Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT05790798 |
| Other study ID # |
59.2023fbu |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
September 15, 2022 |
| Est. completion date |
March 16, 2023 |
Study information
| Verified date |
March 2023 |
| Source |
Hacettepe University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
The aim of this study was to investigate the effects of occupational therapy-based
instrumental activities of daily living intervention on stress levels, quality of life, and
participation in people with disability. The participants were recruited from the Etimesgut
Family and Life Center in Ankara. In this study, an individualized occupational therapy-based
instrumental activities of daily living intervention were implemented for a total of 8 weeks,
lasting 16 sessions, which included an intervention group (n=9) and a control group (n=9).
Changes before and after the intervention were assessed with the Lawton-Brody Instrumental
Activities of Daily Living Scale, Waisman Activities of Daily Living Scale, Modified
Mini-Mental State Examination Test, SF-36 Health Survey Questionnaire, Perceived Stress
Scale, and Community Integration Questionnaire.
Description:
The concept of disability refers to the limitation in activity and social participation and
loss of function due to the inability to fulfill the roles expected from the people depending
on the level of development, sex, and social factors resulting from an impairment or
handicap. The number of people with disabilities is increasing daily in the world, and it was
determined that 15.6% of the population over 18 has a disability. People with disabilities
experience problems in activities such as bathing, dressing, eating, shopping, money
management, preparing food, cleaning, and using drugs, due to physical, cognitive, sensory,
and psychosocial impairments. The above-mentioned activities are the tasks of everyday life
called activities of daily living (ADL). ADLs are classified as basic activities of daily
living (basic ADLs; bathing, eating, toilet, etc.), and instrumental activities of daily
living (IADLs; shopping, money management, meal preparation, shopping, dog walking, paying
bills, etc.).
People with disabilities need IADLs to a large extent in order to continue living more
independently in the community. IADLs are meaningful and purposeful activities that give
meaning to people's lives and reflect their social values and cultures. IADLs include
activities such as taking care of others, using public transport, health management, and
household chores, and have a more complex structure than basic ADLs. Unlike basic ADLs, IADLs
require more complex cognitive skills such as planning, organization, decision-making, and
executive functions, or fine motor, visual sharpness, or hearing skills. In addition, IADLs
are also affected by contextual factors (age, sex, habits, education, culture, environment,
etc.) independently of daily living activities. Because IADLs are carried out in many social
areas outside the home and include activities based on the people's home, work, school, and
social participation. Factors such as environmental suitability, social stigma, and stress of
people with disabilities, limit participation in their IADLs and negatively affect their
quality of life. Therefore, it is seen that low social participation, decreased quality of
life, and increased perceived stress are closely related to IADL performance problems.
In the literature, it is seen that intervention methods are used to improve the IADLs of
people with disabilities. Clarke et al. implemented an 8-week physiotherapy and occupational
therapy-based intervention program in people with mild and moderate Parkinson's disease
(n=762). They made individualized practices on sleep, fatigue, personal care, dressing,
in-home mobility, housework, and environmental problems within the scope of the intervention.
As a result, it was observed that there was a significant increase in IADL performance, and
they recommended the use of activity-based intensified intervention programs for future
studies. In a survey study conducted with 105 hand therapists in the USA, 97% of therapists
stated that interventions that include meaningful and purposeful activities would be more
beneficial for people with upper extremity problems, rather than traditional intervention
programs using physical agent modalities or progressive resistance exercises. Egan et al.
reported a significant increase in the performance and satisfaction levels of self-care,
productivity and leisure activities of the therapy group in the activity-based intervention
program applied to improve the occupational performance of 16 people with stroke. Studies
with high levels of evidence have emphasized that the use of the daily living activities in
intervention programs improves the quality of life of people with disabilities. Politis et
al. implemented a 4-week kit-based intervention that included activities of daily living for
37 people with dementia. As a result of the intervention, it was found that the increased
quality of life and decreased apathy in people with dementia. It has been stated that the use
of kits in intervention programs is relatively inexpensive compared to traditional
intervention programs, it is colorful and interesting, is enthusiastically welcomed by
people, and it is easy to build. In another study, it was determined that 10 activity kits
used to improve the leisure activities of people with Alzheimer's and dementia living in
nursing homes increased the quality of life of people.
In occupational therapy, Dy and Yancosek, who developed IADLs kits consisting of daily living
activities, created an 8-week intervention program within the scope of hand rehabilitation.
Activity kits were used to examine the personal opinions of occupational therapists in terms
of the ease of application of the kits before and after they were applied to people. As a
result, the use of activity kits in evaluation and interventions has been suggested because
they are easy and functional compared to biomechanical intervention programs. Berlet and
Kaskutas prepared 10 activity kits in the hand therapy clinic for 642 people who have
undergone hand surgery, for the areas of basic and instrumental ADLs where they have the most
difficulty. They sent the prepared kits to 30 occupational therapists working in the fields
of hand and community rehabilitation and received their opinions about these kits.
Occupational therapists stated that the kits eliminate the waste of time in building the
materials to be used during the intervention and increase the efficiency of the intervention
as it deals with the occupational performance of the kits.
In the systematic reviews, it is seen that studies examining the effects of interventions for
IADLs are more common in the elderly and that IADL interventions for people with disabilities
are limited. In addition, in studies with IADL kits, programs that develop fine motor skills
were focused on. According to the studies, it was thought that the proposed IADL
interventions to increase the independence of individuals with disabilities should be planned
with a new approach. Therefore, it was aimed to examine the effect of the intervention to be
made with the kits created for IADLs on people with disabilities. Specifically, The aim of
this study was to investigate the effect of occupational therapy-based instrumental
activities of daily living intervention on stress levels, quality of life, and participation
in people with disabilities.
