Possible Effectiveness of Collaboration between Occupational Therapists and Care Managers using the Management Tool for Daily Life Performance for Stroke Patients in Transitional Care

Usefulness of the Daily Life Performance Transfer Sheet in Care Management of People With Stroke

OBJECTIVE

We examined the usefulness of collaboration between occupational therapists and care managers using the Daily Life Performance Transfer Sheet.

METHOD

We administered a questionnaire to obtain care managers' subjective assessments of the usefulness of the Daily Life Performance Transfer Sheet in the care management of clients with stroke 1 mo after discharge.

RESULTS

Most care managers perceived the Daily Life Performance Transfer Sheet as useful. Its perceived usefulness was significantly correlated with all items related to subjective assessment of care management, such as the understanding of clients' abilities, short-term care planning, long-term care planning, interprofessional collaboration, and sense of accomplishment.

CONCLUSION

The Daily Life Performance Transfer Sheet is a useful tool for care managers in the care management of clients with stroke.

Determining whether occupational therapy goals match between pairs of occupational therapists and their clients: a cross-sectional study

PURPOSE

This study examined the degree to which goals perceived by occupational therapists (OTs) matched those perceived by their clients.

METHODS

A total of 100 clients and 79 OTs were recruited from seven subacute rehabilitation wards in Japan. Matched pairs of OTs and their clients were independently asked for their perception about the clients' occupational therapy goals through semi-structured interviews.

RESULTS

Collectively, the OTs reported 239 goals, while the clients reported 161 goals. While both the OTs and the clients reported a high level of client engagement in the goal setting process, 79% of the goal statements were mismatched between pairs of OTs and their clients. Goal matching was slightly better for goals about activities of daily living or participation than for goals about body structure or body function.

CONCLUSIONS

Although most OTs and their clients perceived that they engaged in goal-setting together, only 21% of reported goals actually matched between OTs and clients. It would also be worth investigating whether there is any correlation between the content of goals, patient engagement in goal setting, degree of goal matching, and health outcomes achieved by clients following discharge from rehabilitation services.Implications for rehabilitationAlthough most occupational therapists (OTs) and their clients perceived that they engaged in goal-setting together, 79% of the goals independently reported by OTs and their clients did not match in seven post-acute rehabilitation wards across Japan.Goals were slightly more likely to match if the topic of the goals related to instrumental activities of daily living or participation (30.3%) or basic activities of daily living (24.7%) than if the topic of the goals were about body structure or body function (11.2%); however, the overall rate of goal matching was low.Japanese OTs need to develop more effective methods for recording or communicating goals in ways that clients can understand; this may be the same for other countries.

Differences in the occupational therapy goals of clients and therapists affect the outcomes of patients in subacute rehabilitation wards: a case-control study

[Purpose] This study aimed to examine the effects of differences in the goals recognized by the client and the occupational therapist on patient outcome. [Participants and Methods] A retrospective case-control study was conducted to compare rehabilitation outcomes of cases wherein the occupational therapy goals were matched/unmatched (control) with those of the patients in seven subacute rehabilitation wards in Japan. The outcomes were Functional Independence Measure, number of days of hospitalization, occupational therapy, and total medical cost. [Results] The motor Functional Independence Measure scores in the matched-goal group were significantly higher than those of the unmatched-goal group, and the home discharge rate showed a tendency to increase. It was speculated whether the client had received an explanation about the goal. [Conclusion] Rehabilitation outcome may vary depending on whether occupational therapy goals are matched.