Search

Background/aim Engagement in desired occupations can promote health and wellbeing in older adults. Assessments of engagement often measure frequency, amount or importance of specific activities. This study aimed to develop a scale to measure older adults' evaluation of the extent to which their everyday activities are contributing to their health and wellness. Methods Eighteen items, each scored with a seven-point rating scale, were initially developed by content experts, covering perceptions of how daily activities contribute to physical and mental health, as well as satisfaction and activity participation in the last six months. Rasch analysis methods were used to refine the scale using the pencil and paper responses of 460 community-living older adults. Results Initial Rasch analysis indicated three unlabelled rating scale categories were seldom used, reducing measurement precision. Five items were conceptually different by misfit statistics and principal component analysis. Subsequently, those items were removed and the number of rating scale steps reduced to 4. The remaining 13-item, 4-step scale, termed the Activity Significance Personal Evaluation ( ASPEn), formed a unidimensional hierarchy with good fit statistics and targeting. Person separation reliability (2.7) and internal consistency (.91) indicated the tool is appropriate for individual person measurement. Relative validity indicated equivalence between Rasch measures and total raw scores. Conclusions ASPEn is a brief, easily administered assessment of older adults' perception of the contribution of everyday activities to personal health and wellness. ASPEn may facilitate occupational therapy practice by enabling clinicians to assess change in meaning of an older adult's activity over time. [ABSTRACT FROM AUTHOR]

Background/aim Older people admitted to acute hospitals are at risk of functional decline. There is limited research into strategies that reduce such risks. The aim of this study was to investigate whether individualised activities of daily living retraining programmes improve functional outcomes, influence the choice of discharge destinations and reduce length of stay for older people in acute care. Methods A pilot non-randomised controlled study (pre-test/post-test) with block allocation to control and intervention groups was undertaken in an acute geriatric unit at a large teaching hospital. The study was conducted over a six-month period in two consecutive blocks. The intervention group received activities of daily living retraining three times per week for up to one hour per session. The control group received standard, mainly assessment-based occupational therapy services. The Modified Barthel Index was used to measure functional status on admission and discharge. Results At discharge, there was no statistical difference in the change of total Modified Barthel Index score between control and intervention groups. Of the 10 items scored on the Modified Barthel Index, ambulation and chair/bed transfers approached significance ( P = 0.0603 and P = 0.0547 respectively). No evidence was found for a difference in length of stay between intervention and control groups (mean length of stay 15.2 vs. 11.7 days respectively, P = 0.19). Raw data suggested that retraining programmes may reduce the level of care patients required on discharge. Conclusions Trends from this study indicate that functional retraining programmes could be effective in preventing functional decline. Further research is needed to reach more definite conclusions. [ABSTRACT FROM AUTHOR]