Effects of Individual and Group Occupational Therapy on General Self-Efficacy, Psychological Well-Being, Personal Independence and Occupational Therapy in Older Adults
Condition: Individuality; Self-Efficacy; Well-being
Study type: Interventional

Summary: 
      The objective of this study is to determine whether individual and/or group occupational
      therapy leads to changes in generalized self-efficacy and psychological well-being, and to
      identify the type of therapy that has the best effects on older adults.
    

Detailed description: 
      Objective

      The main objective of this study is to determine whether individual and/or group occupational
      therapy leads to changes in generalized self-efficacy and psychological well-being, and to
      identify the type of therapy that has the best effects on the population of older adults. In
      addition, the investigators aim to determine whether there is a relationship between the
      different domains of psychological well-being and the sense of general self-efficacy.

      Design

      The research draws on a randomized experimental intervention study with a pre-post design. It
      compares two groups: one receiving individual therapy and the other, group therapy.

      Setting

      The intervention was conducted at two state-assisted residential care centers for older
      adults in Málaga (Spain). Each participant was first interviewed to gather sociodemographic
      data (age, gender, education level) as well as to verify that their scores for cognitive
      levels and the required skills and capabilities were sufficient to participate in the study.
      During this interview, the aim and length of the intervention was explained and an invitation
      to participate was given. All participants gave their informed consent. The care center and
      the Ethics Committee of the University of Málaga authorized the study. The same cognitive and
      emotional screening was conducted before and after the intervention. In each care center
      participants were randomly assigned to the two treatment groups.

      Subjects

      From an initial sample of 112 residents, a final sample of 74, divided into two groups of 37,
      was included in the study. For both groups, the inclusion criteria were: 1) able to read; 2)
      having normal cognitive function, scoring >22 on the Mini Mental Scale Examination, the
      cut-off point according to the scoring instructions of the adapted version for the Spanish
      population.

      Method

      In April 2014, after the sample was selected, participants were randomized to two groups of
      34. Following assessment, the intervention began in May. The intervention lasted 6 months,
      after which participants were re-assessed.

      The instruments used were Van Dierendonck's Spanish adaptation of Ryff´s Psychological
      Well-being Scale, comprising 39 items and with an internal consistency of between 0.78 and
      0.81 and the Spanish adaptation of Schwarzer and Jerusalem's General Self-Efficacy Scale
      (GSE), with an internal consistency of 0.84 (Cronbach's alpha).

      Activities were conducted in three 45-minute sessions per week. In both treatment modalities
      the activities included personal independence training (ADLs), sensory-motor stimulation
      activities, cognitive stimulation (attention, memory, language and executive function) and
      animal-assisted therapy (AAT). The group occupational therapy participants also received
      psychosocial skills training.

      To describe the sample, the investigators used descriptive statistics for quantitative and
      qualitative variables. To analyze differences in the main study variables we applied the
      t-student test or the Mann-Whitney U test, depending on whether or not they followed a normal
      distribution. Chi square testing was used to determine the existence of differences in
      distribution by gender, age and educational level. To analyze the main dependent variables
      (self-efficacy and well-being) we conducted a repeated measures ANOVA for intra-subject and
      inter-subject factors. Statistical significance was established at p<0.05. Data were analyzed
      using SPSS, version 21.0.
    

Intervention name(s): Individual Occupational Therapy; Group Occupational Therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 45 minutes 3 times per week 6 months in nursing homes (A and B); 45 minutes 3 times per week 6 months in nursing homes (A and B)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Older adults; Occupational Therapy; Self-Efficacy; Psychological Well-being