Turcotte Pier-Luc, Carrier Annie, Desrosiers Johanne, Levasseur Mélanie
Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Québec, Canada; Research Centre on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke, Québec, Canada.
Aust Occup Ther J. 2015 Feb;62(1):56-67. doi: 10.1111/1440-1630.12174.
BACKGROUND/AIM: Increasingly, health-care systems should promote seniors' health and prevent disability. As they enable engagement in meaningful activities within the individuals' living environment, community occupational therapists have great potential to contribute to health promotion and prevention. Despite this potential, little is known about current health promotion and prevention activities in occupational therapy community practice. This study thus aimed to: (1) identify health promotion and prevention interventions used with seniors having disabilities, and (2) explore barriers to integrating such interventions into practice.
Secondary data analysis of a qualitative study was carried out using thematic saliency analysis. Eleven community occupational therapists working with seniors having disabilities were recruited in six community health settings in Québec, Canada. Observations of 12 home visits, followed by 12 semi-structured interviews, were conducted with occupational therapists.
Most interventions involved optimising independence in personal care and mobility. Explicit health promotion interventions were limited and included enabling healthy lifestyles by increasing health literacy and empowerment. Meaningful activities (leisure, community participation) were not targeted. Barriers to integrating health promotion into practice were clients' complex health conditions and limited openness to change combined with organisational and professional obstacles, such as a misunderstanding of occupational therapists' role in health promotion.
Health promotion and prevention interventions are not intentionally integrated into community occupational therapy practice with seniors having disabilities. As a result, seniors' needs to engage in meaningful activities might remain unmet. Overcoming barriers to integrating health promotion and prevention in practice could help improve population health and wellbeing.
背景/目的:医疗保健系统应越来越多地促进老年人的健康并预防残疾。由于社区职业治疗师能够使老年人在其生活环境中参与有意义的活动,他们在促进健康和预防方面具有巨大潜力。尽管有这种潜力,但对于职业治疗社区实践中当前的健康促进和预防活动却知之甚少。因此,本研究旨在:(1)确定针对残疾老年人使用的健康促进和预防干预措施,以及(2)探讨将此类干预措施纳入实践的障碍。
使用主题显著性分析对一项定性研究进行二次数据分析。在加拿大魁北克的六个社区卫生机构中招募了11名与残疾老年人合作的社区职业治疗师。对职业治疗师进行了12次家访观察,随后进行了12次半结构化访谈。
大多数干预措施涉及优化个人护理和行动能力方面的独立性。明确的健康促进干预措施有限,包括通过提高健康素养和增强权能来促进健康的生活方式。未将有意义的活动(休闲、社区参与)作为目标。将健康促进纳入实践的障碍包括客户复杂的健康状况、对变革的有限接受度,以及组织和专业方面的障碍,例如对职业治疗师在健康促进中作用的误解。
健康促进和预防干预措施并未有意纳入针对残疾老年人的社区职业治疗实践中。因此,老年人参与有意义活动的需求可能仍未得到满足。克服将健康促进和预防纳入实践的障碍有助于改善人群的健康和福祉。