Oct 24, 2016 - Self care, Social ability, Work ability, Use of free time. (leisure) ... Nursing staff â Fairview scale observations to determine the patients level of ...
2016/10/24
Correlation between OT and Nursing levels of functioning of clients with intellectual disability. Presenter: Janine van der Linde Lecturer, E-learning and Occupational therapy, School of therapeutic sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
BACKGROUND Witrand Hospital Mental Health facility (1000 beds) residence intellectually & physical disabled patients, (650) acute & out patient psychiatric patients physical rehabilitation Need to Determine new levels functioning: Main reasons: • Due DIP levels changed dramatically • Services - no longer appropriate • Multi-professional team approach • Differences assessment outcomes conflict between the professions
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BACKGROUND OT’s NB know level of functioning
WHY? Implications quality of care Play role grouping of patients for therapeutic input Determine types of therapeutic input needed High case load only 8 OT’s Nursing staff assist delivery of therapeutic programs in wards Need to ensure that we are in line with what we do Problem did not always agree on outcomes in terms of level of functioning.
Aims of Study The aim of the study To determine if there is a correlation between the levels of functioning as measured by occupational therapists with creative ability and nursing staff using the Fairview self-help observation scale.
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Objectives
To determine level of functioning
To determine level of functioning Fairview selfhelp observation scale To determine
correlation between scales.
Creative ability. OBJECTIVES OF STUDY
Creative Ability OT’s mental health Vona du Toit’s Model of Creative Ability for assessment. Creative participation assessment Why use this model/assessment ??? • Way to Evaluate skills and ability in occupational performance areas • motivation (inner drive to participate) • action (effort put into participation). • Assessment related to participation in ADL Self care, Social ability, Work ability, Use of free time (leisure)
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Fairview • Fairview developed 1970 as screening test cheap easy to administer based on observations • Index of skill development • Nursing staff Fairview scale observations to determine the patients level of functioning in months. According to 5 Domains 1. Motor dexterity 2. Self help skills 3. Communication skills 4. Social Interaction 5. Self direction Final score calculated months
Methodology •
A descriptive correlation study design
• Ethical Approval : Wits, Depth of Health NW & Hospital committee •
Assessment data from 2010 to 2012 gathered from existing hospital database on 586 patients.
• •
Assessment instruments Occupational therapists (Creative participation assessment based on Vona du Toit Model of creative ability (De Witt, 1997)
Analysed information from existing database Organized in Excel worksheets * Demographic background of population descriptive analysis Age Length of stay Severity of intellectual disability Physical disabilities involved * Functional level of patients in % Creative Ability Fairview Nursing scale Statistica 11 Spearman correlation test Correlation between tests
RESULTS: Demographics Demographics Average age Average LOS Mild to moderate Intellectual disability
44 years Range 3 - 94 years 31.2 yrs longest 61 yrs 31%
Correlation Scatterplot of Average Fairview against Creative Ability Witrand Patient stats 30v*594c Average Fairview = -16.0791+20.906*x
•
140 120
Average Fairview
100 80 60 40 20 0 -20 -0.5
0.0
0.5
Creative Ability:Average Fairview:
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
r = 0.8116, p = 0.0000; r2 = 0.6586 Creative Ability
A spearman rank correlation test good to excellent correlation (p = 0.84)
Conclusion & recommendation • average level of functioning Fairview 17 months • Creative ability Self-differentiation (level 2) Similar information from different professionals Important lessen conflict Professions continue to use professions specific measures Approach to intervention more focussed
Information used to plan detailed therapeutic program
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Acknowledgements Mrs. Mocwaledi-Senyane – Witrand Hospital CEO Dr. T. Oosthuizen – Senior Manager Clinical services Matron Annetjie de Bruin – Assistant Director Nursing Occupational Therapy department Hanlie Degenaar – Speech and language therapist Charlotte le Roux – Speech and language therapist Mariet Terblanche – Psychologist Ella Ingram – Nursing assistant Carol Elefeld – Nursing assistant Nursing Assistants involved in program
