Exploring Patient Outcomes After Participation in an Inpatient Occupation-Based Group: A Longitudinal Observational Cohort Study

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Introduction: Occupation-based groups are used in inpatient rehabilitation to enhance delivery and intensity of intervention; however, little research is available to understand their effectiveness. The aim of this study was to examine the process of an occupation-based group to understand mechanisms and success factors.Methods: A mixed methods process evaluation using an evidence-based framework guided implementation and analysis. Participants were those involved in the 'LifeSkills' group run daily in an adult inpatient general rehabilitation ward. Quantitative administrative data, goal achievement outcome measures, group observations and qualitative semistructured interviews were conducted.Results: Thirty participants were recruited. Factors for success included consistency in group structure and support, using meaningful practise opportunities and facilitating a real-world experience. There was no significant relationship between patient outcomes and dose of training or patient demographics. Conclusion:This evaluation contributes to a growing body of evidence for incorporating occupation-based approaches into rehabilitation and offers insights into practice implementation.

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of an inpatient occupation‐based group program using a process evaluation framework

Spalding

Gustafsson

Tommaso

2022

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Student‐led activities of daily living group program in a hospital inpatient rehabilitation setting

Miller,

Mugridge,

Elder

et al. 2024

IntroductionOccupational therapists have vital roles in inpatient rehabilitation to focus on independence in activities of daily living. Occupational therapy interventions are uniquely designed to address goals of service users and can be delivered individually or in group formats. Group interventions promote service users' mutual support and enable therapists to increase frequency and intensity of service provision. Student‐led programs have become an attractive model, benefiting students while providing positive treatment outcomes for service users. There is an emerging body of literature that explores service users' and students' satisfaction with student‐led group models of practice within inpatient rehabilitation and occupational performance outcomes of service users participating in student‐led programs. This study aimed to explore the satisfaction of service users and students in addition to the self‐reported occupational performance outcomes of a student‐led activities of daily living group program in inpatient rehabilitation.MethodsData from 33 service users and seven students were collected retrospectively. The intervention involved a student‐led activities of daily living group program, consisting of three groups: breakfast, morning tea, and home readiness group. All service users and students completed unique satisfaction surveys at the conclusion of their participation in the student‐led program. Service users completed a self‐reported activities of daily living performance measure pre‐ and post‐program. Findings were reported in descriptive statistics, and pre‐ and post‐program data were compared with the Wilcoxon signed‐rank test.ResultsAll students were satisfied with the student‐led program. Majority of service users were satisfied with all components of the student‐led program. Median scores for self‐reported performance increased significantly following the student‐led program (P < 0.001).ConclusionThis study highlighted that service users and students were satisfied with the service delivery of a student‐led activities of daily living group program. The program was effective in addressing self‐reported performance for service users in inpatient rehabilitation. The findings from this study have potential to inform clinical practice on the implementation of student‐led programs in occupational therapy settings.

Designing an occupation‐based group intervention for adult inpatient rehabilitation: Partnering with clinicians and patients using a nominal group technique design

Wall,

Pearce,

Gustafsson

et al. 2024

IntroductionOccupation‐based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation‐based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation‐based groups offer comparable outcomes to occupation‐based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co‐designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient‐centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting.MethodsA modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically.FindingsAll participants agreed the intervention should include patient‐centred, goal‐directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal‐directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals.ConclusionThrough collaboration with clinicians and patients, an occupation‐based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence‐based, patient‐centred, and contextually relevant intervention.