Group items tagged

This article, published by AJOT in July 2006, is titled Occupational Therapy Activities and Intervention Techniques for Clients With Stroke in Six Rehabilitation Hospitals. As the title suggests, this article discusses various occupational therapy intervention strategies, as well as their effectiveness, for the treatment of patients with CVAs. Control of upper extremity exercises as well as activities of daily living practice were the most common form of occupational therapy intervention techniques utilized.

I chose this article because I treat many CVA patients in my setting. I was curious to see how the typical VA treatments related to other hospitals with their treatments. The results were very similar. Mainly we work on functional activities and we add in some exercising to strengthen and further enhance the functional abilities.

This test could be used in acute care. This assessment offers a hospital version (MET_HV) that would be appropriate in the VA setting. This test was developed for use with a wider range of participants than the original version; it has more concrete rules, simplification of task demands and space provided on the instruction sheet for the patient to record the information they were to collect. There are 12 separate subtasks within four sets of simple tasks. These four task sets are as follows: 1. The patient must complete six specific errands (purchase 3 items, use the phone, collect and envelope from reception and send a letter to an external address), 2. The patient must obtain and write down four items of designated information (e.g. the opening time of a shop on Saturday), 3. The patient must meet the assessor outside of the hospital reception in 20 minutes after the test had begun and state the time, 4. The client must inform the assessor when he/she finishes the test. The test cannot be administered to patients confined to bed due to the nature of the questions. The test would be difficult to complete on patients instructed to only get up with help as they would have to have a nurse available at the time they need to meet some of the task requirements. Both validity and reliability have been established for this test for various populations (see citation for specifics).

This is an ADL assessment we're considering to use at my facility to help with "standardizing" our outcomes. The hospital in which we receive most of our referrals uses this assessment...the carryover would benefit to document progress throughout the therapy process. The article itself examines the accuracy of this assessment for discharge planning and concludes the accuracy is good/fair.

Occupational therapy for stroke patients not admitted to hospital: a randomised controlled trial. By - Mphi MF Walker, MD JRF Gladman, Prof, PhD NB Lincoln, MCSP P Siemonsma, SROT T Whiteley

Janszky, J., Blom, S., Georgiades, A., Laszlo, K., Alinaghizadeh, H., Ahnve, S. (2007) study aimed to evaluate the effect of a 1-year stress management program, aimed at reducing symptoms of depression and vital exhaustion (VE) in women in coronary heart disease (CHD). The study included 247 women who were conveniently recruited after a cardiac event of AMI, PCI, CABG at Karolinska University Hospital at Huddinge or at St. Gorans Hospital in Stockholm, Sweden. The experimental group which included stress management (20 2-hour sessions) and medical care by a cardiologist or the control group that consisted of usual care health post heart surgeries with no stress management session. The study had many limitations, first were women who did not want to participate in the 1 year intervention were not compared to those who did. The study also did not enroll subjects who may have been considered healthier. The subjects in the treatment group were in the care of a cardiologist and the self-rated vital exhaustion and depressive symptom measures may have been biased. The results of the study included that vital exhaustion for both groups improved over time and the decreased amount of VE was more pronounced in the intervention group. The change in depressive symptoms between the two groups did not differ.

This assessment is based on observation of a patient in a more natural environment/setting and looks at if they initiate expected activities such as, turning off appliances, closing doors when they leave, doing dishes, prepping dinner.. etc within 15 min of expected time. This is looked at and recorded each day of the week. In acute care this is just not very applicable, as we don't watch patients all day, every day of the week and the Vets are in an unfamiliar setting where they likely won't initiate such activities even if cognition is unimpaired. Even the activities that do occur in the hospital setting, such as eating lunch, don't apply very well because the score is acquired by adding up how they did each day of the week and it is not very practical to see a patient every day for the entirety of their lunch for a week straight. This may be a nice assessment for the nursing home to use in some instances.

This is a fact sheet from AOTA which discusses OT's role in community mental health. This is an area in which OTs play an important role as mental health services shift from a a hospital based setting to more community based. It has been shown that OT interventions help to improve outcomes for those living in the community with serious mental illnesses. OT's can help to address the areas of education, work skills, health/wellness, and cognitive remediation and adaption. This document also discusses ways in which OT can help to address community barriers to functioning such as SES, stigma, safety, and housing options.

This article analyzes the amount and settings of ethical dilemmas from 118 OT's and 107 PT's over a 6-month period. For occupational therapists some of the dilemmas include the risky discharge of patients from hospital, resource limitations, and poor standards of care. For physical therapists these include effectiveness of therapy, conflict between the patients' wishes and professional judgment, and refusal of therapy. The article analyzes the similarities and differences between the types of dilemmas experienced between the two disciplines.

This study aimed to determine the course of anxiety, depression, and perceptions of control, along with the influence of perception of control in patients undergoing CABG before surgery and after surgery, along with two weeks post discharge. The study included 231 participants having CABG surgery were conveniently recruited from two hospitals in Sydney, Australia. Patients took a series of questionnaires before surgery, after surgery, and two weeks post discharge. The questionnaires asked questions on anxiety and depression and were measured by the Hospital Anxiety and Depression Scale (HADS) and the Control Attitudes Scale. Limitations of the study included the use of a convenient sample and loss of participants for the second and third interview. The results showed perceptions of control were moderate before surgery and improved once the surgery was completed, and again in early recovery in the second week after patients had gone home. Perceptions of control are important because they had a positive influence on concurrent anxiety and depression at all times.

Individuals experiencing mental health disorders are susceptible to impairments in occupational functioning due to decreased concentration, memory, thought processes, insight, judgement, decision-making, reality orientation, regulating emotions, understanding perception, motivation, and psycho-motor activity. This is a quantitative study out of the South American Journal of Occupation Therapy that studied the effects of slow vs. fast tempo of music on symptoms of psychosis during occupation. There were 160 individuals with diagnosed psychological disorders in a psych hospital in South Africa. The subjects participated in a leatherwork activity while listening to either fast paced/upbeat music or low tempo/slow music. Attention/focus, ability to follow instructions, directedness towards the activity, and motivation were measured in groups of individuals who had psycho-motor agitation or psycho-motor inhibition psychosis. The study found that listening to music during an activity has the ability to improve all three variables in both agitation and inhibited-motor psychosis. Fast-paced tempo significantly improves attention in individuals with inhibited motor-psychosis. The ability to follow instructions improved in both fast and slow tempo music for both agitated and inhibited individuals. Directedness and motivation did not significantly improve in any of the groups. This study indicates that music can improve the ability to perform occupations and activities in individuals with mental health disorders. Music is very individualized and it may be difficult for OT practitioners to work with groups of individuals when introducing music. IT is important for an OT to gather a good understanding of a patient's preferences and determine if they would be a good candidate for the use of music during therapy. More research is recommended in this area to further determine the effects of music on occupation in this population.

This article aims to use a qualitative descriptive study to describe occupational therapists experiences and improvements in work after adopting the Occupational Therapy Intervention Process Model (OTIPM). The OTIPM is a client-centered, top down, occupation-focused OT model of practice. The assumptions of the model are that every person is unique, has the will to engage in meaningful occupations, occupations are the primary therapeutic means and engagement in occupations in the central focus in OT. The study was conducted in an acute care hospital in Sweden starting in 2001. They were selected because the therapists wanted to improve OT services and promote evidence-practice in their hospital. The participants participated in a total of six semi-structured focus interviews in which the occupational therapists were asked to describe their experiences of the long-term improvements in work, attitudes toward improvements work and thoughts on how this improved work impacts the goal to change to a more sustainable and evidence-based OT practice in their setting. The first three interviews were in 2006 and the last three were in 2011. The interviews were analyzed and broken down into common themes among therapists. The first theme is that the therapists found their thoughts and actions were transformed on an individual and group level after adopting the OTIPM. The second theme discovered how the therapists dealt with conflicting feelings and attitudes toward change. The final theme describes a shared professional culture. In conclusion, the investigators discovered from the 10-year study and testimonies of Swedish therapists that the use of OTIPM can lead to the integration of evidence-based knowledge that has long-lasting achievements in practice.

http://www.tandfonline.com/doi/abs/10.3109/11038128.2013.872183?journalCode=iocc20 I found the article through a SSU library search. The content may not show up on this site, but if you log into the library and search the article you will have access. Here is another resource as well.

This was a study that looked at more effective ways to train students in wheelchair transfers with more dependent patients. Typically, the curriculum allows for transfer practice using other peers. This study occurred in a high-technology laboratory with SimMan technology and mock hospital suite. The SimMan replicates what a dependent transfer patient would be like. The mock hospital suite simulated an acute care setting, complete with medical equipment, vital signs, lines and drains in place. Scenarios were developed for the students with the assistance of practicing occupational therapists. These scenarios included an acutely ill patient, a critical medical management event that occurred during bed-to-wheelchair transfer and occupational need. Students completed 66-88% of transfer items correctly and showed that simulated scenarios were more difficult that practitioners rated them. Student rated this simulation as an effective, more realistic teaching tool. Students attributed this kind of simulation as a positive contribution to curriculum and promoted greater procedural and clinical reasoning skills.