A client-centred ADL intervention: three-month follow-up of a randomized controlled trial

Contact Information

Keywords

Susanne Guidetti, susanne.guidetti@ki.se

activity; caregiver; everyday occupation; goal setting; lived experience; multicentre study; occupational therapy; participation; rehabilitation; stroke.

Abstract

Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit ≤3 months after stroke, dependent in ≥two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain “participation”, 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain “emotion” in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

Citation

Bertilsson, A. S., Ranner, M., von Koch, L., Eriksson, G., Johansson, U., Ytterberg, C., Guidetti, S., & Tham, K. (2014). A client-centred ADL intervention: three-month follow-up of a randomized controlled trial. Scandinavian journal of occupational therapy, 21(5), 377–391. https://doi.org/10.3109/11038128.2014.880126

DOI

10.3109/11038128.2014.880126

EWB Constructs:

(1) goal pursuit; (2) life satisfaction; (3) positive affect; (4) quality of life; (5) sense of meaning

EWB Measures:

(1) Life Satisfaction Scale

data availability:

data availability details:

N/A

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

N/A

Inclusion Criteria

Eligible for inclusion in the study were people who were: (a) treated for acute stroke in a stroke unit ≤3 months after stroke onset, (b) dependent in at least two ADL domains according to Katz Extended ADL Index (KE), (c) not diagnosed with dementia, (d) able to understand and follow instructions, and (e) referred for rehabilitation to one of the 16 participating units.

Non-EWB Behavioral
Measures:

(1) Barthel Index
(2) Katz Extended ADL Index
(3) Stroke Impact Scale
(4) Occupational Gaps Questionnaire
(5) Caregiver Burden Scale (CBS)

First author:

Ann-Sofie Bertilsson

species:

Human

sample size:

280

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

client-centred activities of daily living (ADL) intervention

study population:

(3) patients with other mental health disorders than dementia

sex (% female):

intervention:
control:

ethnicity (%white)

none stated (Sweden)

Age (mean, sd):

intervention: 70, 10
control: 71, 10.8

biological/Physiological Measures:

N/A