Activities of Daily Living Performance and Acute Care Occupational Therapy Utilization: Moderating Factors

2022 ◽  
Vol 76 (1) ◽  
Author(s):  
Adam R. Kinney ◽  
James E. Graham ◽  
Rayyan Bukhari ◽  
Amanda Hoffman ◽  
Matt P. Malcolm
Keyword(s):  
Occupational Therapy ◽  
Activities Of Daily Living ◽  
Acute Care ◽  
Daily Living ◽  
Sociodemographic Factors ◽  
Insurance Type ◽  
Therapy Services ◽  
To Receive ◽  
Adl Performance ◽  
Therapy Treatment

Importance: Hospitalized patients who have difficulty performing activities of daily living (ADLs) benefit from occupational therapy services; however, disparities in access to such services are understudied. Objective: To investigate whether need (i.e., limited ADL performance) predicts acute care occupational therapy utilization and whether this relationship differs across sociodemographic factors and insurance type. Design: A secondary analysis of electronic health records data. Logistic regression models were specified to determine whether ADL performance predicted use of occupational therapy treatment. Interactions were included to investigate whether the relationship between ADL performance and occupational therapy utilization varied across sociodemographic factors (e.g., age) and insurance type. Participants: A total of 56,022 adults admitted to five regional hospitals between 2014 and 2018 who received an occupational therapy evaluation. Intervention: None. Outcomes and Measures: Occupational therapy service utilization, Activity Measure for Post-Acute Care “6-Clicks” measure of daily activity. Results: Forty-four percent of the patients evaluated for occupational therapy received treatment. Patients with lower ADL performance were more likely to receive occupational therapy treatment; however, interaction terms indicated that, among patients with low ADL performance, those who were younger, were White and non-Hispanic, had significant others, and had private insurance (vs. public) were more likely to receive treatment. These differences were smaller among patients with greater ADL performance. Conclusions and Relevance: Greater need was positively associated with receiving occupational therapy services, but this relationship was moderated by age, minoritized status, significant other status, and insurance type. The findings provide direction for exploring determinants of disparities in occupational therapy utilization. What This Article Adds: Acute care occupational therapy utilization is driven partly by patient need, but potential disparities in access to beneficial services may exist across sociodemographic characteristics and insurance type. Identifying potential determinants of disparities in acute care occupational therapy utilization is the first step in developing strategies to reduce barriers for those in need.

Activities of Daily Living Performance and Acute Care Occupational Therapy Utilization: Moderating Factors

2022 ◽  
Vol 76 (1) ◽  
Author(s):  
Adam R. Kinney ◽  
James E. Graham ◽  
Rayyan Bukhari ◽  
Amanda Hoffman ◽  
Matt P. Malcolm
Keyword(s):  
Occupational Therapy ◽  
Activities Of Daily Living ◽  
Acute Care ◽  
Daily Living ◽  
Sociodemographic Factors ◽  
Insurance Type ◽  
Therapy Services ◽  
To Receive ◽  
Adl Performance ◽  
Therapy Treatment

Importance: Hospitalized patients who have difficulty performing activities of daily living (ADLs) benefit from occupational therapy services; however, disparities in access to such services are understudied. Objective: To investigate whether need (i.e., limited ADL performance) predicts acute care occupational therapy utilization and whether this relationship differs across sociodemographic factors and insurance type. Design: A secondary analysis of electronic health records data. Logistic regression models were specified to determine whether ADL performance predicted use of occupational therapy treatment. Interactions were included to investigate whether the relationship between ADL performance and occupational therapy utilization varied across sociodemographic factors (e.g., age) and insurance type. Participants: A total of 56,022 adults admitted to five regional hospitals between 2014 and 2018 who received an occupational therapy evaluation. Intervention: None. Outcomes and Measures: Occupational therapy service utilization, Activity Measure for Post-Acute Care “6-Clicks” measure of daily activity. Results: Forty-four percent of the patients evaluated for occupational therapy received treatment. Patients with lower ADL performance were more likely to receive occupational therapy treatment; however, interaction terms indicated that, among patients with low ADL performance, those who were younger, were White and non-Hispanic, had significant others, and had private insurance (vs. public) were more likely to receive treatment. These differences were smaller among patients with greater ADL performance. Conclusions and Relevance: Greater need was positively associated with receiving occupational therapy services, but this relationship was moderated by age, minoritized status, significant other status, and insurance type. The findings provide direction for exploring determinants of disparities in occupational therapy utilization. What This Article Adds: Acute care occupational therapy utilization is driven partly by patient need, but potential disparities in access to beneficial services may exist across sociodemographic characteristics and insurance type. Identifying potential determinants of disparities in acute care occupational therapy utilization is the first step in developing strategies to reduce barriers for those in need.

Compliance with Prescribed Adaptive Equipment: A Literature Review

2000 ◽  
Vol 63 (2) ◽  
pp. 65-75 ◽  
Author(s):  
Trish Wielandt ◽  
Jenny Strong
Keyword(s):  
Occupational Therapy ◽  
Literature Review ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Current Practice ◽  
Functional Independence ◽  
Under Five ◽  
Functional Potential ◽  
And Training

This article describes a literature review that examined the topic of the postdischarge compliance of individuals with prescribed adaptive equipment. Assisting individuals to accomplish tasks relevant to their activities of daily living and thereby achieve functional independence is central to the role of occupational therapy. The prescription of adaptive equipment is a frequently used intervention. The rationale for prescribing adaptive equipment is that it maximises a client's functional potential, allows for independence in activities of daily living and fosters confidence as a result of being able to accomplish such tasks. All studies that surveyed compliance with prescribed adaptive equipment between 1963 and 1996 were reviewed. The factors that reportedly affect compliance by individuals can be considered under five discrete categories: medical-related, client-related, equipment-related, assessment-related and training-related. On the basis of the findings of this literature review, recommendations are made for further research, specifically investigating methods that therapists could incorporate into current practice to address the problem of non-compliance with prescribed adaptive equipment.

Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study

2014 ◽  
Vol 26 (8) ◽  
pp. 1283-1293 ◽  
Author(s):  
Clarissa M. Giebel ◽  
Caroline Sutcliffe ◽  
Minna Stolt ◽  
Staffan Karlsson ◽  
Anna Renom-Guiteras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Large Scale ◽  
Depressive Symptomatology ◽  
European Study ◽  
Severe Dementia ◽  
People With Dementia ◽  
Adl Performance

ABSTRACTBackground:Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.Methods:Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.Results:ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.Conclusions:Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia.

The Relationship between Engagement in Occupations and Pressure Sore Development in Saudi Men with Paraplegia

2005 ◽  
Vol 68 (7) ◽  
pp. 307-314 ◽  
Author(s):  
Ruth Cutajar ◽  
Anne Roberts
Keyword(s):  
Occupational Therapy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Spinal Cord Injuries ◽  
Occupational Therapists ◽  
Pressure Sore ◽  
Pressure Sores ◽  
Level Of Activity ◽  
Occupational Activities ◽  
The Individual

Various research studies have explored the factors that predispose people with spinal cord injuries to pressure sore development. Two hundred risk factors have been associated with pressure sore occurrence. One of the variables commonly reported to affect pressure sore occurrence is a decreased level of activity (Vidal and Sarrias 1991, Fuhrer et al 1993). This concurs with the philosophy of occupational therapy that a reduction in activity can generate pathology (Miller et al 1988). This research study investigated whether decreased participation in occupational activities (work, leisure and activities of daily living) was related to pressure sore occurrence in paraplegic men. The sample was selected randomly from the occupational therapy discharge files of a rehabilitation facility in Saudi Arabia. The data were collected by means of a telephone questionnaire from a total of 58 men, over a 3-month period. The study showed that there was a large increase in unemployment in paraplegic men following injury (from 10% to 59%) and, as might be expected, manual workers were more vulnerable than office workers. The study found no significant association between pressure sore occurrence and whether or not the individual was employed. However, it showed a statistically significant association between unemployment and pressure sores severe enough to lead to hospitalisation. The study also found a statistically significant association between individuals' independence in activities of daily living and the number of pressure sores that they had reported in the last 2 years. These findings indicate the potential importance of clients remaining occupationally active for their wellbeing and the significant contribution that occupational therapists can make by enabling rehabilitation of occupational activities.

The Assessment of Functional Age Using “Activities of Daily Living” Performance Tests: A Study of Korean Women

1995 ◽  
Vol 3 (1) ◽  
pp. 39-53 ◽  
Author(s):  
Hee Sik Kim ◽  
Kiyoji Tanaka
Keyword(s):  
Activities Of Daily Living ◽  
Older Women ◽  
Older Adult ◽  
Daily Living ◽  
Principal Component ◽  
Performance Tests ◽  
Korean Women ◽  
Principal Component Score ◽  
Performance Tasks ◽  
Adl Performance

The purpose of this study was to assess the extent to which a battery of 24 activities of daily living (ADL) performance tasks could be used to determine functional age in a sample of older women. The subjects were 253 older adult Korean women, aged 60 to 91 years. All subjects completed a comprehensive battery of 24 performance tests related to common activities of daily living. Correlations between the measures were computed, and principal component analysis was applied to the 24 × 24 correlation matrix. A principal component score was computed for each subject and was found to decrease significantly with advancing age. Multiple regression analysis revealed that out of the initial 24 variables, 5 variables accounted for 81% of the variability. An equation was developed to determine ADL age; the equation was considered useful for the assessment of daily living activities of older adult Korean women.

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