Applying PEOP to Develop an Intervention Framework for Employment in Parkinson's Disease.

Employment intervention is essential for supporting people with Parkinson's disease (PwPD), who leave the workforce on average 5 years earlier than those without Parkinson's disease (PD). We developed a framework for occupational therapists (OTs) to address employment for PwPD. Our qualitative analysis employed data source triangulation of environmental scan of resources and publications, electronic medical records data, and focus groups with clinicians and PwPD. The framework underwent expert panel review by OTs and researchers who are knowledgeable of current evidence-based practices for PD. The framework is based on the Person-Environment-Occupation-Performance (PEOP) Model and PEOP Occupational Therapy Process and comprised of four parts: PEOP features of PD relevant to employment, performance changes experienced by PwPD, a process to evaluate and address employment, and intervention ideas. This framework serves as an impetus to explore evidence-based, scalable, proactive intervention approaches to address employment in PwPD.

Creating a framework to help occupational therapists support people with Parkinson's Disease to maintain employmentThis study aims to support people with Parkinson's disease (PwPD) in maintaining employment by developing a framework for occupational therapists (OTs). PwPD often leave their jobs 5 years earlier than others because they lack early employment support. OTs are well suited to address this need due to their expertise in task analysis, client-centered interventions, and enabling participation in meaningful activities.The researchers created a framework through an iterative process. They analyzed various sources, including occupational therapy resources and medical records, and reviewed data from focus groups with clinicians and PwPD. The framework aligns with the Person-Environment-Occupation-Performance (PEOP) Model and PEOP Occupational Therapy Process and consists of four main parts:Understanding how Parkinson's disease affects individuals, their work environment, and job-related aspects.Identifying the changes in employment performance experienced by PwPD.Outlining a process for OTs to evaluate and intervene in employment-related issues.Providing various intervention ideas categorized by therapeutic domain.The study also acknowledges the challenges clinicians face when addressing employment needs in PwPD. In conclusion, this framework serves as a foundation for clinicians and researchers to explore evidence-based, proactive intervention strategies for assisting PwPD in maintaining their employment.

Mobility and self-care outcomes in patients with a bariatric comorbidity during inpatient rehabilitation.

OBJECTIVE: First, we describe the characteristics and functional outcomes of obese and bariatric patients in an inpatient rehabilitation facility (IRF). Second, we assessed differences in functional outcomes for bariatric, obese, and standard weight body mass index (BMI) groups. Third, we explored whether these characteristics differ between time periods and diagnostic groups. DESIGN: A retrospective study comparing electronic medical record data collected in 2016 and 2018, using a repeated cross-sectional cohort design. SETTING: IRF. PARTICIPANTS: Individuals ≥18 years of age diagnosed with brain injury, medical complexity, general neurology, orthopedic, spinal cord injury (SCI), and stroke. Participants grouped as standard (BMI <30 kg/m2 ), obese (BMI 30-39 kg/m2 ), and bariatric (BMI ≥40 kg/m2 ) weights. (N = 2015 in 2016, N = 2768 in 2018.) INTERVENTIONS: Patients received standard inpatient rehabilitation. In 2018, clinicians had access to new weight-appropriate equipment. MAIN OUTCOME MEASURES: Discharge destination; length of stay (LOS) by BMI group and medical diagnoses; item-specific functional index measure (FIM) change scores. RESULTS: Sixty-four percent to 67% of all BMI groups achieved a home discharge. The bariatric BMI group had a longer LOS (21 days) than the standard or obese groups. There was a significant interaction in a linear regression analysis between diagnosis and LOS, where LOS was longer in medically complex patients with bariatric BMI (19.3 days compared to 16.1 days) but shorter in bariatric patients with SCI (20.6 days) compared to standard weight patients (26.2 days). In 2018, the bariatric BMI group had greater average FIM change scores for bathing, lower body dressing, toilet transfers, and bed transfers. CONCLUSIONS: Patient BMI is associated with LOS in the IRF, although affected by diagnosis. Patients with higher BMIs can make changes in specific individual motor FIM items. For patients with bariatric BMIs, FIM change scores were higher in 2018, possibly due to the use of equipment and facilities designed for higher weight capacities.