Birken Mary, Wenborn Jennifer, Connell Catriona
Division of Psychiatry, University College London, London, UK.
Salvation Army Centre for Addiction Services, University of Stirling, Stirling, UK.
Br J Occup Ther. 2022 Oct;85(10):761-778. doi: 10.1177/03080226221086206. Epub 2022 Apr 26.
High-quality randomised controlled trials (RCTs) of interventions are essential for determining whether an intervention is effective. However, many RCTs that examine the effectiveness of occupational therapy interventions for adults with mental health conditions or dementia have methodological limitations that reduce confidence in their results. We aimed to systematically review the quality of methods and outcome measures used in RCTs of occupational therapy interventions for adults with a mental health condition or dementia. This will inform future research in this area and enable practitioners to appraise the evidence when selecting interventions.
We searched peer-reviewed English language publications from 2000 to 2021 in MEDLINE, PsycINFO, ASSIA, CINAHL and e-thos, and hand-searched 12 journals. We included papers that met pre-specified inclusion criteria, appraised quality using a validated tool and extracted data. We conducted a narrative synthesis.
Of thirty-three included papers, 26 reported full or pilot RCTs, two reported secondary analysis or secondary outcomes of included RCTs, three reported process evaluations and two reported economic evaluations. Methodological limitations were found in many studies and outcome measures varied in their psychometric quality.
High-quality RCTs of occupational therapy interventions are needed for adults with mental health conditions and dementia. Researchers should follow international guidelines for rigorously developing and evaluating interventions and reporting studies. Practitioners should critically apply RCT evidence when selecting occupational therapy interventions.
高质量的干预随机对照试验（RCT）对于确定一项干预措施是否有效至关重要。然而，许多检验职业疗法干预对患有精神健康问题或痴呆症的成年人有效性的随机对照试验存在方法学上的局限性，这降低了人们对其结果的信心。我们旨在系统回顾职业疗法干预对患有精神健康问题或痴呆症的成年人进行的随机对照试验中所使用的方法和结果测量的质量。这将为该领域未来的研究提供参考，并使从业者在选择干预措施时能够评估证据。
我们检索了2000年至2021年发表在MEDLINE、PsycINFO、ASSIA、CINAHL和电子论文服务系统（e-thos）上的同行评审英文出版物，并手工检索了12种期刊。我们纳入了符合预先设定纳入标准的论文，使用经过验证的工具评估质量并提取数据。我们进行了叙述性综合分析。
在纳入的33篇论文中，26篇报告了完整或试点随机对照试验，2篇报告了纳入随机对照试验的二次分析或次要结果，3篇报告了过程评估，2篇报告了经济评估。许多研究存在方法学上的局限性，结果测量在心理测量质量方面各不相同。
对于患有精神健康问题和痴呆症的成年人，需要高质量的职业疗法干预随机对照试验。研究人员应遵循国际指南，严格开展和评估干预措施并报告研究结果。从业者在选择职业疗法干预措施时应审慎应用随机对照试验的证据。
