Clinical Reasoning Guideline for Home Modification Interventions / Susan L. Stark in American Journal of Occupational Therapy, Vol. 69/2 (Mars/Avril 2015)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 69/2 (Mars/Avril 2015) . - p.1-8 Titre : Clinical Reasoning Guideline for Home Modification Interventions Type de document : texte imprimé Auteurs : Susan L. Stark, Auteur ; Emily Somerville, Auteur ; Marian Keglovits, Auteur Année de publication : 2015 Article en page(s) : p.1-8 Langues : Anglais (eng) Mots-clés : Aménagement du domicile  Ergothérapie  Décision médicale  ModificationDecision making  Environment design  Guidelines as topic  Occupational therapy  Patient-centered care Résumé : OBJECTIVE. The objective of this study was to develop and validate a clinical reasoning tool to describe an occupational therapist’s clinical reasoning process while delivering home modification interventions. METHOD. We used a two-phase, mixed-methods approach. In Phase 1, we developed a personal factors guideline to support clinical reasoning in home modification interventions based on in-depth interviews, a focus group, and field observations of 6 home modification experts. In Phase 2, the guideline was validated by a second group of 6 home modification experts. RESULTS. During analysis, 16 personal and environmental factors with a corresponding set of conditions and strategies for each factor emerged to form a clinical reasoning guideline, which was validated by a second group of experts. CONCLUSION. Unpacking the “black box” of the clinical reasoning process has yielded a useful clinical reasoning tool that will allow occupational therapists to deliver complex interventions with fidelity. Permalink : ./index.php?lvl=notice_display&id=35877 [article] Clinical Reasoning Guideline for Home Modification Interventions [texte imprimé] / Susan L. Stark, Auteur ; Emily Somerville, Auteur ; Marian Keglovits, Auteur . - 2015 . - p.1-8. Langues : Anglais (eng) in American Journal of Occupational Therapy > Vol. 69/2 (Mars/Avril 2015) . - p.1-8 Mots-clés : Aménagement du domicile  Ergothérapie  Décision médicale  ModificationDecision making  Environment design  Guidelines as topic  Occupational therapy  Patient-centered care Résumé : OBJECTIVE. The objective of this study was to develop and validate a clinical reasoning tool to describe an occupational therapist’s clinical reasoning process while delivering home modification interventions. METHOD. We used a two-phase, mixed-methods approach. In Phase 1, we developed a personal factors guideline to support clinical reasoning in home modification interventions based on in-depth interviews, a focus group, and field observations of 6 home modification experts. In Phase 2, the guideline was validated by a second group of 6 home modification experts. RESULTS. During analysis, 16 personal and environmental factors with a corresponding set of conditions and strategies for each factor emerged to form a clinical reasoning guideline, which was validated by a second group of experts. CONCLUSION. Unpacking the “black box” of the clinical reasoning process has yielded a useful clinical reasoning tool that will allow occupational therapists to deliver complex interventions with fidelity. Permalink : ./index.php?lvl=notice_display&id=35877

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Feasibility of a novel intervention to improve participation after stroke / Susan Stark in The British Journal of Occupational Therapy, Vol.81 Issue 2 (February 2018)

Public ISBD [article]  inThe British Journal of Occupational Therapy > Vol.81 Issue 2 (February 2018) . - p. 116-124 Titre : Feasibility of a novel intervention to improve participation after stroke Type de document : texte imprimé Auteurs : Susan Stark ; Marian Keglovits ; Emily Somerville ; [et al...] Année de publication : 2018 Article en page(s) : p. 116-124 Langues : Anglais (eng) Mots-clés : ergothérapie  accident vasculaire cérébral  domicile  adaptation  participation sociale Résumé : Introduction Stroke is a leading cause of serious, long-term disability in the United States. With shorter inpatient hospital stays, more time in rehabilitation is devoted to medical stabilization and less on skills to regain independence in daily activities. The transition home may be an opportunity for intervention focused on regaining independence. We propose an enhanced rehabilitation transition program called Community Participation Transition after Stroke. Method A prospective, randomized, single-blinded, parallel-group pilot study was completed with 15 participants to demonstrate feasibility. Findings Fidelity to the protocol was achieved: The Community Participation Transition after Stroke group received 81% of the planned minutes and 83% of the intervention visits. There was no difference between groups for healthcare utilization or falls. Adherence was 85% at three months and 71% at nine months for the home modification intervention. At 6 months, scores improved by 17.39 points for the Community Participation Transition after Stroke group, and 1.30 points for the control group. Environmental barriers decreased in both groups. Conclusion This pilot study demonstrated that it is feasible to implement a community participation intervention during the period of transitioning home from inpatient rehabilitation for stroke survivors. Additional studies are necessary to determine the efficacy of the intervention. Permalink : ./index.php?lvl=notice_display&id=57840 [article] Feasibility of a novel intervention to improve participation after stroke [texte imprimé] / Susan Stark ; Marian Keglovits ; Emily Somerville ; [et al...] . - 2018 . - p. 116-124. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Vol.81 Issue 2 (February 2018) . - p. 116-124 Mots-clés : ergothérapie  accident vasculaire cérébral  domicile  adaptation  participation sociale Résumé : Introduction Stroke is a leading cause of serious, long-term disability in the United States. With shorter inpatient hospital stays, more time in rehabilitation is devoted to medical stabilization and less on skills to regain independence in daily activities. The transition home may be an opportunity for intervention focused on regaining independence. We propose an enhanced rehabilitation transition program called Community Participation Transition after Stroke. Method A prospective, randomized, single-blinded, parallel-group pilot study was completed with 15 participants to demonstrate feasibility. Findings Fidelity to the protocol was achieved: The Community Participation Transition after Stroke group received 81% of the planned minutes and 83% of the intervention visits. There was no difference between groups for healthcare utilization or falls. Adherence was 85% at three months and 71% at nine months for the home modification intervention. At 6 months, scores improved by 17.39 points for the Community Participation Transition after Stroke group, and 1.30 points for the control group. Environmental barriers decreased in both groups. Conclusion This pilot study demonstrated that it is feasible to implement a community participation intervention during the period of transitioning home from inpatient rehabilitation for stroke survivors. Additional studies are necessary to determine the efficacy of the intervention. Permalink : ./index.php?lvl=notice_display&id=57840

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Feasibility Trial of Tailored Home Modifications: Process Outcomes. / Susan Stark in American Journal of Occupational Therapy, Vol. 72/1 (January/February 2018)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 72/1 (January/February 2018) . - pp.1-10 Titre : Feasibility Trial of Tailored Home Modifications: Process Outcomes. Type de document : texte imprimé Auteurs : Susan Stark, Auteur ; Emily Somerville, Auteur ; Jane Conte, Auteur Année de publication : 2018 Article en page(s) : pp.1-10 Langues : Américain (ame) Mots-clés : Activités de la vie quotidienne  Sujet âgé  Chutes accidentelles  ergothérapie Résumé : OBJECTIVE. The aim of this study was to conduct a process evaluation to examine the implementation of a randomized controlled trial of home modifications designed to reduce the risk of falls and improve daily activity performance among community-dwelling older adults. METHOD. A process evaluation was conducted alongside a blinded, randomized sham-controlled trial (n = 92). Participants were followed for 1 yr after intervention. The process evaluation was framed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. RESULTS. The treatment group improved daily activity performance over 12 mo compared with the sham control group (F = 4.13; p = .024). The intervention elements and dose were delivered with greater than 90% accuracy. Participants reported a 91% adherence rate at 12 mo. CONCLUSION. The complex intervention of home modifications examined in this study is acceptable to older adults, is feasible, and can be delivered with high fidelity for frail, community-dwelling older adults. Permalink : ./index.php?lvl=notice_display&id=60731 [article] Feasibility Trial of Tailored Home Modifications: Process Outcomes. [texte imprimé] / Susan Stark, Auteur ; Emily Somerville, Auteur ; Jane Conte, Auteur . - 2018 . - pp.1-10. Langues : Américain (ame) in American Journal of Occupational Therapy > Vol. 72/1 (January/February 2018) . - pp.1-10 Mots-clés : Activités de la vie quotidienne  Sujet âgé  Chutes accidentelles  ergothérapie Résumé : OBJECTIVE. The aim of this study was to conduct a process evaluation to examine the implementation of a randomized controlled trial of home modifications designed to reduce the risk of falls and improve daily activity performance among community-dwelling older adults. METHOD. A process evaluation was conducted alongside a blinded, randomized sham-controlled trial (n = 92). Participants were followed for 1 yr after intervention. The process evaluation was framed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. RESULTS. The treatment group improved daily activity performance over 12 mo compared with the sham control group (F = 4.13; p = .024). The intervention elements and dose were delivered with greater than 90% accuracy. Participants reported a 91% adherence rate at 12 mo. CONCLUSION. The complex intervention of home modifications examined in this study is acceptable to older adults, is feasible, and can be delivered with high fidelity for frail, community-dwelling older adults. Permalink : ./index.php?lvl=notice_display&id=60731

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In-Home Medication Management Performance Evaluation (HOME-Rx): A Validity Study. / Mary Catherine Murphy in American Journal of Occupational Therapy, Vol. 71/4 (2017)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 71/4 (2017) Titre : In-Home Medication Management Performance Evaluation (HOME-Rx): A Validity Study. Type de document : texte imprimé Auteurs : Mary Catherine Murphy, Auteur ; Emily Somerville, Auteur ; Marian Keglovits, Auteur Année de publication : 2017 Langues : Américain (ame) Résumé : OBJECTIVE. This study assessed the initial psychometric properties of a novel in-home, performance-based instrument for older adults called the In-Home Medication Management Performance Evaluation (HOME-Rx). METHOD. Content validity of the HOME-Rx was determined through the multistep content validity index (CVI) process. Content experts provided qualitative and quantitative judgment of the instrument's ability to measure medication management. The assessment's target population provided qualitative feedback. CVI outcomes informed instrument revisions. RESULTS. Content experts (n = 7) were in agreement that the overall instrument was valid for measuring medication management (scale-level CVI = .95). Six items were deleted because of low agreement (item- level CVI <.80). Twenty-nine minor edits were made to the order of questions and language. Older adult participants (n = 5) reported the instrument was relevant, acceptable, and easy to understand. CONCLUSION. The HOME-Rx appears to be a relevant and valid method to assess performance barriers to medication management in the home. Permalink : ./index.php?lvl=notice_display&id=49306 [article] In-Home Medication Management Performance Evaluation (HOME-Rx): A Validity Study. [texte imprimé] / Mary Catherine Murphy, Auteur ; Emily Somerville, Auteur ; Marian Keglovits, Auteur . - 2017. Langues : Américain (ame) in American Journal of Occupational Therapy > Vol. 71/4 (2017) Résumé : OBJECTIVE. This study assessed the initial psychometric properties of a novel in-home, performance-based instrument for older adults called the In-Home Medication Management Performance Evaluation (HOME-Rx). METHOD. Content validity of the HOME-Rx was determined through the multistep content validity index (CVI) process. Content experts provided qualitative and quantitative judgment of the instrument's ability to measure medication management. The assessment's target population provided qualitative feedback. CVI outcomes informed instrument revisions. RESULTS. Content experts (n = 7) were in agreement that the overall instrument was valid for measuring medication management (scale-level CVI = .95). Six items were deleted because of low agreement (item- level CVI <.80). Twenty-nine minor edits were made to the order of questions and language. Older adult participants (n = 5) reported the instrument was relevant, acceptable, and easy to understand. CONCLUSION. The HOME-Rx appears to be a relevant and valid method to assess performance barriers to medication management in the home. Permalink : ./index.php?lvl=notice_display&id=49306

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In-Home Occupational Performance Evaluation for Providing Assistance (I–HOPE Assist): An Assessment for Informal Caregivers / Marian Keglovits in American Journal of Occupational Therapy, Vol. 69/5 (Septembre-Octobre 2015)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 69/5 (Septembre-Octobre 2015) . - p.6905290010p1-6905290010p9 Titre : In-Home Occupational Performance Evaluation for Providing Assistance (I–HOPE Assist): An Assessment for Informal Caregivers Type de document : texte imprimé Auteurs : Marian Keglovits, Auteur ; Emily Somerville, Auteur ; Susan L. Stark, Auteur Année de publication : 2015 Article en page(s) : p.6905290010p1-6905290010p9 Langues : Anglais (eng) Mots-clés : Caregiver  self efficacy Résumé : Home modification interventions have the potential to provide support to informal caregivers; however, the impact of these interventions on caregivers is understudied, and adequate assessments are lacking. This study describes the development and preliminary psychometric properties of a performance-based assessment that identifies environmental barriers to performance of daily caregiving activities. An existing assessment of person–environment fit was modified using key informant interviews and was administered to 31 informal caregivers. The In–Home Occupational Performance Evaluation for Providing Assistance demonstrated reliability across raters, good internal consistency for all subscales, and convergent validity with existing measures. This assessment has the potential to guide home modification interventions and measure the impact on informal caregiving in the home. Permalink : ./index.php?lvl=notice_display&id=40871 [article] In-Home Occupational Performance Evaluation for Providing Assistance (I–HOPE Assist): An Assessment for Informal Caregivers [texte imprimé] / Marian Keglovits, Auteur ; Emily Somerville, Auteur ; Susan L. Stark, Auteur . - 2015 . - p.6905290010p1-6905290010p9. Langues : Anglais (eng) in American Journal of Occupational Therapy > Vol. 69/5 (Septembre-Octobre 2015) . - p.6905290010p1-6905290010p9 Mots-clés : Caregiver  self efficacy Résumé : Home modification interventions have the potential to provide support to informal caregivers; however, the impact of these interventions on caregivers is understudied, and adequate assessments are lacking. This study describes the development and preliminary psychometric properties of a performance-based assessment that identifies environmental barriers to performance of daily caregiving activities. An existing assessment of person–environment fit was modified using key informant interviews and was administered to 31 informal caregivers. The In–Home Occupational Performance Evaluation for Providing Assistance demonstrated reliability across raters, good internal consistency for all subscales, and convergent validity with existing measures. This assessment has the potential to guide home modification interventions and measure the impact on informal caregiving in the home. Permalink : ./index.php?lvl=notice_display&id=40871

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