Occupational Therapy
Conditions
Keywords
OCCUPATIONAL THERAPY, RANDOMISED CLINICAL TRIAL, AGED, PATIENT CARE
Brief summary
Objectives: To compare the benefits of structured occupational therapy intervention by a single geriatric therapist with the benefits of the conventional treatment model in the functional recovery of patients admitted to an acute geriatric unit. Design: Non-pharmacological randomised clinical trial. Setting: Acute Geriatric Unit, Albacete, Spain. Participants: The trial included 400 patients admitted consecutively over 6 months to an acute geriatric unit for acute illness or exacerbation of a chronic medical condition. Participants were randomised to the occupational therapy intervention or conventional treatment model group; 198 patients received occupational therapy. All patients completed the study. The mean age was 83.5, and 56.8% were women. Interventions: Needs assessment, iatrogenic prevention, retraining in basic and instrumental activities of daily living, assessment of need for technical aids, instruction for primary caregiver in patient mobilisation techniques, and structured social and occupational motivation as per protocol in three groups of patients (cardiopulmonary disease, stroke, and other conditions) 5 days a week, 30 to 45 minutes a day over the entire hospital stay.
Interventions
Day 1: Physical, functional, cognitive, social, and emotional assessment. Need analysis for iatrogenic prevention, retraining in BADL and IADL, technical aids, instructions in patient mobilisation techniques, and for social and occupational motivation. Day 2 until discharge: 45-minute sessions. Cognitive stimulation and confusional syndrome prevention, instructions to the caregivers on how to prevent complications such as immobility, delirium, falls, urinary incontinence, or pressure sores, and patient stimulation, retraining in activities of daily living. Day of discharge: Instruction for caregivers on managing the patient's residual deficits, assessment for technical aids, recommendations for patient increased independence in ADL, and social and occupational activities.
Sponsors
Instituto Ciencias de la Salud, Junta de Comunidades de Castilla-La Mancha
Complejo Hospitalario Universitario de Albacete
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients age 65 or older consecutively admitted to the acute geriatric unit at the Complejo Hospitalario Universitario in Albacete, Spain, between November 2002 and June 2003 for an acute medical illness or exacerbation of a previous chronic condition
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional recovery | The day of discharge from hospitalization (average 10 days) | Recovery of 10 or more Barthel index points |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Death | The day of discharge from hospitalization (average 10 days) | — |
| Hospital stay | The day of discharge from hospitalization (average 10 days) | — |
| Confusional status | The day of discharge from hospitalization (average 10 days) | Confusion Assessment Method |
| Improvement in gait pattern | The day of discharge from hospitalization (average 10 days) | Increase of one level on the Holden scale between admission and discharge |
| Residence change | The day of discharge from hospitalization (average 10 days) | Institutionalisation and residence change because of a new disability |
| Upper limb function improvement | The day of discharge from hospitalization (average 10 days) | Touching either shoulder blade with the hand, picking up a full glass of water, unbuttoning a button, and cutting with a knife. Improvement was defined as the ability to perform more such functions at discharge compared with admission. |
Countries
Spain
Outcome results
None listed