Home visits by occupational therapists improve adherence to recommendations: Process evaluation of a randomised controlled trial
| Autor: | Kylee J Lockwood, Nicholas F. Taylor, Katherine E. Harding, Jude N. Boyd |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Occupational therapy medicine.medical_specialty law.invention Occupational Therapists Patient Education as Topic Occupational Therapy Randomized controlled trial law Community living Activities of Daily Living Hospital discharge Humans Medicine Aged Randomized Controlled Trials as Topic Home modification Hip fracture business.industry medicine.disease Patient Discharge House Calls Home visits Socioeconomic Factors Accidents Home Physical therapy Accidental Falls Female Process evaluation business Follow-Up Studies |
| Zdroj: | Australian Occupational Therapy Journal. 67:287-296 |
| ISSN: | 1440-1630 0045-0766 |
| DOI: | 10.1111/1440-1630.12651 |
| Popis: | Introduction As part of hospital discharge planning, occupational therapists often provide recommendations to improve the interaction between a person and their home environment. The aim of this study was to investigate the number and type of recommendations made by occupational therapists during a home assessment visit compared to hospital-based assessment for patients recovering from hip fracture. A secondary aim was to explore adherence rates to the different types of recommendations. Methods Process evaluation of a randomised controlled trial of 65 participants recovering from hip fracture, returning to community living after hospital discharge. All participants received inpatient multidisciplinary rehabilitation and hospital-based assessment by an occupational therapist (usual care). In addition, the intervention group participated in a single home visit with an occupational therapist prior to hospital discharge. Analysis included the number and type of occupational therapy recommendations, adherence to recommendations at 30 days after discharge, and mediation analysis. Results Participants in the home visit group received more recommendations than the usual care group (mean difference [MD] 2.8, 95% CI 1.6 to 3.9) and adhered to a greater proportion of recommendations for assistive technologies (MD 11.4%, 95% CI 2.6 to 20.2) and task modifications (MD 10.0%, 95% CI 0.7 to 19.3). Participants in both groups had lower rates of adherence to recommendations for home modifications compared with other types of recommendations. Adherence to recommendations was a mediator in the relationship between participants' involvement in a pre-discharge home visit and reduced hospital readmissions. Conclusion There was greater adherence to occupational therapy recommendations when patients recovering from hip fracture participated in a home visit compared to hospital-based assessment, contributing to reduced readmissions to hospital in the first 30 days. Home visits offer additional benefits to hospital-based assessment through the use of a collaborative approach to decision making in the home environment. |
| Databáze: | OpenAIRE |
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