1
|
Yabuwaki K, Shinohara K, Fujioka A, Inagaki S, Hirao K. Effectiveness of Comprehensive Environmental Support for Community-Dwelling Older Adults: A Single-Blind Randomized Controlled Trial. Am J Occup Ther 2024; 78:7803205070. [PMID: 38602705 DOI: 10.5014/ajot.2024.050431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
IMPORTANCE The importance of developing age-friendly environments is globally recognized. However, few clinical trials have comprehensively evaluated physical and social components of environments and examined the effects of offering support. OBJECTIVE To clarify the effectiveness of occupational therapy-based comprehensive environmental support for community-dwelling older adults. DESIGN A single-blind parallel-groups randomized controlled trial with blinded participants. SETTING Eight community-based settings under the long-term-care insurance system in regional towns and cities throughout Japan. PARTICIPANTS Sixty older adults age ≥65 yr who were new users of adult day care or adult day health care and allocated by stratified block randomization on the basis of age. INTERVENTION Comprehensive environmental support was provided to participants for 3 mo according to results on the Comprehensive Environmental Questionnaire for older adults (CEQ) to make improvements in environmental factors participants wanted to change to create a more satisfying life. OUTCOMES AND MEASURES The primary outcome measure was the Japanese Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) score at 3 mo postrandomization. Additionally, scores on the Short-Form Six-Dimension utility index were calculated. RESULTS The experimental group showed significant improvements in the SF-36's Role/Social Component Summary (p = .005) and Role-Physical (p = .02), Role-Emotional (p = .01), and Mental Health (p = .05) domains, with moderate effect sizes. The number needed to treat was 3.46, showing statistical significance. CONCLUSIONS AND RELEVANCE Occupational therapy-based comprehensive environmental support based on CEQ scores was effective, resulting in moderate improvements in health-related quality of life among community-dwelling older adults. Plain-Language Summary: Older adults experience a decline in physical and mental functions along with changes in social relationships. These problems make it challenging for older adults to perform valuable occupations, thus reducing their quality of life. This study demonstrated that occupational therapy based on the Comprehensive Environmental Questionnaire for older adults can improve health-related quality of life among community-dwelling older adults. Our findings pave the way for the development of an effective compensatory intervention model in occupational therapy practice.
Collapse
Affiliation(s)
- Kenji Yabuwaki
- Kenji Yabuwaki, PhD, OTR, is Professor, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan;
| | - Kazuya Shinohara
- Kazuya Shinohara, PhD, OTR, is Professor, Faculty of Health and Medical Sciences, Tokoha University, Hamamatsu, Japan
| | - Akira Fujioka
- Akira Fujioka, MS, OTR, is Association Certified Occupational Therapist, Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Okayama, Japan
| | - Shigeaki Inagaki
- Shigeaki Inagaki, MS, OTR, is Associate Professor, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Japan
| | - Kazuki Hirao
- Kazuki Hirao, PhD, OTR, is Associate Professor, Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| |
Collapse
|
2
|
De Coninck L, Declercq A, Bouckaert L, Döpp C, Graff MJL, Aertgeerts B. Promoting meaningful activities by occupational therapy in elderly care in Belgium: the ProMOTE intervention. BMC Geriatr 2024; 24:275. [PMID: 38509458 PMCID: PMC10953191 DOI: 10.1186/s12877-024-04797-6] [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: 03/21/2023] [Accepted: 02/08/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Older people want to age in place. Despite advancing functional limitations and their desire of aging in place, they are not always faithful to therapy that maintains independence and promotes safety. Occupational therapists can facilitate aging in place. Occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation. AIM To describe the content a high-adherence-to-therapy and evidence-based occupational therapy intervention to optimize functional performance and social participation of home-based physically frail older adults and wellbeing of their informal caregiver, and the research activities undertaken to design this intervention. METHODS A roadmap was created to develop the occupational therapy intervention. This roadmap is based on the Medical Research Council (MRC) framework and is supplemented with elements of the Intervention Mapping approach. The TIDieR checklist is applied to describe the intervention in detail. A systematic review and two qualitative studies substantiated the content of the intervention scientifically. RESULTS The application of the first two phases of the MRC framework resulted in the ProMOTE intervention (Promoting Meaningful activities by Occupational Therapy in Elderly). The ProMOTE intervention is a high-adherence-to-therapy occupational therapy intervention that consists of six steps and describes in detail the evidence-based components that are required to obtain an operational intervention for occupational therapy practice. CONCLUSION This study transparently reflects on the process of a high-quality occupational therapy intervention to optimize the functional performance and social participation of the home-based physically frail older adult and describes the ProMOTE intervention in detail. The ProMOTE intervention contributes to safely aging in place and to maintaining social participation. The designed intervention goes beyond a description of the 'what'. The added value lies in the interweaving of the 'why' and 'how'. By describing the 'how', our study makes the concept of 'therapeutic use-of-self' operational throughout the six steps of the occupational therapy intervention. A further rigorous study of the effect of the ProMOTE intervention on adherence, functional performance and social participation is recommended based to facilitate the implementation of this intervention on a national level in Belgium.
Collapse
Affiliation(s)
- Leen De Coninck
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium.
- CEBAM Belgian Center for Evidence-based Medicine vzw, Kapucijnenvoer 7, Leuven, 3000, Belgium.
| | - Anja Declercq
- LUCAS Center for Care Research and Consultancy & CESO Center for Sociological Research, KU Leuven, Minderbroedersstraat 8, Leuven, 3000, Belgium
| | - Leen Bouckaert
- Department of Occupational Therapy, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Carola Döpp
- Scientific Institute for Quality of Health Care, Department of Rehabilitation, Radboudumc Research Institute, Radboud University Medical Center, Houtlaan 4, Nijmegen, 6525 XZ, The Netherlands
| | - Maud J L Graff
- Scientific Institute for Quality of Health Care, Department of Rehabilitation, Radboudumc Research Institute, Radboud University Medical Center, Houtlaan 4, Nijmegen, 6525 XZ, The Netherlands
| | - Bert Aertgeerts
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium.
- CEBAM Belgian Center for Evidence-based Medicine vzw, Kapucijnenvoer 7, Leuven, 3000, Belgium.
| |
Collapse
|
3
|
Maximos M, Dal Bello-Haas V, Tang A, Stratford P, Kalu M, Virag O, Kaasalainen S, Gafni A. Barriers and Facilitators of a Community-Based, Slow-Stream Rehabilitation, Hospital-to-Home Transition Program for Older Adults: Perspectives of a Multidisciplinary Care Team. Can J Aging 2024; 43:124-140. [PMID: 37665030 DOI: 10.1017/s0714980823000442] [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] [Indexed: 09/05/2023] Open
Abstract
The purpose of this study was to examine the perspectives of support staff, health care professionals, and care coordinators working in or referring to a community-based, slow-stream rehabilitation, hospital-to-home transition program regarding gaps in services, and barriers and facilitators related to implementation and functioning of the program. This was a qualitative descriptive study. Recruitment was conducted through purposive sampling, and 23 individuals participated in a focus groups or individual semi-structured interview. Transcripts were analyzed by six researchers using inductive thematic analysis. Themes that emerged were organized based on a socio-ecological framework. Themes were categorized as: (1) macro level, meaning gaps while waiting for program, limited program capacity, and gaps in service post-program completion; (2) meso level, meaning lack of knowledge and awareness of the program, lack of specific referral process and procedures, lack of specific eligibility criteria, and need for enhanced communication among care settings; or (3) micro level, meaning services provided, program participant benefits, person-centred communication, program structure constraints, need for use of outcome measures, and follow-up or lack of follow-up. Implementation of seamless patient information sharing, documentation, use of specific referral criteria, and use of standardized outcome measures may reduce the number of unsuitable referrals and provide useful information for referral and program staff.
Collapse
Affiliation(s)
- Melody Maximos
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Ada Tang
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Paul Stratford
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Michael Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Olivia Virag
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Sharon Kaasalainen
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| | - Amiram Gafni
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Institute of Applied Health Science, Hamilton, ON, Canada
| |
Collapse
|
4
|
Colón-Ramirez WI, Román-Oyola RL, Segarra-Vazquez B, Mercado-Rolón KJ, Dávila Collazo E, Camacho-Martínez AJ, Vélez-Jiménez LM. Significance of an Interprofessional Healthy Aging Program for Community-Dwelling Older Adults: A Narrative Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241228187. [PMID: 38323344 DOI: 10.1177/10497323241228187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Participation is widely recognized as an important health determinant for older adults. Exploring interventions to promote active participation of community-dwelling older adults is an important step in translating current knowledge into practice. Few studies have examined community-level interventions to support older adults' participation. The study purpose was to examine the significance of the lived experiences of community-dwelling older adults who participated in an interprofessional healthy aging promotion program. The specific aims were to uncover the narrative significance of the lived experiences and how they evolved and intertwined with the life histories of the older adults 2 years after the intervention ended. A narrative inquiry design was used. Four key informants participated in two semi-structured interviews and a member-checking process. The data were analyzed from a three-dimensional inquiry space of time and continuity, place and context, and social interactions. The findings affirmed three core threads that wove the participants' lived experiences within the program together with their life histories after the intervention. These were enjoyment, learning, and sharing. Four themes revealed the essential elements of the lived experience, and three others exposed participants' growth and life enrichment, all being fundamental to participation. The 3-year community-level intervention was valued and a novel opportunity for facilitating participation and successful aging. It allowed the participants to acquire an evolved vision of self, have meaningful interactions, develop the means to engage in future community activities, implement new self-care strategies, and establish memories and friendships significant for life participation.
Collapse
Affiliation(s)
- Wanda I Colón-Ramirez
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Rosa L Román-Oyola
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Bárbara Segarra-Vazquez
- Clinical Laboratory Science Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Karla J Mercado-Rolón
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Emanuel Dávila Collazo
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Alma J Camacho-Martínez
- Cytotechnology Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Lypzia M Vélez-Jiménez
- Physical Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| |
Collapse
|
5
|
Lancey A, Slater CE. Heart failure self-management: a scoping review of interventions implemented by allied health professionals. Disabil Rehabil 2023:1-12. [PMID: 37975543 DOI: 10.1080/09638288.2023.2283105] [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: 05/30/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Heart failure (HF) is typically managed using both medical and patient self-management interventions. Individuals with HF often have frequent readmissions to hospital for medical management. Effective self-management can help to reduce the exacerbation of HF symptoms and the frequency of readmissions. METHODS A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines was conducted to identify literature on the interventions used by allied health professionals to promote HF self-management. A search strategy was implemented, and articles were reviewed by two independent reviewers. RESULTS Twenty articles met the inclusion criteria. Articles included interventions from physical therapy, nutrition, social work, and occupational therapy, as well as other health professions in team-based programs. The most common interventions were verbal education, textual information, monitoring resources, and skills practice. Interventions addressed diet/fluid control, exercise and activity, symptom monitoring, medication management, cardiovascular disease knowledge, and mental health. Many interventions were theory informed. CONCLUSION There is nascent evidence that interventions promoting HF self-management positively impact health and quality of life outcomes. HF self-management is multi-faceted and requires interprofessional collaboration. Further work is warranted exploring the impact of theory-informed interventions, and the effectiveness of interventions on self-management competence and desired health outcomes.
Collapse
Affiliation(s)
- Allyson Lancey
- Department of Occupational Therapy, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Craig E Slater
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA, USA
| |
Collapse
|
6
|
Toles M, Li Z, Bankole AO, Conklin JL, Vu T, Womack J. Characteristics of health care interventions in affordable senior housing: A scoping review. Geriatr Nurs 2023; 53:122-129. [PMID: 37536003 DOI: 10.1016/j.gerinurse.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
AIMS Older adults in affordable senior housing often experience chronic illness and unmet health care needs. This review describes studies reporting the characteristics and primary outcomes of health care interventions for older adults living in affordable senior housing. DESIGN A scoping review METHODS: After a systematic search in three databases, a team of investigators screened 1,284 titles and abstracts and selected 31 records with reports on 28 studies for review. Narrative synthesis was used to describe studies of interventions in senior housing and primary outcomes. RESULTS Studies typically used observational designs and added clinical staff, such as nurses and social workers, to provide health care interventions in groups (n = 15) or with individuals (n = 13). Outcomes were classified in four groups: wellness, symptom management, health care use, and physical function. A subset of 23 studies (82.1%) reported effective interventions. IMPACT Findings identify innovative interventions to promote health in affordable senior housing.
Collapse
Affiliation(s)
- Mark Toles
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, Campus Box #7460, Chapel Hill, NC 27599-7460, USA.
| | - Zhaoying Li
- University of North Carolina at Chapel Hill, Department of Health Sciences, Division of Occupational Science and Occupational Therapy, Bondurant Hall, Campus Box #7120, Chapel Hill, NC 27599-7120, USA
| | - Ayomide Okanlawon Bankole
- University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall, Campus Box #7460, Chapel Hill, NC 27599-7460, USA
| | - Jamie L Conklin
- University of North Carolina at Chapel Hill, Health Sciences Library, 335 S Columbia St., Chapel Hill, NC 27599, USA
| | - Thi Vu
- Yale University, School of Public Health, Department of Social and Behavioral Sciences, P.O. Box 208034, 60 College Street, New Haven, CT 06520-083, USA
| | - Jenny Womack
- Appalachian State University, Department of Rehabilitation Sciences, Levine Hall of Health Sciences, Suite 460, Boone, North Carolina, USA
| |
Collapse
|
7
|
Nielsen TL, Holst-Stensborg HW, Nielsen LM. Strengthening problem-solving skills through occupational therapy to improve older adults' occupational performance - A systematic review. Scand J Occup Ther 2023; 30:1-13. [PMID: 35995214 DOI: 10.1080/11038128.2022.2112281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Evidence supports the role of occupational therapy (OT) for older adults, and therapeutic use of problem solving may provide a way to improve older adult's occupational performance.Aim: To assess the effectiveness and describe the contents of OT interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills.Material and Methods: This systematic review followed the phases recommended by the Cochrane Collaboration. The following databases were searched for clinical trials on OT for populations 65+ years: CINAHL, EMBASE, MEDLINE and PsycINFO. The Cochrane risk-of-bias tool (RoB-2) and the GRADE approach were used to assess the quality of the evidence. Results were presented in tables and by narrative syntheses.Results: Five studies were included comprising a total of 685 participants. In four studies, OT with a problem-solving approach outperformed control conditions post intervention. The interventions involved problem identification, analysis, strategy development and implementation. Although no serious risk of bias was detected in the individual studies, the quality of evidence was deemed low due to inconsistent and imprecise results.Conclusions: Low-quality evidence suggests that strengthening older adults' problem-solving skills may improve their occupational performance.Significance: Further investigation is required before firm practice recommendations can be prepared.
Collapse
Affiliation(s)
- Tove Lise Nielsen
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark.,Programme for rehabilitation, Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
| | | | - Louise Moeldrup Nielsen
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark.,Programme for rehabilitation, Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
| |
Collapse
|
8
|
Klinedinst TC, Ciro CA, Kendzor DE. A pilot, randomized, feasibility study to improve health self-management behaviors in older adults with multiple chronic conditions and functional limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT). JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231163037. [PMID: 36911183 PMCID: PMC9998403 DOI: 10.1177/26335565231163037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
Background Approximately 45% of older adults in the U.S. have 2 or more chronic health conditions (e.g., arthritis, hypertension, diabetes) in addition to functional limitations that prevent performance of health self-management activities. Self-management continues to be the gold standard for managing MCC, but functional limitations create difficulty with these activities (e.g., physical activity, symptom monitoring). Restricted self-management accelerates the downward spiral of disability and accumulating chronic conditions which, in turn, increases rates of institutionalization and death by 5-fold. Currently, there are no tested interventions designed to improve independence in health self-management activities in older adults with MCC and functional limitations. Research suggests that older adults are more likely to change behavior with interventions that assist with planning health-promoting daily activities, especially when contending with complex medical regimens and functional limitations. Our team asserts that combining occupational therapy (OT) and behavioral activation (BA) shows promise to improve health self-management in populations with chronic conditions and/or functional limitations. This innovative combination uses the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach as well as the environmental modification, activity adaptation, and focus on daily routines from OT practice. Objectives We will test the effect of this combined approach in a Stage I, randomized controlled pilot feasibility study compared to enhanced usual care. We will recruit 40 older adults with MCC and functional limitation and randomize 20 to the PI- delivered BA-OT protocol. This research will inform modification and larger-scale testing of this novel intervention.
Collapse
Affiliation(s)
- Tara C Klinedinst
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center- Schusterman Campus, Tulsa, OK, USA.,Department of Internal Medicine, OU-TU School of Community Medicine, Tulsa, OK, USA
| | - Carrie A Ciro
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Heath Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
9
|
Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
Collapse
Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| |
Collapse
|
10
|
Takagi M, Goami N, Bontje P. Benefits of Daily Occupational Diary Use 3 Months After a Health Promotion Program for Community-Dwelling Older Adults. Am J Occup Ther 2022; 76:23894. [PMID: 35972878 DOI: 10.5014/ajot.2022.049153] [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] Open
Abstract
IMPORTANCE To enable community-dwelling older adults to continue to live satisfying lives, a feasible health promotion program is needed that consists of relatively few sessions and can be implemented over a brief period. OBJECTIVE To verify the relationship between a short-duration group program using an occupational diary and changes in satisfaction with occupation, a sense that life is worth living, and life satisfaction among community-dwelling older adults 3 mo after program cessation and to identify factors associated with changes in satisfaction with occupation after the program. DESIGN Before-and-after comparison study and case-control study. SETTING Public university in Japan. PARTICIPANTS Community-dwelling older adults (N = 144). INTERVENTION Four weekly group sessions and daily occupational diary keeping. OUTCOMES AND MEASURES Activity and Daily Life Satisfaction Scale for the Elderly, K-I Scale for the Feeling that Life is Worth Living among the Aged, and Life Satisfaction Index-Z. RESULTS Scores 3 mo postprogram were significantly higher than the pretest scores. Continued use of the diary was selected as a factor associated with changes in participants' satisfaction with occupation after the program. CONCLUSIONS AND RELEVANCE The program may improve satisfaction with occupation, a sense that life is worth living, and life satisfaction among community-dwelling older adults 3 mo after conclusion. Continued use of the diary may increase the possibility of maintaining or improving older adults' satisfaction with occupation beyond the duration of the program. What This Article Adds: The program consists of a small number of sessions and can be implemented in a short period. Occupational therapists can include it as an option for promoting the health of community-dwelling older adults.
Collapse
Affiliation(s)
- Masayuki Takagi
- Masayuki Takagi, PhD, OTR, is Associate Professor, Department of Occupational Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan;
| | - Naruko Goami
- Naruko Goami, OTR, is Freelance Occupational Therapist, Hiroshima, Japan
| | - Peter Bontje
- Peter Bontje, PhD, OTR, is Professor, Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| |
Collapse
|
11
|
Contandriopoulos D, Stajduhar K, Sanders T, Carrier A, Bitschy A, Funk L. A realist review of the home care literature and its blind spots. J Eval Clin Pract 2022; 28:680-689. [PMID: 34614538 DOI: 10.1111/jep.13627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES There is a large body of literature from all over the world that describes, analyzes, or evaluates home care models and interventions. The present article aims to identify the practical lessons that can be gained from a systematic examination of that literature. METHOD We conducted a three-step sequential search process from which 113 documents were selected. That corpus was then narratively analysed according to a realist review approach. RESULTS A first level of observation is that there are multiple blind spots in the existing literature on home care. The definition and delimitation of what constitutes home care services is generally under-discussed. In the same way, the composition of the basket of care provided and its fit with the need of recipients is under-addressed. Finally, the literature relies heavily on RCTs whose practical contribution to decisions or policy is disputable. At a second level, our analysis suggests that three mechanisms (system integration, case management and relational continuity) are core characteristics of home care models' effectiveness. CONCLUSION We conclude by providing advice for supporting the design and implementation of stronger home care delivery systems. Our analysis suggests that doing so implies a series of sequential steps: identify what system-level goals the model should achieve and which populations it should serve; identify what type of services are likely to achieve those goals in order to establish a basket of services; and finally, identify the best ways and specific means to effectively and efficiently provide those services. Those same steps can also support ex-post evaluations of existing home care systems.
Collapse
Affiliation(s)
- Damien Contandriopoulos
- School of Nursing, University of Victoria, Victoria, British-Columbia, Canada.,Institute on Aging and Lifelong Health, University of Victoria, Victoria, British-Columbia, Canada
| | - Kelli Stajduhar
- School of Nursing, University of Victoria, Victoria, British-Columbia, Canada.,Institute on Aging and Lifelong Health, University of Victoria, Victoria, British-Columbia, Canada
| | - Tanya Sanders
- School of Nursing, University of Victoria, Victoria, British-Columbia, Canada.,School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Annie Carrier
- École de Réadaptation, Faculté de Médecine et des Sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre de recherche sur le vieillissement, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Ami Bitschy
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British-Columbia, Canada
| | - Laura Funk
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
12
|
A Pilot Study of a Group Program Focused on Enabling Life Performance for Older Adults Living in the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073761. [PMID: 35409444 PMCID: PMC8998135 DOI: 10.3390/ijerph19073761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 02/01/2023]
Abstract
Background: This study attempts to determine whether a program focused on improving literacy in daily living is effective in preventing physical frailty, and to compare standard treatments for physical frailty. Methods: This study was designed as a pilot intervention study involving two groups. Twenty-five older adults aged 65 to 85 in Ward A, Tokyo, were randomly assigned to the literacy group or the exercise group on a regional basis and were given a 60- to 90-minute program twice a month, eight times over four months. The literacy group mainly used video materials to monitor learning, and the exercise group used a multifactor exercise program. Results: The LSI-Z, GAS-L, Maximum 5 m walking time, and TUG tests showed the main effects before and after the intervention in both groups (p < 0.05, p < 0.01). The WHOQOL26, Maximum 5 m walking time, and TUG tests also showed the main effects across both groups (p < 0.05). Conclusion: Both programs, when implemented independently, showed specific effects on subjective well-being, occupational performance, and physical fitness. However, QOL and physical fitness were significantly higher in the exercise group than in the literacy group. These results should be considered with caution because of the limited sample size of this pilot study.
Collapse
|
13
|
Lucas Molitor W, Feldhacker DR, Lohman H, Lampe AM, Jensen L. Occupational Therapy and the IMPACT Act: Part 1. A Systematic Review of Evidence for Fall Prevention and Reduction, Community Discharge and Reintegration, and Readmission Prevention Interventions. Am J Occup Ther 2022; 76:23116. [PMID: 34962516 DOI: 10.5014/ajot.121.049044] [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] Open
Abstract
IMPORTANCE Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. OBJECTIVE In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. DATA SOURCES We conducted a search of the literature published between 2009 and 2019. Study Selection and Data Collection: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. Conclusion and Relevance: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas. What This Article Adds: Our study provides important insights into the state of the evidence related to occupational therapy interventions to address three outcome areas of the IMPACT Act.
Collapse
Affiliation(s)
- Whitney Lucas Molitor
- Whitney Lucas Molitor, PhD, OTD, OTR/L, BCG, is Assistant Professor, Department of Occupational Therapy, and Undergraduate Public Health Program Director, University of South Dakota, Vermillion;
| | - Diana R Feldhacker
- Diana R. Feldhacker, OTD, OTR/L, BCPR, is Department Chair, Program Director, and Assistant Professor, Department of Occupational Therapy, Des Moines University, Des Moines, IA
| | - Helene Lohman
- Helene Lohman, OTD, OTR/L, is Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Angela M Lampe
- Angela M. Lampe, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Lou Jensen
- Lou Jensen, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| |
Collapse
|
14
|
Lucas Molitor W, Feldhacker DR, Lohman H, Lampe AM, Jensen L. Occupational Therapy and the IMPACT Act: Part 1. A Systematic Review of Evidence for Fall Prevention and Reduction, Community Discharge and Reintegration, and Readmission Prevention Interventions. Am J Occup Ther 2022; 76:23123. [PMID: 34967846 DOI: 10.5014/ajot.2022.049044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. OBJECTIVE In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. DATA SOURCES We conducted a search of the literature published between 2009 and 2019. Study Selection and Data Collection: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. Conclusion and Relevance: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas. What This Article Adds: Our study provides important insights into the state of the evidence related to occupational therapy interventions to address three outcome areas of the IMPACT Act.
Collapse
Affiliation(s)
- Whitney Lucas Molitor
- Whitney Lucas Molitor, PhD, OTD, OTR/L, BCG, is Assistant Professor, Department of Occupational Therapy, and Undergraduate Public Health Program Director, University of South Dakota, Vermillion;
| | - Diana R Feldhacker
- Diana R. Feldhacker, OTD, OTR/L, BCPR, is Department Chair, Program Director, and Assistant Professor, Department of Occupational Therapy, Des Moines University, Des Moines, IA
| | - Helene Lohman
- Helene Lohman, OTD, OTR/L, is Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Angela M Lampe
- Angela M. Lampe, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Lou Jensen
- Lou Jensen, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| |
Collapse
|
15
|
Smallfield S, Fang L, Kyler D. Self-Management Interventions to Improve Activities of Daily Living and Rest and Sleep for Adults With Chronic Conditions: A Systematic Review. Am J Occup Ther 2021; 75:12523. [PMID: 34780611 DOI: 10.5014/ajot.2021.046946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Chronic conditions often cause functional impairments in activities of daily living (ADLs) and rest and sleep, leading to decreased independence and self-efficacy. OBJECTIVE To aid occupational therapy practitioners in making informed decisions regarding self-management interventions to improve ADLs and rest and sleep for community-dwelling adults with chronic conditions. DATA SOURCES We identified literature published from 1995 to 2019 through searches of the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, and OTseeker. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to abstract and assess data quality and validity. The review followed American Occupational Therapy Association Evidence-Based Practice Project methodology. Studies addressing self-management interventions for community-dwelling adults ages 18 and older with chronic cardiovascular disease, Type 2 diabetes, heart disease, hypertension, chronic respiratory problems, or kidney disease were included. FINDINGS Fifteen articles met inclusion criteria and were categorized into ADLs and sleep. Strong evidence supports education to improve diabetic foot self-care. Low evidence addresses exercise and education to improve ADLs for people with heart disease and chronic obstructive pulmonary disease. Moderate evidence supports mind-body self-care education to enhance sleep. CONCLUSIONS AND RELEVANCE Occupational therapy practitioners working with adults with diabetes are encouraged to routinely offer education that includes discussion of risk factors and daily foot inspections and hygiene. When addressing sleep, education that addresses sleep hygiene, nutrition, relaxation techniques, and physical activity should routinely be provided to adults with chronic conditions. Further research is needed to understand the dosage needed. What This Article Adds: This systematic review supports the role of occupational therapy in providing self-management interventions to address ADLs and sleep for adults with diabetes and other chronic conditions.
Collapse
Affiliation(s)
- Stacy Smallfield
- Stacy Smallfield, DrOT, MSOT, OTR/L, BCG, FAOTA, is Associate Program Director and Capstone Coordinator, Division of Occupational Therapy, College of Allied Health Professions, University of Nebraska Medical Center, Omaha. At the time of the study, Smallfield was Associate Professor of Occupational Therapy and Medicine and Assistant Director, Occupational Therapy Entry-Level Professional Programs, Washington University School of Medicine, St. Louis, MO;
| | - Lea Fang
- Lea Fang, OTD, OTR/L, is Occupational Therapist, SSM Health Physical Therapy, St. Louis, MO. At the time of the study, Fang was Doctoral Student, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Darby Kyler
- Darby Kyler, OTD, OTR/L, is Occupational Therapist. At the time of the study, Kyler was Doctoral Student, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| |
Collapse
|
16
|
Estrany-Munar MF, Talavera-Valverde MÁ, Souto-Gómez AI, Márquez-Álvarez LJ, Moruno-Miralles P. The Effectiveness of Community Occupational Therapy Interventions: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063142. [PMID: 33803688 PMCID: PMC8002958 DOI: 10.3390/ijerph18063142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 01/28/2023]
Abstract
Background: This review aims to evaluate the level of scientific evidence for the effectiveness of Community Occupational Therapy interventions. Methods: A systematic review was used to analyze and synthesize the studies collected. The databases of Cochrane, OTseeker, OTCATS, Web of Science, Scielo and Scopus were used in order to collect articles published between 2007 and 2020. PRISMA recommendations were followed. Results: A total of 12 articles comprised part of the study (7 randomized controlled studies, 4 systematic reviews and 1 meta-analysis). The main areas of practice were geriatric gerontology (22.1%) and mental health (19.7%), which were statistically significant (χ2; p < 0.005) compared to the rest. Regarding the studies analyzed, all of them had scores of >7 on the PEDro and AMSTAR scales. Conclusions: Research on Community Occupational Therapy constitutes a consolidated line of research but the objectives and areas of research were limited. Descriptive qualitative methodology predominated and studies on the effectiveness of Community Occupational Therapy interventions showed a medium–low level of evidence.
Collapse
Affiliation(s)
| | - Miguel-Ángel Talavera-Valverde
- Integra Saúde Research Unit, Department of Health Sciences, Universidade da Coruña, 15001 A. Coruña, Spain
- Correspondence: (M.-Á.T.-V.); (A.-I.S.G.)
| | - Ana-Isabel Souto-Gómez
- Integra Saúde Research Unit, University School of Social Work, Universidade Santiago de Compostela, 15704 Santiago de Compostela, Spain
- Correspondence: (M.-Á.T.-V.); (A.-I.S.G.)
| | | | - Pedro Moruno-Miralles
- Department of Nursing, Physiotherapy and Occupational Therapy, Castilla-La Mancha University, 45600 Toledo, Spain;
| |
Collapse
|
17
|
Role of Occupational Therapy in Primary Care. Am J Occup Ther 2020; 74:7413410040p1-7413410040p16. [DOI: 10.5014/ajot.2020.74s3001] [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] Open
Abstract
Abstract
The American Occupational Therapy Association (AOTA) affirms that occupational therapy practitioners1 are well prepared to contribute to interprofessional collaborative care teams addressing the primary care needs of individuals across the life course. Because of an increased focus on preventive population health and social determinants of health by health care organizations, synergy between primary care and occupational therapy is growing, with support for client-centered,2 comprehensive whole-person care, health promotion and prevention, disease self-management, and quality of life (Halle et al., 2018). Occupational therapy practitioners’ distinct knowledge of the significant impact that roles, habits, and routines have on health and wellness makes their contribution to primary care valuable (AOTA, 2020b). Occupational therapy’s focus on meaningful engagement in occupations is relevant and vital to participation in individual, family, and community life (AOTA, 2020c). In addition, occupational therapy practitioners’ holistic and population perspectives allow them to be effective both as interprofessional health care team members and as direct care providers to support client, family, and community needs in primary care delivery models (Leland et al., 2017). The purposes of this position paper are to define primary care and to describe occupational therapy’s evolving and advancing role in primary care, including expansion of services into specialty primary care areas such as pediatric primary care and obstetrics and gynecology (AOTA, 2018).
Collapse
|
18
|
Reitz SM, Scaffa ME, Dorsey J. Occupational Therapy in the Promotion of Health and Well-Being. Am J Occup Ther 2020; 74:7403420010p1-7403420010p14. [PMID: 32365325 DOI: 10.5014/ajot.2020.743003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A balanced pattern of occupations enhances the health and fulfills the needs of individuals, families, communities, and populations (American Occupational Therapy Association [AOTA], 2014b; Hocking, 2019; Meyer, 1922). Occupations are personalized "everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life" (World Federation of Occupational Therapists, 2012, para. 2). The purpose of this statement is to describe occupational therapy's role and contribution in the areas of health promotion and prevention for internal and external audiences. AOTA supports and promotes the involvement of occupational therapy practitioners¹ in the development and delivery of programs and services that promote health, well-being, and social participation of all people.
Collapse
|
19
|
Nielsen TL, Nielsen LM. Can strengthening older adults' problem-solving skills through occupational therapy improve their occupational performance? A protocol for a systematic review and meta-analysis. Scand J Occup Ther 2020; 28:348-353. [PMID: 32544358 DOI: 10.1080/11038128.2020.1775886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Older adults' occupational performance is challenged due to chronic health conditions, aging processes, and deteriorating functioning. Thus, their occupational performance cannot be expected to remain stable in the long term after an occupational therapy intervention. Older adults may therefore need to strengthen their problem-solving skills during occupational therapy not only to solve current occupational performance issues but also to maintain their improvements and deal with new such issues a later point in time. AIMS This systematic review and meta-analysis aims to identify, analyse and present current scientific knowledge about the effectiveness and contents of occupational therapy interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills. METHODS MEDLINE, EMBASE, CINAHL and PsycINFO will be searched systematically to identify trials of occupational therapy interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills. We will include randomized controlled trials and quasi-experimental trials in populations aged 65+. Three reviewers will independently screen and select references, extract data and assess the quality of included studies using the Cochrane Collaboration's risk of bias tool. SIGNIFICANCE The findings can inform and inspire clinical practice and will help to identify the need for further research.
Collapse
Affiliation(s)
- Tove Lise Nielsen
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark.,Programme for rehabilitation, VIA University College Research Centre for Health and Welfare Technology, Aarhus, Denmark
| | - Louise Moeldrup Nielsen
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark.,Programme for rehabilitation, VIA University College Research Centre for Health and Welfare Technology, Aarhus, Denmark
| |
Collapse
|
20
|
Smallfield S, Elliott SJ. Occupational Therapy Interventions for Productive Aging Among Community-Dwelling Older Adults. Am J Occup Ther 2020; 74:7401390010p1-7401390010p5. [PMID: 32078523 PMCID: PMC7018457 DOI: 10.5014/ajot.2020.741003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Evidence Connection articles provide clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of an older adult who was referred to outpatient occupational therapy services due to chronic back pain from herniated discs. Findings from the systematic review of occupational therapy for community-dwelling older adults were published in the July/August 2018 issue of the American Journal of Occupational Therapy (Berger et al., 2018; Elliott & Leland, 2018; Hunter & Kearney, 2018; Liu et al., 2018; Smallfield & Lucas Molitor, 2018a, 2018b) and in the American Occupational Therapy Association's Occupational Therapy Practice Guidelines for Productive Aging for Community-Dwelling Older Adults. Each article in the Evidence Connection series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. These articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.
Collapse
Affiliation(s)
- Stacy Smallfield
- Stacy Smallfield, DrOT, OTR/L, BCG, FAOTA, is Associate Professor of Occupational Therapy and Medicine and Assistant Director of Entry-Level Programs, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO;
| | - Sharon J Elliott
- Sharon J. Elliott, DHS, GCG, OTR/L, BCG, FAOTA, is Healthy Aging Specialist, Pitt County Council on Aging, Greenville, NC
| |
Collapse
|
21
|
Liu CJC. Functional Ability in the Changing Demographic Landscape: Evidence and Opportunities for Occupational Therapy. Am J Occup Ther 2019; 72:7204170010p1-7204170010p5. [PMID: 29953824 DOI: 10.5014/ajot.2018.724002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The growing number of older adults is changing the demographic landscape. Occupational therapy can better serve the older adult population by helping them maintain their functional ability, which is the ability to engage in occupations. This special issue includes both studies of interventions to evaluate and support functional ability in community-dwelling older adults and systematic reviews of such studies. This editorial highlights the six systematic reviews, which were completed in collaboration with the American Occupational Therapy Association's Evidence-Based Practice Project. These reviews compile evidence for the effectiveness of interventions within the scope of occupational therapy practice to promote occupational performance in community-dwelling older adults. The distinct value of occupational therapy in supporting the functional ability of community-dwelling older adults with stable or declining health is discussed using the World Health Organization's framework for healthy aging.
Collapse
Affiliation(s)
- Chiung-Ju Cj Liu
- Chiung-ju (CJ) Liu, PhD, OTR, FGSA, is Associate Professor, Indiana University Department of Occupational Therapy, School of Health and Human Sciences, Indiana University, Indianapolis;
| |
Collapse
|