The Outcomes of Seamless ADL Training Between Occupational Therapist and Nurse in Stroke Patients
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      This study aimed to develop and implement an interdisciplinary team model with integration of
      all the relevant expertise and to establish powerful collaboration and communication among
      the team. To this extent, we designed a new approach toward self-care training called the
      "seamless self-care training" technique, which involves enhanced coordination and
      communication between OTs and nurses in the rehabilitation ward to promote interdisciplinary
      cooperation in self-care training.
    

Detailed description: 
      Rehabilitation is mandatory to promote functional recovery and minimize the distress of
      stroke survivors as much as possible. Even though rehabilitation outcomes are expected in all
      aspects, in one study the highest improvements were observed for bowel and bladder functions,
      transfer, and mobility, while the lowest improvements were seen in bathing (washing oneself),
      grooming (caring of body parts), dressing, and stair climbing.

      Occupational therapists (OTs) are responsible for assessing and teaching skills to facilitate
      patients' activities and participation, including maximizing their performance of ADLs, and
      provide training programs and techniques that are tailor-made for each individual's
      impairment using targeted task-specific training, which has been acknowledged as the most
      effective method for enhancing functional outcomes. Nevertheless, the most important key
      factor for successful training outcomes is the collaboration of multiple healthcare
      professionals. All team members, especially nurses who spend lots of time with patients,
      should focus on encouraging and facilitating patients in transferring the newly relearned
      skills from professionals into their lives. Unfortunately, each expert usually approaches the
      patients from their own aspects, causing a lack of team perspective that could potentially
      preclude the patients from achieving their rehabilitation goals.

      In current inpatient rehabilitation practice, there is still a gap in carrying out self-care
      training. Self-care training is usually carried out by OTs at the occupational therapy unit,
      whereas nursing staff assists washing and dressing the patients during admission at the
      rehabilitation ward. Due to time constraints, nurses usually concentrate on preparing the
      patients to be ready on time for other specific training. This hinders them from allowing
      patients the time and opportunity to practice by themselves, resulting in patients' having
      low confidence and a perception of low self-efficacy. Consequently, some patients may not
      develop sufficient skills to perform self-care independently after discharge. This situation
      was reported by Pryor and Long that an integrative function of nurses and other professionals
      was sub-optimal.

      Therefore, in the present study, we aimed to develop and implement an interdisciplinary team
      model with integration of all the relevant expertise and to establish powerful collaboration
      and communication among the team. To this extent, we designed a new approach toward self-care
      training called the "seamless self-care training" technique, which involves enhanced
      coordination and communication between OTs and nurses in the rehabilitation ward to promote
      interdisciplinary cooperation in self-care training. We hope that this technique could make
      therapeutic intervention more successful and fill the gap in treatment processes, as well as
      to increase the self-efficacies of stroke survivors. The objective of this study was to
      explore the outcomes of providing this seamless self-care training to stroke patients.
    

Intervention name(s): Seamless ADL training; Conventional ADL training
Intervention type(s): Procedure; Procedure
Intervention description(s): The experimental group receive the seamless ADL training which occupational therapist and nurse work with effective communication and cooperate in dressing and bathing training; The control group receive the conventional ADL training programme
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research