Is there a relationship between intensity of occupational therapy and functional outcomes in hospitalised older patients? A prospective cohort study
Corresponding Author
Celia Marston
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
Correspondence
Celia K. Marston BAppSc (OT), MPallCare, PhD Candidate (UTS), Occupational Therapy Department, The Royal Melbourne Hospital, 300 Grattan Street, Parkville 3050, Victoria, Australia.
Email: [email protected]
Search for more papers by this authorDigsu N. Koye
Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
MISCH (Methods and Implementation Support for Clinical Health research platform), Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorRose Goonan
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorKwang Lim
Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorGenevieve Juj
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorMarlena Klaic
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
Search for more papers by this authorCorresponding Author
Celia Marston
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
Correspondence
Celia K. Marston BAppSc (OT), MPallCare, PhD Candidate (UTS), Occupational Therapy Department, The Royal Melbourne Hospital, 300 Grattan Street, Parkville 3050, Victoria, Australia.
Email: [email protected]
Search for more papers by this authorDigsu N. Koye
Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
MISCH (Methods and Implementation Support for Clinical Health research platform), Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorRose Goonan
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorKwang Lim
Department of Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorGenevieve Juj
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Search for more papers by this authorMarlena Klaic
Allied Health, Occupational Therapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
Search for more papers by this authorAbstract
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.
CONFLICT OF INTEREST
The author(s) declared no conflicts of interest with research, authorship and/or publication of this article.
Open Research
DATA AVAILABILITY STATEMENT
Research data are not shared.
Supporting Information
| Filename | Description |
|---|---|
| aot12808-sup-0001-Supporting Information.docxWord 2007 document , 12.8 KB |
Data S1: Supporting Information Table S1: Comparison of functional outcomes at three time points using the Friedman Test |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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