Functional and Cognitive Occupational Therapy (FaCoT) Improves Self-Efficacy and Behavioral–Emotional Status of Individuals with Mild Stroke; Analysis of Secondary Outcomes

Abstract

Background: Mild stroke is characterized by subtle impairments, such as low self-efficacy and emotional and behavioral symptoms, which restrict daily living. Functional and Cognitive Occupational Therapy (FaCoT) is a novel intervention, developed for individuals with mild stroke. Objectives: To examine the effectiveness of FaCoT compared to a control group to improve self-efficacy, behavior, and emotional status (secondary outcome measures). Material and Methods: Community-dwelling individuals with mild stroke participated in a single-blind randomized controlled trial with assessments at pre, post, and 3-month follow-up. FaCoT included 10 weekly individual sessions practicing cognitive and behavioral strategies. The control group received standard care. The New General Self-Efficacy Scale assessed self-efficacy; the Geriatric Depression Scale assessed depressive symptoms; the Dysexecutive Questionnaire assessed behavior and emotional status; and the ‘perception of self’ subscale from the Reintegration to Normal Living Index assessed participation. Results: Sixty-six participants were randomized to FaCoT (n = 33, mean (SD) age 64.6 (8.2)) and to the control (n = 33, age 64.4 (10.8)). Self-efficacy, depression, behavior, and emotional status improved significantly over time in the FaCoT group compared with the control, with small to large effect size values. Conclusion: The efficacy of FaCoT was established. FaCoT should be considered for community-dwelling individuals with mild stroke.

Motivational strategies used by health care professionals in stroke survivors in rehabilitation: a scoping review of experimental studies

“…Among the included studies ( Table 2 ), five were conducted in Australia ( 35 , 36 , 42 , 44 , 45 ) two in China ( 47 , 48 ), two in Israel ( 43 , 50 ), one in the Netherlands ( 37 ) one in Norway ( 38 ), one in France ( 40 ) one in Denmark ( 39 ), one in Spain ( 41 ) one in Thailand ( 46 ), one in Ghana ( 49 ), and one in Sweden ( 51 ).…”

“…These past performances can serve as potent influences in cultivating self-efficacy. In this context, several studies have been identified that applied strategies such as the establishment of a therapeutic alliance ( 39 , 41 , 44 , 47 , 48 , 50 ), enhancing health literacy ( 35 – 37 , 40 – 42 , 44 – 49 , 51 ), setting achievable goals ( 38 , 40 – 42 , 44 – 48 , 50 , 51 ), personalizing rehabilitation programs ( 37 – 42 , 44 , 46 – 49 , 51 ), and honing problem-solving skills ( 39 , 42 – 47 , 50 , 51 ).…”

The Functional-Cognitive and Sensory Treatment (F-CaST) to improve rehabilitation outcomes of individuals with substance use disorder: a study protocol for a mixed-method randomized controlled trial

“…The COPM has been found sensitive to change in the perceived occupational performance [ 57 ] and as a reliable and valid assessment for people with varied health conditions [ 58 – 60 ]. The COPM has been translated into Hebrew and used in other studies to assess daily performance e.g., [ 48 , 49 ].…”

“…The F-CaST is based on the Functional and Cognitive Occupational Therapy (FaCoT) intervention which was developed for individuals with mild stroke, experiencing deficits in EF and emotional-behavioral symptoms [ 49 ]. The FaCoT was based on theoretical models from the field of cognitive rehabilitation and Bandura’s social learning theory.…”

“…The F-CaST teaches participants “how to” (vs. the more traditional virtue of “ what to ”). We based the F-CaST on the Functional and Cognitive Occupational Therapy (FaC o T) intervention, which was found to be effective in improving daily performance [ 49 ] and increasing self-efficacy [ 50 ] in adults with mild stroke. In addition, the F-CaST is based on The Ecological Model of SMD [ 51 ], which embraces the environment as a critical factor and recognizes the interplay between sensation, attention and emotion, which are linked to EF.…”