Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Canberra, Australia.
Occupational Therapy Department, University of Canberra Hospital, Canberra, Australia.
Disabil Rehabil. 2024 Jun;46(13):2747-2768. doi: 10.1080/09638288.2023.2236021. Epub 2023 Jul 31.
To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting.
Five databases were searched from 2000-2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted.
Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included ( = 1646 participants). Results indicate good evidence to support occupation-based interventions to improve occupational performance and participation outcomes in inpatient rehabilitation; it is unclear whether they are more effective than any control/alternative intervention. Research in the acute and mental health hospital settings were scarcer. Understanding the benefits of occupation-based interventions was enhanced through qualitative results including improving independence and confidence to discharge home, increasing motivation for therapy, connecting with others, and peer-based learning.
Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance.Implications For RehabilitationThe use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting.There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer.Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience.
批判性地回顾在医院环境中改善职业表现和参与结果的基于职业的干预措施的证据。
从 2000 年至 2022 年，对五个数据库进行了搜索。纳入了任何设计的研究，以调查医院环境中基于职业的干预措施对职业表现和参与结果的影响。使用每种研究设计的适当工具评估方法学质量。在提取数据后，进行了叙述性综合。
共纳入 33 项研究，包括 26 项实验研究、5 项非实验研究和 2 项混合方法研究（ = 1646 名参与者）。结果表明，有很好的证据支持基于职业的干预措施改善住院康复中的职业表现和参与结果；但尚不清楚它们是否比任何对照/替代干预措施更有效。在急性和心理健康医院环境中的研究较少。通过定性结果（包括提高出院回家的独立性和信心、增加对治疗的动力、与他人联系和基于同伴的学习），可以更好地理解基于职业的干预措施的好处。
现有研究之间的异质性和方法学弱点限制了对医院环境中基于职业的干预措施影响的结论。应进行更严格的研究，更好地报告干预设计，并使用职业表现的可靠措施。
应考虑在医院环境中使用基于职业的干预措施来提高职业表现和参与结果。有很好的证据支持基于职业的干预措施对改善职业表现和参与结果在住院康复环境中的影响；在急性和心理健康环境中的证据较少。基于职业的干预措施因其对患者结局和患者体验的影响而受到患者和临床医生的重视。
