Hand Carri, Donnelly Catherine, Bobbette Nicole, Borczyk Maria, Bauer Martha, O'Neill Collen
School of Occupational Therapy, University of Western Ontario, London, ON, Canada.
School of Rehabilitation Therapy and Director, Health Services and Policy Research Institute, Queen's University, Kingston, ON, Canada.
Br J Occup Ther. 2022 Jul;85(7):477-486. doi: 10.1177/03080226211042272. Epub 2022 Feb 28.
Occupational therapists are increasingly part of interprofessional primary care teams, helping to expand primary care to meet client needs. Effectiveness of occupational therapy services is difficult to determine with currently collected data, and little is known about the best tools to use or how to integrate tools into practice. We explored the utility and feasibility of implementing patient-reported outcome measures (PROMs) within occupational therapy primary care practice.
We integrated pre-test/post-test and exploratory qualitative designs. Over 7 months, nine occupational therapists administered two PROMs to clients receiving falls prevention services, addressing falls efficacy and participation in daily occupations. Subsequent interviews with therapists explored the utility and feasibility of using the tools. We assessed pre-to-post change in PROM scores and thematically analyzed interview data.
The occupational therapists valued measuring function and participation in daily occupations to inform practice, communicate with team members, and demonstrate effectiveness. The falls efficacy scale appeared to capture change over time and was feasible to implement at pre-test.
PROMs appear useful within occupational therapy primary care falls prevention services and can be feasible with attention to administration processes. Further development and testing of PROMs is needed to support occupational therapy primary care practice.
职业治疗师越来越多地成为跨专业初级保健团队的一员,有助于扩大初级保健以满足客户需求。目前收集的数据难以确定职业治疗服务的有效性,对于最佳使用工具或如何将工具整合到实践中知之甚少。我们探讨了在职业治疗初级保健实践中实施患者报告结局测量(PROMs)的效用和可行性。
我们采用了前后测试和探索性定性设计相结合的方法。在7个多月的时间里,9名职业治疗师为接受预防跌倒服务的客户实施了两项PROMs,涉及跌倒效能和日常活动参与情况。随后对治疗师进行访谈,探讨使用这些工具的效用和可行性。我们评估了PROMs分数的前后变化,并对访谈数据进行了主题分析。
职业治疗师重视测量功能和日常活动参与情况,以便为实践提供信息、与团队成员沟通并证明服务的有效性。跌倒效能量表似乎能够反映随时间的变化,并且在测试前实施是可行的。
PROMs在职业治疗初级保健预防跌倒服务中似乎很有用,并且在关注管理流程的情况下是可行的。需要对PROMs进行进一步的开发和测试,以支持职业治疗初级保健实践。