Authors (including presenting author) :
Cheung MC(1), Lee WT(1), So TW(1)
Affiliation :
Occupational Therapy Department, North Lantau Hospital
Introduction :
Patient with CI may experience various emotional distress alongside cognitive and functional declines which may affect their motivation and adherence in rehabilitation. Various psychosocial interventions have been designed to promote the psychological well-being of people with CI by alleviating psychological symptoms and enhancing social interaction. A wide spectrum of HT activities have been attempted throughout these years. Involved therapists held an opinion that more structured program design and a more systematic way in capturing outcome data shall facilitate the evaluation of effectiveness of HT program. Therefore, a pilot program was implemented in 2024 in order to test out a newly refined program model and with the good will to determine the most effective means of therapeutic intervention for this particular group of patients.
Objectives :
To evaluate the effectiveness and feasibility on the structured HT group for patient with CI, in different aspects including the cognitive function, hand function, self-care and level of psychosocial wellbeing.
Methodology :
MoCA was conducted for patient age 60 or above, referred to OT for cognitive assessment and training. Once patient was detected with cognitive impairment (below 16th percentile), or subjectively complained of cognitive declines with expression of low mood, they were invited to join an 8-sessions HT group. However, patient with severe hearing / vision impairment, failed to follow simple instructions with no carer available, patient presented with uncontrolled disturbing behavior during the HT group or patient did not interest in HT were excluded in this program.
Result & Outcome :
Throughout 2024, 14 patients were recruited in three closed group. 9 patients completed all scheduled assessments. For cognitive function, the average of MoCA score improved from 18.1 to 18.5, while 6 patients showed improvement or maintained their cognitive functions after the HT group. For hand function, the average time of completing 9-hole peg test improved from 32.3sec to 31.6sec (Right hand) and from 32.4sec to 30.3sec (Left hand). For self-care performance, most patient’s Modified Barthel Index (MBI) remained static at independent to supervision level. For psychosocial aspect, a visual analogue scale (ranged from 0-6) was used to compare patient’s positive and negative emotions before and after the HT group, higher score means they felt more portion of that emotions. The average score was increase in Happiness (From 3.6 to 4.89), Joyful (From 3.7 to 4.7), Enjoyment (From 3.6 to 3.8), and the average score of anxious was decreased from 2.7 to 1.7. Although there was no significant different found in Geriatric Depression Scale, an increasing number of patient (from 78% to 89%) rated moderate level of wellbeing with Warrick-Edinburgh Mental Wellbeing Scale (WEMWBS). A tailor-made HT group evaluation questionnaire was developed to collect patient and care-givers’ feedback after the program completion. Most of the participant agreed that the program can increase patient’s awareness to the environment, provide opportunity in learning new things and increase participation in physical activities. More than half of participant agreed that the program can enhance patient’s cognitive performance (attention, sequencing and problem solving) and psychosocial wellbeing (positive thinking, mood expression). Both patient & care-giver expressed positive attitude towards group-based activities and moderately satisfied with this program. The refined HT group program demonstrated much benefit in uplifting patient's psychosocial wellbeing and functional performance.
