Effectiveness of Home-Based Occupational Therapy on COPM Performance and Satisfaction Scores in Patients with COPD

Abstract

Background. Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. Purpose. To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients Method. We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. Findings. Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 ± 1.1 versus 6.9 ± 0.9; P<0.001) and satisfaction (4.6 ± 1.3 versus 6.9 ± 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). Implications. Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.

Occupational therapy in adults with chronic respiratory conditions: A scoping review

“…Of these, three assessed quality of life: the Chronic Respiratory Disease Questionnaire (CRQ) (Koolen et al, 2021; Migliore, 2004a) and Saint George's Respiratory Questionnaire (SGRQ) (Martinsen et al, 2017); two assessed functional status: the Pulmonary Functional Status and Dyspnea Questionnaire—Modified (PFSDQ‐M) (Migliore, 2004a) and the number of functions lost in the modified Basic Activity of Daily Living (BADL) scale (Lorenzi et al, 2004); and one assessed goal attainment using goal attainment scaling (GAS) (Koolen et al, 2021). An informal interview was used in one study (Finnerty et al, 2001), and semi‐structured interviews were used in six studies incorporating modified versions of the Canadian Occupational Performance Measure (COPM) (Koolen et al, 2021; Lorenzi et al, 2004; Martinsen et al, 2017; Rosenbek Minet et al, 2015; Vaes et al, 2019) and the Occupational Performance History Inventory (Chan, 2004). Two studies reported administering observational assessments of occupational performance (Gysels et al, 2015; Higginson et al, 2014).…”

“…Eighteen studies incorporated interventions by occupational therapists that targeted body functions and structures. The majority targeted functions of the cardiovascular and respiratory systems such as breathing techniques (Chan, 2004; Enfield et al, 2010; Giusti et al, 2022; Knox et al, 2019; Koolen et al, 2021; Migliore, 2004a; Norweg et al, 2005, 2008; Wingårdh et al, 2020), general energy conservation (Chan, 2004; Enfield et al, 2010; Gysels et al, 2015; Higginson et al, 2014; Ip et al, 2004; Martinsen et al, 2017), and management of lung condition (Giusti et al, 2022; Kanao et al, 2017; Norweg et al, 2005). Others targeted movement‐related functions through strength and conditioning (Benninger & Mastronarde, 2015); and mental functions through relaxation techniques (Chan, 2004; Kanao et al, 2017; Williams et al, 2010), psychological and emotional support (Ip et al, 2004), memory storage and recall (Migliore, 2004a), and anxiety management (Knox et al, 2019).…”

“…This typically involved application of energy conservation or breathing techniques while performing individually identified challenging occupations (Lorenzi et al, 2004; Maekura et al, 2015; Martinsen et al, 2017; Migliore, 2004b; Norweg et al, 2005, 2008; Rosenbek Minet et al, 2015; Vaes et al, 2019). Others provided education to improve performance of occupations using energy conservation or breathing techniques (Giusti et al, 2022; Kanao et al, 2017; Koolen et al, 2021; Rubí et al, 2010; Wingårdh et al, 2020; Zainuldin et al, 2016), and some studies used occupations as a means of therapy through facilitating engagement in meaningful occupations (Benninger & Mastronarde, 2015; Chan, 2004; Enfield et al, 2010; Lorenzi et al, 2004).…”

“…Fourteen studies incorporated interventions targeting environmental factors through products and technology such as equipment/aid recommendations (Enfield et al, 2010; Giusti et al, 2022; Gysels et al, 2015; Higginson et al, 2014; Martinsen et al, 2017; Migliore, 2004a; Vaes et al, 2019; Wingårdh et al, 2020) and home or activity specific modifications (Benninger & Mastronarde, 2015; Ip et al, 2004; Koolen et al, 2021). Others targeted supports and relationships (Finnerty et al, 2001; Gysels et al, 2015; Higginson et al, 2014; Martinsen et al, 2017) and natural environment/human made changes to the environment (Maekura et al, 2015; Norweg et al, 2005).…”

“…Variation existed in the choice and focus of assessments within included studies; however, they commonly involved a combination of occupation‐focussed, disease impact, and/or occupation‐based assessments. The majority of studies incorporated a top‐down occupation‐focussed assessment to explore occupational performance from the participants perspective (Chan, 2004; Finnerty et al, 2001; Gysels et al, 2015; Higginson et al, 2014; Koolen et al, 2021; Lorenzi et al, 2004; Martinsen et al, 2017; Migliore, 2004a; Rosenbek Minet et al, 2015; Vaes et al, 2019). For example, the COPM, with proven reliability (Sewell & Singh, 2001) and sensitivity (Sewell et al, 2005) for people with COPD, was used most frequently to facilitate the identification and prioritisation of occupational performance problems.…”