Occupational-Therapy-Service课件.ppt

Occupational Therapy ServiceEast and North CHCPCommunity Elderly Mental HealthServiceInfluential Factors on Group Development vRecovering Ordinary Lives (The strategy for occuptaional therapy in mental health services 2007 2017,A vision for the next ten years)vScottish Perspective on Nice Public Health Guidance 16 Dementia:The Nice-scie guideline on supporting people with dementia and their carers in health and social carevCo-ordinated,integrated and fit for purpose:A Delivery Framework for Adult Rehabilitation in ScotlandRecovering Ordinary Lives “Occupation is central to the existence of individuals,groups and communities.It is the mechanism by which people maintain themselves in the world and realise their potentials(Wilcock 1998)”“Older People need occupations and activities that support their ability to be independent and give them a valued role in society”Scottish Perspective on NICE Public Health Guidance 16“Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care”Identifies occupational therapy interventions will:Provide individual/group interventions“to encourage older people to identify,construct,rehearse and carry out daily routines and activities that help to maintain or improve their health and wellbeing”Co-ordinated,integrated and fit for purposeA Delivery Framework for Adult Rehabilition in ScotlandFramework adopts the Kings Fund definition for rehabilitation as;“A process aiming to restore personal autonomy to those aspects of daily life considered most relevant by patients or service users,and their family carers”Impact of Group Development on OccupationalTherapy Service nOccupational focus now more evident in all aspects of service delivery with earlier referrals to service for core skill assessment.nDevelopment of poster presentationnLinking practice to SIGN and NICE guidelines and Recovering Ordinary Lives plan.Occupation and Memory groupEast and North CHCPTheoretical basis and group approachnModel of Human Occupation(MOHO)(Keilhofner and Forsyth 1997)provides the framework for group content and evaluationnThe focus of the model is on the motivation for occupation;the patterning of occupational behaviour into routines and lifestyles;the nature of skilled performance and the influence of environment on occupational behaviour(Keilhofner&Forsyth 1997)nA therapeutic group approach was adopted to provide:-a safe supportive environment -to allow exploration of the functional impact of memory problemsnCarers involvement encouraged but not part of the groupThe Group ProcessClient referred toGroup by MDT memberHome visit conducted to assess clientssuitability for group.Carer involvement encouraged at this stageClients attend seven weekly sessions lasting 1hr30 mins approxMOHOST completedafter 2nd group sessionQualitative evaluation gathered andMOHOSTrepeatedHome visit conducted to address any further Occupational performance needs and to contribute to wider multidisciplinary interventionsExploration of coping strategies foremotional difficultiesExploration of the emotions memory loss emoteEducation onmemory aidsand occupational supportsGoal setting to maintain currentoccupationalperformanceTeach practicalproblemssolving skillsand abilitiesDiscussions onthe impact ofmemory impairmenton daily lifeEducation on memory and memory problemsFocus of Group sessionsQualitative feedbackIm reading more and writing letters againBefore the group I would sit down and do nothingI feel better than I didVery interesting.i now understand moreGreat meeting people with similar problemsI found the content of the group very good and feel I understand some things betterMy husband would come,but Id rather come myselfMOHOST evaluationnModel of human occupation screening tool(MOHOST)is a standardised occupational therapy outcome measurenMOHOST is split in to six sections which allows 24 skills items related to occupational participation to be rated.nThe groups MOHOST detected positive change in -Motivation for occupation -Appraisal of ability -Occupational choices -Communication and interactions skillsReferences:nZarit S(2004)Memory Club:A group Intervention for people with Early stage Dementia and their Care Partners.The Gerontologist 44(2):262-269nClare L(1999)Memory rehabilitation in early dementia.The Journal of Dementia care Research Focus.Nov/Dec:33-38 nClare L et al(2000)Intervening with Everyday Memory Problems in Dementia of Alzheimer Type:An Errorless Learning Approach.Journal of Clinical and Experimental Neuropsychology.22(1):132-146.nGraff et al(2006)Community based occupational therapy for patients with dementia and their care givers:randomised controlled trial.British Medical Journal.Dec 333:1196 nKielhofner G&Forsyth K(1997)The Model of Human Occupation:an overview of current concepts.The British Journal of OccupationTtherapy.60(3):103-110.nParkinson S et al(2004)A Users Manual for the Model of Human Occupation Screening Tool.University of Illinois at Chicago.nCollege of Occupational Therapists 2006 Recovering Ordinary Lives the strategy for occupational therapy in mental health services 2007-2017 College of occupational therapists London nScottish Executive(2007)Co-ordinated,integrated and fit for purpose;A delivery Framework for Adult rehabilitation in Scotland,Edinburgh Scottish executivenScottish government Nhs Scotland(2009)Scottish perspective on Nice public health guidance 16:Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care