Occupation

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 Occupational Therapists (COT) (2010) Code of ethics
and professional conduct. London: COT.
Kronenberg, F. K., Algado, S. S., & Pollard, N. (Eds.). (2005).
Occupational 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 Occupational 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
Occupational 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 Occupational
Therapists. London: College of Occupational 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 Occupational 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 Occupational
Therapists. London: College of Occupational Therapists.
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