Authors (including presenting author) :
Kang N (1), Tsai KL (1)
Affiliation :
(1) Occupational Therapy Department, Haven of Hope Hospital
Introduction :
Chronic Stroke patients with permanent physical & cognitive dysfunction, which lead to decrease IADL participation, negative sickness impact and poor subjective well-being. Occupational Therapy (OT) plays a crucial role in helping patient to deal with various barriers, equip with positive strategies and build up confidence in activities of daily living
Objectives :
To explore the effectiveness of OT in improving IADL, QOL and subjective well-being of chronic stroke patients in stroke clinic.
Methodology :
Young stroke patients with mild to moderate severity were recruited to attend stroke clinic. Before attending Doctor’s consultation, patients were assigned to conduct pre-consultation intervention by OT. The designed OT intervention included: (1) Stroke related disease management; (2) Caregiver education; (3) Counselling & encouraging IADL participation & social interaction; (4) Introduction to Occupational Lifestyle Redesign (OLSR) program so as to learn & regain adaptive strategies to re-structure daily activities within own limitations. Pre-post comparison was evaluated by 27-score Lawton IADL Scale, QOL by Stroke Adapted Sickness Impact Profile-30 (SA-SIP30) and well-being status by the 5-items World Health Organization Well-Being Index (WHO-5) using Wilcoxon-signed ranks test
Result & Outcome :
There were 18 stroke patients with 32 OT consultation attendances (7 patients with single follow-up and 11 ≥ 2 follow-ups) during the measurement period. Most age group range from 41 to 70 (82%). Stroke had occurred 12–24 months previously mostly (56%). The numbers of stroke patients with mild severity was approximately equal to those with moderate severity. Results showed that patients didn’t have much hand function improvement during the consultation period (i.e. 94% of patients maintained same level of hand function according to Functional Test for the Hemiplegic Upper Extremity (FTHUE). Nevertheless, patients showed significant difference in increasing IADL participation and reducing sickness impact (P<0.05) after OT intervention. Although 60% of patients follow up by OT also reported better subjective well-being, significant difference was not drawn.
In summary, OT involvement in stroke clinic has the capability to promote IADL participation and reduce sickness impact after stroke. However, larger sample size may be needed and longer follow up should be done in order to see the effect on subjective well-being on one hand, and to generalized the result on the other hand.
