An exploratory study on the role of occupational therapists in home-based rehabilitation team in South Korea.

Introduction: Cooperation among rehabilitation team members is essential in the home-based rehabilitation setting. Q-methodology that can quantitatively analyze the subjectivity of members of the rehabilitation team was used to explore the role of occupational therapists (OTs) in home-based rehabilitation. Methods: The Q-methodology process was implemented in five steps: Step 1 - Representative statements about the role of OTs were collected through in-depth interviews, open questionnaires, and literature reviews (Q-sample); Step 2 - A total of 34 rehabilitation team members (physical therapists, OTs, social workers, nutritionists) were recruited (P-sample); Step 3 - The statements were classified according to their subjective perspective (Q-sort); Step 4 - Factor analysis was performed based on the correlation among the responses from the participants (Q-factor analysis); Step 5 - The awareness factor for roles was interpreted (Interpretation of awareness factors). Results: The roles of OTs perceived by members of the home-based rehabilitation team were formed into five factors (A) Adaptation within home environments; (B) Professional development; (C) Reliable service execution; (D) Client needs resolution; and (E) Focus on activity participation. In all factors, perspectives on the role of OTs in helping clients participate in their roles and activities at home were included. These factors included issues and directions addressed in prior literature on the development of occupational therapy. Conclusions: In home-based rehabilitation, OTs must play a professional role in ensuring clients live fully at home, and cooperate with team members for an effective rehabilitation approach.

Effects of assistive technology-based occupational therapy on community-dwelling people recovering from stroke.

PURPOSE: The purpose of this study was to investigate the effect of assistive technology-based occupational therapy on occupational performance, satisfaction, and psychosocial impacts of community-dwelling people recovering from stroke. METHODS: A total of eleven community-dwelling people recovering from stroke participated in an occupational therapy intervention based on the core concepts of the Human Activity Assistive Technology (HAAT) model. The intervention involved the adoption of assistive technology devices (ATDs) to perform individual goal activities in the daily lives of people recovering from stroke. The intervention was conducted weekly as a 30-min session for a total of 4 weeks, in the home where each participant actually resided. RESULTS: All participants in the intervention showed statistically significant improvements in occupational performance, satisfaction, and goal attainment level with regard to the individually meaningful activities, between pretest, posttest, and follow-up. User satisfaction with the ATDs and associated services was generally 'satisfactory,' and the mean score significantly increased from post-intervention to follow-up. The psychosocial impact of assistive technologies significantly improved from post-intervention to follow-up evaluation. CONCLUSION: Interventions involving concepts, processes, and strategies based on the HAAT model should be continuously performed to select and adopt appropriate interventions involving assistive technologies.

Effects of environmental modification on activities of daily living, social participation and quality of life in the older adults: a meta-analysis of randomized controlled trials.

Purpose: This study aims to provide evidence of the benefits and effects of environmental modification intervention on activities of daily living, quality of life and social participation in older adults.Methods: This study searched and used randomized controlled trial research studies from the databases of MEDLINE, CINAHL and the Cochrane Library. A systematic review and meta-analysis were conducted using the Jadad scale, risk of bias and the patient, intervention, comparison, outcome (PICO) process. The domains of impact considered in this meta-analysis were activities of daily living, quality of life and social participation. The analysis was completed with the Review Manager software 5.3.Results: Jadad scores of collected studies were 3-4 in seven studies and 2 in one study, which means that most studies had high levels of quality. This study comprised of 733 subjects in the experimental group and 672 subjects in the control group. The effect size of environmental interventions on basic activities of daily living, instrumental activities of daily living and overall activities of daily living were 0.37, 0.65 and 0.47, respectively. Meanwhile, the environmental intervention was neither effective on quality of life nor social participation.Conclusions: Environmental modifications are effective in facilitating the daily life activities of older adults. This kind of intervention is shown to be useful for enhancing life performance. In order to confirm intervention effects on the quality of life and social participation of older adults, studies should conduct environmental modifications interventions that take into account contexts such as individual characteristics, lifestyle and physical activities.Implications for rehabilitationEnvironmental modifications are effective in improving older adults' performance of daily activities (ADL).Appropriate environmental modification interventions should be considered before the quality of life (QoL) and levels of social participation of older adults decline.