt having the opportunity to participate was important to their recovery, and after discharge would use the skills they had learnt. Age, sex, and level of education were associated with some of the questionnaire responses. Three main themes emerged from the interview data: importance of engaging/doing, connections with food, and being involved in a group process.

Conclusion

Individuals who participated in the food skills group valued having the opportunity to build skills and engage in meaningful activities with others while in hospital. They identified the food skills group as important to their recovery.

A Rasch analysis of the model of human occupation screening tool single observation form (MOHOST-SOF) in mental health

Introduction

This study examined the psychometric properties of the model of human occupation screening tool single observation form.

Method

Clinical records were extracted pre- and post-treatment for 152 mental health service users. Data were model of human occupation screening tool single observation form scores and demographics. We investigated the form using Rasch analysis; we also present an analysis of change over time.

Results

We identified four misfitting items and evidence of instability with respect to change over time. After anchoring to adjust for unstable estimates, it was possible to measure client change, and there were significant differences in form scores pre–post treatment indicating client improvement in ability.

Conclusion

The study provides initial psychometric assessment of this version of the model of human occupation screening tool.

Introducing Prioritisation Protocols to Promote Efficient and Effective Allocation of Mental Health Occupational Therapy Resources

At a time of unprecedented financial constraints in the National Health Service, occupational therapy services are required to develop mechanisms to ensure the efficient allocation of occupational therapy resources. This paper describes the development of prioritisation protocols within a mental health trust. A review of their implementation found that occupational therapists were finding the protocols helpful in prioritising referrals and clarifying the added value of their interventions. These findings and the follow-up action plan suggest how protocols such as these can be used effectively to ensure that the occupational needs of service users are met, resulting in enhanced outcomes.