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Tove Lise Nielsen, Mhsc, Ot (Reg), Ph.D. Student
Kirsten Schultz Petersen, Helene Polatajko
Niels Trolle Andersen, Claus V...
Older adults’ activity and participation
Health condition
Body function
And structure
ParticipationActivity
Environmental
...
OCCUPATIONS
Groups of activities and tasks of everyday life
Given value and meaning by individuals and a culture
Everythin...
CLIENT-CENTRED OCCUPATIONAL
THERAPY
Co-operation
Partnership
Empowerment
Client’s goals
Listening, respecting clients’ val...
Two ways to go
- in a Danish municipality
Client-centred
occupational therapy
Home-care
reablement
Occupational
therapists...
Study aim – hypothesis:
Home-based, Intensive Client-Centred
Occupational Therapy
ICC-OT
Is more effective than usual care...
Design and participants
An assessor-blinded randomised controlled superiority trial
participants: 119 home-dwelling older...
Intervention group: ICC-OT
Aim Improved occupational performance
Focus Decided by the older adult, based on COPM
interview...
Control group: usual practice
Aim Compensation (ADL, cleaning, cooking), minimised
need for home help
Focus Decided by the...
Schedule
Time frame: (figure)
-
T1
0 T1 T3
3
months
T6
6
months
ENROLMENT X
RANDOM ALLOCATION X
INTERVENTIONS
Intervention...
Assessment of occupational performance,
at baseline, 3 and 6 months
Canadian Occupational Performance Measure Assessment o...
Details: intensity of ICC-OT
88 % of the ICC-OT group received the intervention and
had
mean 15 visits / 11 hours with the...
Details: types of activities and tasks
trained in the ICC-OT group
Self-
care
32%
Productivit
Leisure
29%
COPM performance, preliminary results
Baseline – 3 months (figure)
Usual-practice improved 0.61
points*
ICC-OT improved 1....
Secondary outcomes, preliminary results
3 months, both groups:
Improved satisfaction with occupational performance (COPM)
...
Take-home messages
ICC-OT effectively improves older adults’
occupational performance and satisfaction
Effects persist 3...
Thank-you for listening
And my warm thanks to:
Citizens, occupational therapists, home-care officers and
consultants in th...
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RIWC_PARA_A127 Occupational Therapy at Home in Denmark

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A127 Occupational Therapy at Home in Denmark

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RIWC_PARA_A127 Occupational Therapy at Home in Denmark

  1. 1. Tove Lise Nielsen, Mhsc, Ot (Reg), Ph.D. Student Kirsten Schultz Petersen, Helene Polatajko Niels Trolle Andersen, Claus Vinther Nielsen Client-centred occupational therapy in the homes of older adults improves their occupational performance Results from a randomised controlled trial
  2. 2. Older adults’ activity and participation Health condition Body function And structure ParticipationActivity Environmental factors Personal factors Cells Organs Musculosceletal system Disease Trauma Physical Attitudinal Social environment Home help Rehabilitation Self-care Productivity Leisure Life style Motivation Coping Social participation Mobility
  3. 3. OCCUPATIONS Groups of activities and tasks of everyday life Given value and meaning by individuals and a culture Everything people do to occupy themselves within the areas of self-care, productivity, and leisure Have a therapeutic potential
  4. 4. CLIENT-CENTRED OCCUPATIONAL THERAPY Co-operation Partnership Empowerment Client’s goals Listening, respecting clients’ values, meeting clients’ needs
  5. 5. Two ways to go - in a Danish municipality Client-centred occupational therapy Home-care reablement Occupational therapists: ”Will home- care reablement erode older adults’ access to valued occupations?”
  6. 6. Study aim – hypothesis: Home-based, Intensive Client-Centred Occupational Therapy ICC-OT Is more effective than usual care in improving older adults’ occupational performance and satisfaction
  7. 7. Design and participants An assessor-blinded randomised controlled superiority trial participants: 119 home-dwelling older adults Mean age 78 years 72 % women, 28 % men 87 % were receiving home-care Danish speaking Exclusion: Former home rehabilitation Predefined severe diagnoses Severe pain Drug or alcohol abuse
  8. 8. Intervention group: ICC-OT Aim Improved occupational performance Focus Decided by the older adult, based on COPM interview Approach Occupation-based individual therapy + Usual access to home-care, meal service, assistive devices, physiotherapy Amount, OT 11 weeks, twice a week, max. 22 visits
  9. 9. Control group: usual practice Aim Compensation (ADL, cleaning, cooking), minimised need for home help Focus Decided by the municipality’s home-care policy Approach Acces to home-care, meal service, assistive devices, physiotherapy Acces to 3 weeks of home-care reablement
  10. 10. Schedule Time frame: (figure) - T1 0 T1 T3 3 months T6 6 months ENROLMENT X RANDOM ALLOCATION X INTERVENTIONS Intervention group: ICC-OT X X Intervention group: usual practice X X Control group: usual practice X X
  11. 11. Assessment of occupational performance, at baseline, 3 and 6 months Canadian Occupational Performance Measure Assessment of Motor and Process Skills
  12. 12. Details: intensity of ICC-OT 88 % of the ICC-OT group received the intervention and had mean 15 visits / 11 hours with the occupational therapist
  13. 13. Details: types of activities and tasks trained in the ICC-OT group Self- care 32% Productivit Leisure 29%
  14. 14. COPM performance, preliminary results Baseline – 3 months (figure) Usual-practice improved 0.61 points* ICC-OT improved 1.87 points*** Difference 1.26 points. T-test p 0.001 Baseline – 6 months Usual-practice improvement lost ICC-OT most improvement maintained***
  15. 15. Secondary outcomes, preliminary results 3 months, both groups: Improved satisfaction with occupational performance (COPM) Improved quality of performance (AMPS motor scale) 6 months, the ICC-OT group Further improved their scores, between-group differences highly significant
  16. 16. Take-home messages ICC-OT effectively improves older adults’ occupational performance and satisfaction Effects persist 3 months after discharge Use these results to plan intensive occupational therapy interventions and home- care reablement with more focus on clients’ priorities
  17. 17. Thank-you for listening And my warm thanks to: Citizens, occupational therapists, home-care officers and consultants in the municipality of Randers The Tryg Foundation The Danish Association of Occupational Therapists VIA University College, Aarhus University and DEFACTUM

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