Preventive Occupational Therapy Research Articles

De Quervain Tenosynovitis as a Risk Factor of New-Onset Adhesive Capsulitis: A Nationwide Cohort Study.

This study investigated the association of de Quervain tenosynovitis (DQT) with subsequent adhesive capsulitis (AC) development. Patients with DQT between 2001 and 2017 from the Taiwan National Health Insurance Research Database were the DQT cohort. The 1:1 propensity score matching method was applied for creating control cohort. The primary outcome was defined as new-onset of AC at least 1 year after the date of confirmed diagnosis of DQT. In total, 32,048 patients with mean age 45.3 years were included. DQT was significantly positively associated with risk of new-onset AC after adjustment for baseline characteristics. Furthermore, severe DQT requiring rehabilitation was positively associated with risk of new-onset AC. In addition, male gender and age under 40 may be additional risk factors for new-onset AC, compared to female gender and age over 40. Cumulative incidence of AC after 17 years was 24.1% among patients with severe DQT requiring rehabilitation and was 20.8% among patients with DQT without rehabilitation. This is the first population-based study to demonstrate an association between DQT and new-onset AC. The findings recommend that preventive occupational therapy, including active modification for the shoulder joint and adjustments to daily activities, may be necessary for patients with DQT to reduce their risk of developing AC.

Life Domains and Lifestyle of Older Adults Living in a Nursing Home: A Pilot Study.

Although the preventive occupational therapy intervention program Lifestyle Redesign® has proven to be effective in maintaining and improving the health and quality of life of older adults, a similar program has not yet been culturally adapted to the Spanish population. As a preliminary step in developing a lifestyle intervention tailored to healthy Spanish older adults living in a nursing home (Lifestyle Choice; originally in Spanish "Elección de Estilo de Vida"), we aimed to identify and describe the life domains of this population and determine overlap with content areas addressed in the Lifestyle Redesign® program. An observational cross-sectional study was carried out using quantitative methods, including 30 healthy older adult residents in the "Virgen del Prado" nursing home in Talavera de la Reina (Toledo), based on the development of a questionnaire and a survey. Six life domains were identified: self-care, sleep and rest, mobility, personal safety, health maintenance, spirituality, and free time usage. The results of this study reveal important overlaps with content areas of Lifestyle Redesign®, suggesting that it may be feasible to develop a lifestyle intervention ("Elección de Estilo de Vida") tailored to the sociocultural features of the healthy Spanish population over 65 years old living in nursing homes.

Optimizing Occupations, Habits, and Routines for Health and Well-Being With Lifestyle Redesign®: A Synthesis and Scoping Review.

Lifestyle Redesign® originated as a preventive occupational therapy intervention for healthy older adults, and it was found to be both effective and cost effective in the Well Elderly Studies initiated in the 1990s. Building on that empirical foundation, the scope of Lifestyle Redesign has been greatly expanded as a general intervention framework addressing prevention and chronic condition management in a wide range of populations, settings, and conditions. Yet until now, its full scope, defining characteristics, and supporting evidence have not been clearly and succinctly described, limiting its potential reach and impact. To outline the definition and key characteristics of Lifestyle Redesign, provide a scoping review of its evidence base and future directions for research, describe its current applications, and make recommendations for its use in clinical practice. We searched PubMed and CINAHL, tables of contents of 10 occupational therapy journals, and citations in two seminal Lifestyle Redesign publications to identify articles published in 1997-2020 that described quantitative outcomes (for n ≥ 20) of interventions meeting the defining characteristics of Lifestyle Redesign. Our scoping review yielded 12 publications providing supportive evidence for Lifestyle Redesign's positive impact on a range of health and well-being outcomes among both well populations and those with chronic conditions. Lifestyle Redesign has the potential to meet a growing need in clinical and community settings for health care services that address prevention, health promotion, and chronic disease management. What This Article Adds: Current evidence supports the use of Lifestyle Redesign to improve health and well-being for a range of client populations. This review outlines its defining characteristics and current applications to improve its implementationin clinical practice and expand related research efforts.

Feasibility of Lifestyle Redesign® for community-dwelling older adults with and without disabilities: Results from an exploratory descriptive qualitative clinical research design.

Although Lifestyle Redesign® has been shown to be effective in improving older adults' health and well-being, little is known about the feasibility of implementing this programme to develop meaningful and health-promoting routines of community-dwelling older adults in Canada. This study thus aimed to explore the feasibility of implementing a culturally-adapted 6-month version of Lifestyle Redesign® with community-dwelling older French-Canadians with and without disabilities. An exploratory descriptive qualitative clinical research design was used with 17 older adults living at home or in a seniors' residence, divided into two groups participating in Lifestyle Redesign®. Semi-structured interviews were conducted with participants and the occupational therapist who delivered the programme and recorded clinical notes. Participants were aged between 65 and 90; they were mainly women (n = 11; 64.7%), and seven (41.2%) had disabilities. The intervention was tailored to the participants' needs, interests, and capacities in each group (e.g. modules selected, number of individual sessions, and assistance of volunteer). Over the 6-month period, older adults participated in an average of about 25 group sessions with the occupational therapist and in four or five outings with their group (e.g. restaurant, market, and museum) and attended between 5 and 11 individual sessions with the occupational therapist. The most common reasons for missing group sessions were being ill, working, or having another appointment. Personal facilitators and barriers to participation in the intervention were mainly related to abilities, needs, spiritual life, and health. Environmental facilitators were mostly the regularity of the sessions, group, and external support, including human resources to deliver the intervention, whereas barriers were the residence's time restrictions and staff's attitudes, cost of some activities targeted in the programme, and transportation problems. Lifestyle Redesign® is a feasible preventive occupational therapy intervention for community-dwelling older French-Canadians. These findings will guide future studies including large-scale clinical trials.

Effects of colour narrative in community-dwelling older adults: A mixed methods study

Background Based on occupational storytelling/story-making, this study developed Colour Narrative, a program to promote the health and well-being of community-dwelling older adults. Objectives To conduct a pilot study to implement Colour Narrative in a heavy snowfall area of Japan and verify the participants’ experiences in the program and its effectiveness. Material and methods An advanced mixed methods design was used. The participants were 22 members of a community-based social group for older adults. Quantitative measurements of life functions and health-related quality of life (HRQOL) were conducted before and after the intervention. Qualitative data were collected from focus group interviews regarding the participants’ experiences during the intervention process. Lastly, both datasets were integrated. Results The harsh living conditions due to heavy snowfall reduced the participants’ overall activity. In this environment, Colour Narrative encouraged them to control their lives more in their own ways and enhanced their HRQOL. The core of their experiences was ‘negotiating occupations’. This negotiation was a highly intellectual task that significantly improved their cognitive function. Conclusions The structure and content of Colour Narrative were found to be useful and feasible for community-dwelling older adults. Significance Colour Narrative offers a new occupation-based intervention strategy for preventive occupational therapy.

Bayesian Analysis of the Relationship Between Belief Conflict and Occupational Dysfunction.

Elucidation of the relationship between belief conflict and occupational dysfunction in occupational health is needed. Knowledge of this relationship is important to the development of preventive occupational therapy. To examine the relationship between belief conflict and occupational dysfunction. Cross-sectional study. Participants were recruited via nonrandom sampling, and data were analyzed with Bayesian modeling. Health care institutions in Japan. Participants were 890 health care workers. Data were collected by means of the Participant Profile, the Assessment of Belief Conflict in Relationship-14 (ABCR-14), and the Classification and Assessment of Occupational Dysfunction. Belief conflict and occupational dysfunction showed moderate to strong positive correlations. The cutoff value for the ABCR-14 was estimated to be 58 points. The odds ratio indicated that groups with high belief conflict were very likely to experience occupational dysfunction. These findings show that belief conflict and occupational dysfunction are more than moderately associated. Longitudinal studies are needed to prove the causal relationship between belief conflict and occupational dysfunction. Considering that those falling into the high-belief-conflict group are likely to experience occupational dysfunction, it is necessary to focus efforts not only on teamwork but also on the improvement of health. Preventive occupational therapy needs to assume a leading role in improving the occupational health of health care workers who experience belief conflict and occupational dysfunction.

Influence of Lifestyle Redesign® on Health, Social Participation, Leisure, and Mobility of Older French-Canadians.

Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. To explore the influence of Lifestyle Redesign on older French-Canadians' health, social participation, leisure, and mobility. A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. Community. Sixteen volunteers (10 women) aged 65-90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking. French-Canadian 6-mo version of Lifestyle Redesign. Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide. The French-Canadian Lifestyle Redesign had a beneficial effect on participants' mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect. The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians. This study sheds light on the influence of the French-Canadian version of the intervention not only on older adults' health and social participation but also on their leisure activities and life-space mobility, two important outcomes not addressed in previous Lifestyle Redesign studies. Moreover, this study provides an in-depth understanding of the Lifestyle Redesign experience of French-Canadian older adults with and without disabilities, including participants with significant communication and mobility disabilities.

Cost-effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials.

A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy [3] and the other was occupational therapy for dementia [5]) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future studies on the cost-effectiveness of occupational therapy in older people are strongly warranted. Copyright © 2015 John Wiley & Sons, Ltd.

Promoting Well-Being and Engagement in Life Through Occupational Therapy Lifestyle Redesign

Research supports both the role of lifestyle to promote health and well-being for older adults and preventive occupational therapy lifestyle redesign to promote engagement in life activities and enhance health for “at risk” community living elders. Occupational therapy lifestyle redesign programs seek to provide older adults with strategies and opportunities to increase participation in identified meaningful activities for life satisfaction and to positively impact physical and mental health. This article reports on a 16-week lifestyle redesign pilot study conducted within medical model adult day programs with cognitively intact frail older adults. Data analysis found that experimental group subjects showed favorable results on Role Functioning, Bodily Pain, and General Health on the 36-item Short Form Health Survey (SF-36); Social Activity on the Functional Status Questionnaire; and on the Center for Epidemiologic Studies Depression Scale (CES-D). No statistically significant differences were noted between groups upon posttests after adjusting for covariates; however, a small sample resulted in limited statistical power. Further studies with a larger sample are recommended for convincing conclusions.

Occupational therapy intervention with children survivors of war.

A preventive occupational therapy program with children surviving the Kosovo conflict is examined. The objective of the program was to facilitate the emotional expression of traumatic experiences in order to prevent the development of future psychological problems. The intervention was based on a community-centred approach with spirituality as a central focus of the intervention. The Model of Human Occupational and the Occupational Performance Process Model were utilized to guide the identification and intervention of occupational performance issues. The children's return from a land of war to a land of children demonstrates the potential of occupational therapy intervention in this field. With increasing awareness of populations facing social and political challenges, there is a growing importance of the concept of occupational justice and the need to work against occupational apartheid.

Psychometric properties of a Chinese translation of the SF-36 health survey questionnaire in the Well Elderly Study.

To evaluate the psychometric properties of a Chinese translation of the 36-item Short Form Health Survey (SF-36) in the Well Elderly Study--a randomized clinical trial designed to evaluate the effectiveness of preventive occupational therapy services specifically tailored for multiethnic, independent-living, older adults. Translation and back-translation procedures were used to obtain appropriate meanings for the SF-36 survey questions and to ensure face, functional, and conceptual equivalence. Statistical analyses demonstrated satisfactory reliability and validity, with the results generally similar to those reported for older Anglo adults. As the percentage of older adults of diverse ethnicity increases, the need for health care research and service strategies that can effectively include multiple ethnicities becomes paramount. The results of this study suggest that a Chinese-translated SF-36 can be used to assess multiple dimensions of health in a Mandarin-speaking population of older adults.

Practical contributions of occupational science to the art of successful ageing: How to sculpt a meaningful life in older adulthood

Given that the longevity revolution has already arrived and will continue to flourish in the upcoming decades, Western societies are confronted with the urgent challenge of promoting the goal of successful ageing for untold millions of citizens. With regard to this goal, current thinking points to the optimistic conclusion that potentially controllable lifestyle factors play a crucial role in enabling people to experience health and satisfying lives well into older adulthood. In this paper, the importance of occupation as providing a fundamental, personally relevant context for the enactment of sustainable lifestyle choices that foster successful ageing is described. This stress on the significance of occupation is supported by the successful outcome of an experimental test of a preventive occupational therapy intervention designed to promote health and psychosocial well‐being in community dwelling elders. Based on the theory and research that is discussed, a practically oriented synthetic overview is provided of the conditions conducive to successful ageing.

Occupation in lifestyle redesign: the Well Elderly Study Occupational Therapy Program.

This article describes an innovative preventive occupational therapy intervention for well older adults, the Well Elderly Treatment Program. In a previously reported large-scale randomized effectiveness study, this intervention was found to be highly successful in enhancing the physical and mental health, occupational functioning, and life satisfaction of multicultural, community-dwelling elders. In this article, the philosophical background, manner of development, topical content, methods of program delivery, and mechanisms underlying the program's positive effects are discussed, along with implications for occupational therapy practice. The treatment was based on application of occupational science theory and research and emphasized the therapeutic process of lifestyle redesign in enabling the participants to actively and strategically select an individualized pattern of personally satisfying and health-promoting occupations. The wide-ranging effectiveness of the program supports the occupational therapy profession's emphasis on occupation in affecting health and positions practitioners to extend their services to the realm of preventive interventions.

Occupational Therapy for Independent-Living Older Adults

Preventive health programs may mitigate against the health risks of older adulthood. To evaluate the effectiveness of preventive occupational therapy (OT) services specifically tailored for multiethnic, independent-living older adults. Design.-A randomized controlled trial. Two government subsidized apartment complexes for independent-living older adults. A total of 361 culturally diverse volunteers aged 60 years or older. An OT group, a social activity control group, and a nontreatment control group. The period of treatment was 9 months. A battery of self-administered questionnaires designed to measure physical and social function, self-rated health, life satisfaction, and depressive symptoms. Benefit attributable to OT treatment was found for the quality of interaction scale on the Functional Status Questionnaire (P=.03), Life Satisfaction Index-Z (P=.03), Medical Outcomes Study Health Perception Survey (P=.05), and for 7 of 8 scales on the RAND 36-Item Health Status Survey, Short Form: bodily pain (P=.03), physical functioning (P=.008), role limitations attributable to health problems (P=.02), vitality (P=.004), social functioning (P=.05), role limitations attributable to emotional problems (P=.05), and general mental health (P=.02). Significant benefits for the OT preventive treatment group were found across various health, function, and quality-of-life domains. Because the control groups tended to decline over the study interval, our results suggest that preventive health programs based on OT may mitigate against the health risks of older adulthood.

Occupational therapy in rural India

AbstractIndia is called the land of villages. In 1951, 82.7% of the Indian population lived in rural areas. Sanskritisation and urbanisation have changed the pattern. It is expected that by the year 2020 this percentage would come down to 55%. These villagers are relocating in urban slums. Thus from the rehabilitation point of view both problems pose challenges. An Indian village community is a political, economic and cultural unit. At the urban slum area at Malwani and in small villages near Juchandra, community rehabilitation programmes were found to be most pragmatic. Community education and preventive occupational therapy are found to be essential steps in rural rehabilitation. Therapists have to work on ‘disability, attitude and beliefs’ and change the behaviour to deal with the grass root (basic) causes. It is felt that for longer sustainment, community‐based rehabilitation should originate within the community. Heath professionals must recognise the capabilities of individuals within the support structure of the family and community, while helping individuals to improve the quality of their lives.