Carrie Ciro

Instrumental Activities of Daily Living Performance and Role Satisfaction in People With and Without Mild Cognitive Impairment: A Pilot Project

OBJECTIVE We investigated differences in observed performance of instrumental activities of daily living (IADLs) and self-reported satisfaction with social role performance between people with amnestic mild cognitive impairment (a-MCI) and age- and gender-matched control participants. METHOD We measured observed performance of 14 IADLs using the Independence, Safety, and Adequacy domains of the Performance Assessment of Self-Care Skills (PASS) and the Patient-Reported Outcomes Measurement Information Systems (PROMIS) to examine satisfaction with social role performance. RESULTS Total PASS scores were significantly lower in participants with a-MCI (median=40.6) than in control participants (median=44.2; p=.006). Adequacy scores were also significantly lower. No significant differences were found between groups on the PROMIS measures. CONCLUSION IADL differences between groups were related more to errors in adequacy than to safety and independence. Occupational therapy practitioners can play a key role in the diagnosis and treatment of subtle IADL deficits in people with MCI.

Enhanced task-oriented training in a person with dementia with Lewy bodies.

Despite the inevitable loss of function seen in people with progressive dementias, interventions for reversing or minimizing functional loss are understudied. Research supports task-oriented training, but practical gaps in how to best evaluate clients for this training and how to implement it in clinical settings may be thwarting translation to occupational therapy practice. We structured an intervention model called STOMP (Skill-building through Task-Oriented Motor Practice) using a unique blend of task-oriented training and motor-learning principles. In this article, we describe through a case study the process and outcome of using STOMP to improve functional skills in a woman with moderate dementia with Lewy bodies. Our findings suggest that STOMP has the potential to serve as a structure for the evaluation and treatment of occupational performance deficits in people with dementia and that this model warrants further investigation.

Improving Daily Life Skills in People with Dementia: Testing the STOMP Intervention Model

People with Alzheimer’s disease and related dementias suffer inevitable losses in the performance of daily life activities. Emerging research demonstrates that improvement in performance may be achievable, yet clinicians lack a standardized approach for evaluation, planning and implementation. The STOMP intervention (Skill-building through Task-Oriented Motor Practice) was created using current knowledge of teaching new behaviours through motor learning principles and task-dependent neuroplasticity which occurs through mass practice and task-specific training. In this quasi-experimental design, we sought to examine the feasibility of the techniques, tolerance of a mass practice schedule and efficacy of the intervention for improving performance in daily life skills and reducing caregiver burden. Our results indicated that participants not only improved in their performance of daily living skills but also maintained the improvement at the three- month follow-up. Mass practice schedules were tolerated by people with mild-moderate dementia. Caregiver burden was unchanged at either follow-up period. Future research examining the advantages conferred from delivering STOMP in the home environment is recommended

Simulating Interprofessional Geriatric Patient Care Using Telehealth: A Team-Based Learning Activity

Introduction More than one-third of Oklahomans live in rural counties, and 63 of Oklahomas 77 counties are classified as health professional shortage areas, where telemedicine would be beneficial. In response to this need, in 2012, the Colleges of Nursing and Allied Health at the University of Oklahoma Health Sciences Center implemented a sequence of interprofessional learning experiences to prepare nurse practitioner, physical therapy, and occupational therapy students in team-based geriatric care using telehealth technologies. Methods The sequence included modules on interprofessional competencies, a simulated patient case, and clinical experiences. This publication includes instructional materials and evaluation tools for replicating this sequence. Results Student responses to the guided reflection exercise provided a snapshot of their thoughts and reactions during this learning activity. Overall, their reflections suggested that they were highly motivated and actively thinking about how to work together effectively as a team to care for their standardized patient. Discussion This case is most applicable for educators who own telehealth equipment; however, a telehealth patient encounter could be simulated with other technologies.

Exploring families’ experiences of health: contributions to a model of family health

Abstract Child health and developmental outcomes are influenced by the health of the family and the context created. Research suggests symptoms of poor family health (e.g. suboptimal family interactions, parenting stress) yet there is limited understanding of the factors which contribute to robust family health which may unveil opportunities for targeted intervention and family health promotion. The present study examined families’ experiences of family health and factors contributing to family health. We performed a qualitative study using constructivist grounded theory methods to guide our understanding of family health for families with typically developing children aged 5–18. Interviews were conducted in family homes and all members were invited to participate. Data from interviews were transcribed, coded, thematically analyzed, and verified with select families. Ten families, including 10 mothers, 8 fathers, and 15 children participated in the study. Participants described family health as a process of balance, living purposefully, and sharing experiences together in alignment with family identity. Mediating family health were processes of awareness and reflection, and adapting, adjusting, and changing in response to family life including external stress factors. Results highlight the possibility for healthcare practitioners to facilitate families’ self-reflection and awareness about their health in order to mediate family health development.

Student rating of skill performance opportunities in faculty-directed research

The purpose was to examine the feasibility of creating a faculty-driven research-based fieldwork (FW) I experience and to examine whether students engaged in a research-based FW I would report equivalent skill performance opportunities as students engaged in traditional FW I experiences. Twenty-four first-year occupational therapy students were given the option of choosing either a research-based FW I experience with a faculty member (n = 5) or a traditional FW I site (n = 19). The students self-reported their opportunities to perform ACOTE standards of practice related to professionalism, professional reasoning, use of sciences, and experiential learning using a Likert scale. Results are provided through non-parametric tests. Students in the research-based FW I reported significantly higher scores for skill performance opportunities than the students in the traditional FW I in areas of professionalism (p = .03), professional reasoning (p = .02), and experiential learning (p = .04), but there were no differences in use of sciences scores. In this small sample, first-year occupational therapy students reported a difference in skill performance opportunities for practicing professionalism, professional reasoning, and experiential learning in a research-based FW I structured by a faculty member, compared to students who chose a traditional FW I setting.