Abstract
Although aquatic-based interventions are increasingly used in the psychiatric rehabilitation services, the effects of this type of community program as an adjuvant therapy for psychosocial problems of people with serious mental illness (SMI) have been under-explored. This research evaluated the feasibility and outcomes of an occupational therapy program consisting of aquatic-based activities (AA-OT program) in the community in Spain. This study is the first randomized controlled trial (RCT) on this topic. This pilot trial was conducted with a sample of 16 adults with SMI who were randomly allocated to the AA-OT program plus treatment as usual or treatment as usual alone (eight in each group). The AA-OT program included activation of daily living skills, warm-up, group activities/tasks, and relaxation. It consisted of two sessions per week over 12weeks. Outcomes were evaluated at week 0 and 12. A total of 14 participants (87.5%) completed the trial. No adverse events or side-effects were noted. Comparisons between the two groups on change scores showed that participants in the intervention group showed significant improvements in several outcome measures: psychosocial problems (HoNOS), two health-related quality of life scales (SF-36: Physical Functioning and Mental Health), and performance of social activities (Activity and Social Relations scale). Satisfaction with the program was high. In conclusion, the results support the feasibility and potential benefits of this occupational therapy program. 12weeks of aquatic-based activities in a group intervention may enhance the outcomes of psychiatric rehabilitation improving the severity of psychosocial problems, patient-reported health status, and social relations. This community-based program may be beneficial as a non-pharmacologic method in the illness management and recovery of people with SMI. The findings from this pilot trial need to be confirmed in a large, fully-powered RCT.
Highlights
Cardiovascular disease increases the prevalence of disability and mortality in Western countries
significant roles is the main goal of Occupational Therapy
Individualized counselling and training actions include incorporating the principles of energy conservation
Summary
1.1 Enfermedad cardiovascular y rehabilitación cardíaca: un desafío para los servicios sanitarios y sociales occidentales. El abordaje educativo y la rehabilitación cardíaca (RC) son estrategias destacadas para evitar la evolución de la ECV hacia la discapacidad, así como para reducir la morbimortalidad y la pérdida de calidad de vida en las personas con esta condición de salud, de especial prevalencia en los países desarrollados, en el contexto internacional actual. Los programas de RC están integrados en un proceso de atención global y se encuentran influidos de una manera relevante por las características de la valoración clínica multidisciplinar, el tratamiento médico, la evaluación de los factores de riesgo modificables, así como, dentro del ámbito propio de la Terapia Ocupacional, el análisis de las barreras y facilitadores que encuentra el usuario en el desempeño ocupacional. Los resultados aportarán información científica de interés como herramienta para la planificación de intervenciones de Terapia Ocupacional en personas con enfermedad con una ECV y para futuras investigaciones en este ámbito de actuación
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