Abstracts Tuesday 28 June 2016 Session 9.4 Understanding the ways in which occupation is affected by postural tachycardia syndrome: a UK <strong>Occupation</strong>al Therapy Perspective Welford J, McKenna C, Teesside University Postural tachycardia syndrome (PoTS) is a form of dysautonomia that can be life altering and debilitating (McDonald et al, 2014). The condition can cause marked physical and cognitive impairment that can significantly impact upon activity. Although the exact UK prevalence is unknown, diagnosis rates are increasing (Anderson et al, 2014). Therefore, occupational therapy services can anticipate a rise in clients with PoTS. Objective: To determine how PoTS impacts upon activity in order for occupational therapists to understand the implications of this condition and develop appropriate interventions. Method: 201 adults (aged 18–70) were recruited via two patient support charities to participate in an online quantitative survey. Participants rated their experiences pre-symptoms vs present day in relation to their occupations, producing ordinal data under self-care, leisure and productivity domains (CAOT, 1997), including their physical ability, motivation and fatigue levels. Results: The pre-symptom vs present day probability scores of
Abstracts Tuesday 28 June 2016 spending time with occupational therapists, university lecturers and students in Northern and Central Brazil and the impact it has had on my thinking and future practice. References College of <strong>Occupation</strong>al Therapists (COT) (2010) Code of ethics and professional conduct. London: COT. Kronenberg, F. K., Algado, S. S., & Pollard, N. (Eds.). (2005). <strong>Occupation</strong>al therapy without borders: learning from the spirit of survivors. Edinburgh: Elsevier Churchill Livingstone. The Kings Fund (2015) How is the NHS performing? Accessed from: http://qmr.kingsfund.org.uk/2015/16/?gclid=CJLa24XCv8g CFUNAGwodKj4OYA World Bank (2015) Brazil. Accessed from: http://www. worldbank.org/en/country/brazil/overview World Federation of <strong>Occupation</strong>al Therapy (2011) Fundamental Beliefs. Accessed from: http://www.wfot.org/AboutUs/ FundamentalBeliefs.aspx Contact email address c.sant@edu.salford.ac.uk Social care Session 11.1 <strong>Occupation</strong>al therapy in re-ablement: results of a feasibility randomised controlled trial Whitehead P, Drummond A, Parry R, Walker M, University of Nottingham Introduction: Homecare re-ablement services (HcRS) have been widely implemented by local authorities in England (Glendinning et al., 2010). Although occupational therapy is believed to be an essential component of such services (COT, 2010), it is not known whether this contributes to successful outcomes for people using services (SCIE, 2011). The aim of this study was to determine the feasibility of conducting a randomised controlled trial (RCT) of OT in HcRS. Method: Re-ablement users were randomised to receive either: usual HcRS without routine OT input (control), or usual HcRS plus an OT intervention targeted at activities of daily living (ADL). This included: goal-setting, teaching or practising techniques, equipment and adaptations, and provision of advice or support. Outcomes were assessed at two-weeks, three and six months post re-ablement by an assessor masked to group allocation. Outcomes were: personal and extended ADL quality of life falls and health and social care service use. Results: There were methodological challenges due to changes in service configurations which affected usual care and recruitment. However, 30 participants were randomised 15 to each group. It was feasible to recruit and retain participants, deliver the intervention, and collect outcome data which were responsive to change. Participants in both groups showed improvements from baseline, although overall the OT group showed greater improvement than the control. They also used homecare services less and had fewer falls. Confidence intervals were wide, reflecting the small sample. Conclusion: The RCT was feasible and a further powered definitive study is warranted. However, some changes to the study design will be necessary. The favourable trends in the OT group indicate the potential benefits in this population group. This is the first RCT of OT in re-ablement and is therefore an important study in the development of the evidence base for this area of practice. References COT (2010) Reablement: the added value of <strong>Occupation</strong>al Therapists. London: College of <strong>Occupation</strong>al Therapists. Glendinning, C., Jones, k., Baxter, K., Rabiee, P., Curtis, l., Wilde, A., Arksey, H., & Forder, J (2010) Home Care Re-ablement Services: Investigating the Longer Term Impacts. York, Social Policy Research Unit, University Of York. SCIE (2010) Reablement: a key role for occupational therapists. London: Social Care Institute for Excellence. Keywords Social Care, Research, Practice – present and future, Social Care Contact E-mail Addresses phillip.j.whitehead@nottingham.ac.uk Author Biographies Phillip Whitehead is an NIHR Doctoral Research Fellow at the University of Nottingham. For his doctoral research he has undertaken a programme of work on <strong>Occupation</strong>al Therapy in Re-ablement encompassing: a systematic review qualitative interview study and feasibility RCT. Before working in research he was as an occupational therapist in social care in a variety of different roles. Session 11.2 Content of an occupational therapy intervention in homecare re-ablement Whitehead P, Drummond A, Parry R, Walker M, University of Nottingham Introduction: Although occupational therapists are believed to be key contributors to homecare re-ablement services (HcRS) (COT, 2010) there is a paucity of literature about what is actually delivered. We conducted a randomised controlled trial (RCT) (Whitehead et al., 2014) and this study reports the evaluation of the content of the intervention. Method: Thirteen participants completed the OT intervention which focussed on activities of daily living (ADL). The OT completed a pro-forma checklist after each visit, for each participant, recording what was delivered, how much time was spent on each activity, and the participant goals which were set. Data were entered into an electronic database and analysed using descriptive statistics. Results: An average of 10 hours of OT time was spent per participant. Time was divided into: 43% direct contact (visits), 32% administration/liaison, 25% travel. Direct contact time was split by: assessment (29%), case management/advice (24%), practising activities (19%), goal reviewing (12%), teaching techniques (11%), and goal setting (5%). A median of 2 goals was set per participant (range 1–4) with 62% having a goal in relation to bathing/showering, 46% for kitchen activities, 31% for strip-washing, 23% for outdoor mobility. Conclusion: Participants received approximately 5 hours of OT contact time with the majority of this spent on assessment and case management. Direct treatment focussed mainly on practising and teaching techniques relating to bathing, showering or strip-washing, and kitchen activities. Thus the main priorities for users in the service were in relation to ADL activities within the home, which occupational therapists are well placed to deliver. References COT (2010) Reablement: the added value of <strong>Occupation</strong>al Therapists. London: College of <strong>Occupation</strong>al Therapists. 11
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