Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study
Introduction Delivering high‐intensity occupational therapy can improve functional outcomes for patients and reduce length of stay. However, there is little published evidence of this in the aged rehabilitation setting. This study aims to explore the association between intensity of occupational the...
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| Veröffentlicht in: | Australian occupational therapy journal 2022-10, Vol.69 (5), p.536-545 |
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| container_title | Australian occupational therapy journal |
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| creator | Marston, Celia Koye, Digsu N. Goonan, Rose Lim, Kwang Juj, Genevieve Klaic, Marlena |
| description | Introduction
Delivering high‐intensity occupational therapy can improve functional outcomes for patients and reduce length of stay. However, there is little published evidence of this in the aged rehabilitation setting. This study aims to explore the association between intensity of occupational therapy interventions and functional outcomes in geriatric rehabilitation inpatients.
Methods
A prospective cohort study was conducted with adult inpatients admitted to a geriatric rehabilitation program. The intervention was the intensity of occupational therapy measured as high (≥30 minutes per day) versus low ( |
| doi_str_mv | 10.1111/1440-1630.12808 |
| format | Article |
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Delivering high‐intensity occupational therapy can improve functional outcomes for patients and reduce length of stay. However, there is little published evidence of this in the aged rehabilitation setting. This study aims to explore the association between intensity of occupational therapy interventions and functional outcomes in geriatric rehabilitation inpatients.
Methods
A prospective cohort study was conducted with adult inpatients admitted to a geriatric rehabilitation program. The intervention was the intensity of occupational therapy measured as high (≥30 minutes per day) versus low (<30 minutes per day). The primary outcome measured was change in functional performance, defined as a minimum of half a point improvement in the Katz Index of Activities of Daily Living (ADL) and/or the Lawton and Brody Scale of Instrumental ADL (IADL) at admission to rehabilitation, discharge and 3months post‐discharge.
Results
A total of 693 patients were included in the analysis. The mean age was 82.2 years (standard deviation [SD] = 7.9), 57% were females, and 64% had cognitive impairment. Patients (n = 210) who received greater than or equal to 30 minutes of occupational therapy daily were more likely to have clinically relevant functional improvements.; for both ADL (odds ratio [OR] = 1.87, 95% confidence interval [CI]: 1.24–2.83) and IADL (OR = 3.00, 95% CI: 1.96–4.61), after adjusting for age, sex, severity of function (ADL ≤ 2) at admission, frailty and cognitive impairment. Improvements in ADL and IADL were maintained for at least 3 months following discharge.
Conclusion
This study found that geriatric rehabilitation inpatients who received higher intensity of occupational therapy interventions were more likely to functionally improve than those who received lower intensity. Further research is required to determine if other factors, such as therapy type, influence functional outcomes.</description><identifier>ISSN: 0045-0766</identifier><identifier>EISSN: 1440-1630</identifier><identifier>DOI: 10.1111/1440-1630.12808</identifier><identifier>PMID: 35502588</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Activities of daily living ; aged ; Cognitive ability ; Cognitive impairment ; Cohort analysis ; comprehensive geriatric assessment ; Functional impairment ; Functional performance ; Geriatrics ; Intervention ; Length of stay ; Occupational therapy ; Older people ; Rehabilitation</subject><ispartof>Australian occupational therapy journal, 2022-10, Vol.69 (5), p.536-545</ispartof><rights>2022 Occupational Therapy Australia.</rights><rights>2022 Occupational Therapy Australia</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3018-a261009978585781e3d2731a39e52e3971ea61b6d2e159a57363042b476ee5e53</citedby><cites>FETCH-LOGICAL-c3018-a261009978585781e3d2731a39e52e3971ea61b6d2e159a57363042b476ee5e53</cites><orcidid>0000-0002-6400-804X ; 0000-0002-8442-3048 ; 0000-0003-4559-2276 ; 0000-0003-2328-0503 ; 0000-0003-1248-4359</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1440-1630.12808$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1440-1630.12808$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,30999,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35502588$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marston, Celia</creatorcontrib><creatorcontrib>Koye, Digsu N.</creatorcontrib><creatorcontrib>Goonan, Rose</creatorcontrib><creatorcontrib>Lim, Kwang</creatorcontrib><creatorcontrib>Juj, Genevieve</creatorcontrib><creatorcontrib>Klaic, Marlena</creatorcontrib><title>Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study</title><title>Australian occupational therapy journal</title><addtitle>Aust Occup Ther J</addtitle><description>Introduction
Delivering high‐intensity occupational therapy can improve functional outcomes for patients and reduce length of stay. However, there is little published evidence of this in the aged rehabilitation setting. This study aims to explore the association between intensity of occupational therapy interventions and functional outcomes in geriatric rehabilitation inpatients.
Methods
A prospective cohort study was conducted with adult inpatients admitted to a geriatric rehabilitation program. The intervention was the intensity of occupational therapy measured as high (≥30 minutes per day) versus low (<30 minutes per day). The primary outcome measured was change in functional performance, defined as a minimum of half a point improvement in the Katz Index of Activities of Daily Living (ADL) and/or the Lawton and Brody Scale of Instrumental ADL (IADL) at admission to rehabilitation, discharge and 3months post‐discharge.
Results
A total of 693 patients were included in the analysis. The mean age was 82.2 years (standard deviation [SD] = 7.9), 57% were females, and 64% had cognitive impairment. Patients (n = 210) who received greater than or equal to 30 minutes of occupational therapy daily were more likely to have clinically relevant functional improvements.; for both ADL (odds ratio [OR] = 1.87, 95% confidence interval [CI]: 1.24–2.83) and IADL (OR = 3.00, 95% CI: 1.96–4.61), after adjusting for age, sex, severity of function (ADL ≤ 2) at admission, frailty and cognitive impairment. Improvements in ADL and IADL were maintained for at least 3 months following discharge.
Conclusion
This study found that geriatric rehabilitation inpatients who received higher intensity of occupational therapy interventions were more likely to functionally improve than those who received lower intensity. Further research is required to determine if other factors, such as therapy type, influence functional outcomes.</description><subject>Activities of daily living</subject><subject>aged</subject><subject>Cognitive ability</subject><subject>Cognitive impairment</subject><subject>Cohort analysis</subject><subject>comprehensive geriatric assessment</subject><subject>Functional impairment</subject><subject>Functional performance</subject><subject>Geriatrics</subject><subject>Intervention</subject><subject>Length of stay</subject><subject>Occupational therapy</subject><subject>Older people</subject><subject>Rehabilitation</subject><issn>0045-0766</issn><issn>1440-1630</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqFkTtPwzAUhS0EglKY2ZAlFpZQP-I4nlBV8ZKQWMpsucmtapTGwXZA-R_8YNwHDCx4sXz9nSMfH4QuKLmhaU1onpOMFjwdWUnKAzT6nRyiESG5yIgsihN0GsIbIVQowY7RCReCMFGWI_T1FHBcgQdssIfGROvasLIdXkD8BGixbSO0wcYBuyV2VdV3W8Y0W5npBmzaGi_7ttqPXR8rt4aQlHjlQmejaWyAGrumBo83cmhjuMVT3Pl0D0n4AbhyK-cjDrGvhzN0tDRNgPP9Pkav93fz2WP2_PLwNJs-ZxUntMwMKyghSslSlEKWFHjNJKeGKxAMuJIUTEEXRc0gBTdC8vQtOVvksgAQIPgYXe9800PeewhRr22ooGlMC64PmhVCMSYVVQm9-oO-ud6nvImSjDCi8uQ-RpMdVaVkwcNSd96ujR80JXpTmN7Uozf16G1hSXG59-0Xa6h_-Z-GEiB2wKdtYPjPT09f5jvjb-p4oNU</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Marston, Celia</creator><creator>Koye, Digsu N.</creator><creator>Goonan, Rose</creator><creator>Lim, Kwang</creator><creator>Juj, Genevieve</creator><creator>Klaic, Marlena</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6400-804X</orcidid><orcidid>https://orcid.org/0000-0002-8442-3048</orcidid><orcidid>https://orcid.org/0000-0003-4559-2276</orcidid><orcidid>https://orcid.org/0000-0003-2328-0503</orcidid><orcidid>https://orcid.org/0000-0003-1248-4359</orcidid></search><sort><creationdate>202210</creationdate><title>Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study</title><author>Marston, Celia ; Koye, Digsu N. ; Goonan, Rose ; Lim, Kwang ; Juj, Genevieve ; Klaic, Marlena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3018-a261009978585781e3d2731a39e52e3971ea61b6d2e159a57363042b476ee5e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Activities of daily living</topic><topic>aged</topic><topic>Cognitive ability</topic><topic>Cognitive impairment</topic><topic>Cohort analysis</topic><topic>comprehensive geriatric assessment</topic><topic>Functional impairment</topic><topic>Functional performance</topic><topic>Geriatrics</topic><topic>Intervention</topic><topic>Length of stay</topic><topic>Occupational therapy</topic><topic>Older people</topic><topic>Rehabilitation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marston, Celia</creatorcontrib><creatorcontrib>Koye, Digsu N.</creatorcontrib><creatorcontrib>Goonan, Rose</creatorcontrib><creatorcontrib>Lim, Kwang</creatorcontrib><creatorcontrib>Juj, Genevieve</creatorcontrib><creatorcontrib>Klaic, Marlena</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Australian occupational therapy journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marston, Celia</au><au>Koye, Digsu N.</au><au>Goonan, Rose</au><au>Lim, Kwang</au><au>Juj, Genevieve</au><au>Klaic, Marlena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study</atitle><jtitle>Australian occupational therapy journal</jtitle><addtitle>Aust Occup Ther J</addtitle><date>2022-10</date><risdate>2022</risdate><volume>69</volume><issue>5</issue><spage>536</spage><epage>545</epage><pages>536-545</pages><issn>0045-0766</issn><eissn>1440-1630</eissn><abstract>Introduction
Delivering high‐intensity occupational therapy can improve functional outcomes for patients and reduce length of stay. However, there is little published evidence of this in the aged rehabilitation setting. This study aims to explore the association between intensity of occupational therapy interventions and functional outcomes in geriatric rehabilitation inpatients.
Methods
A prospective cohort study was conducted with adult inpatients admitted to a geriatric rehabilitation program. The intervention was the intensity of occupational therapy measured as high (≥30 minutes per day) versus low (<30 minutes per day). The primary outcome measured was change in functional performance, defined as a minimum of half a point improvement in the Katz Index of Activities of Daily Living (ADL) and/or the Lawton and Brody Scale of Instrumental ADL (IADL) at admission to rehabilitation, discharge and 3months post‐discharge.
Results
A total of 693 patients were included in the analysis. The mean age was 82.2 years (standard deviation [SD] = 7.9), 57% were females, and 64% had cognitive impairment. Patients (n = 210) who received greater than or equal to 30 minutes of occupational therapy daily were more likely to have clinically relevant functional improvements.; for both ADL (odds ratio [OR] = 1.87, 95% confidence interval [CI]: 1.24–2.83) and IADL (OR = 3.00, 95% CI: 1.96–4.61), after adjusting for age, sex, severity of function (ADL ≤ 2) at admission, frailty and cognitive impairment. Improvements in ADL and IADL were maintained for at least 3 months following discharge.
Conclusion
This study found that geriatric rehabilitation inpatients who received higher intensity of occupational therapy interventions were more likely to functionally improve than those who received lower intensity. Further research is required to determine if other factors, such as therapy type, influence functional outcomes.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35502588</pmid><doi>10.1111/1440-1630.12808</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-6400-804X</orcidid><orcidid>https://orcid.org/0000-0002-8442-3048</orcidid><orcidid>https://orcid.org/0000-0003-4559-2276</orcidid><orcidid>https://orcid.org/0000-0003-2328-0503</orcidid><orcidid>https://orcid.org/0000-0003-1248-4359</orcidid></addata></record> |
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| subjects | Activities of daily living aged Cognitive ability Cognitive impairment Cohort analysis comprehensive geriatric assessment Functional impairment Functional performance Geriatrics Intervention Length of stay Occupational therapy Older people Rehabilitation |
| title | Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study |
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