Aug 16 2019 / By
Compass engaged A Chance for Life Ltd to provide Occupational Therapy assessment and to facilitate the existing staff to implement the treatment plans with clients attending Compass. The pilot had 3 phases: setting up; intervention and review. The pilot built on work which had already been undertaken by Compass. Evaluation of the interventions was through observation, client feedback and the use of validated outcome measures. The validated outcome measures used were Goal Attainment Scaling (GAS), Quality of Life after Brain Injury questionnaire (QOLIBRI) and PHQ-9 (Patient health questionnaire – a measure of depression) and GAD-7 (Generalised anxiety disorder assessment).
Clients were: male: 2, female: 2; age range 25 -59 years; time since onset of brain injury 6-19 years. All clients had physical and cognitive disabilities following their brain injury and were attending Compass regularly.
Each client was assessed individually and a 12-week treatment plan set up according to their agreed goals. The assessment for each client by the Occupational Therapist led to the development of an intervention plan which was implemented by the Compass staff team who were already supporting the clients. A review of client progress was made after 6 weeks and changes made to the programme if required. A final review of progress was undertaken after 12 weeks.
The GAS scores show that all clients improved on their own goal achievement from the baseline score. The changes ranged from 45%-89% improvement with mean improvement being 65%. These scores show that where clients and staff are working towards agreed goals over a 12-week period, improvements can be demonstrated.
Total QOLIBRI scores showed improvement for each of the 3 clients who could use this outcome measure. Some individual items scores on QOLIBRI showed a lower (worse) score at the end of the project. In the use of QOLIBRI during rehabilitation this is not uncommon. Score reductions usually occur where people are making steps towards greater insight into their difficulties or where new skills are being learned and this was true for all these clients.
PHQ and GAD scores stayed within the same severity bandings for 2 out of the 3 clients who could access the assessments. One client’s PHQ score (depression) changed from “moderate” to “moderate-severe” and other clients did demonstrate trends towards worsening of PHQ and GAD scores, however this was attributed, by the treating therapist, to particular circumstances at home in each case.
All clients agreed that the involvement of OT in their programmes helped them to make changes which they would not have been able to make otherwise. All clients could see the benefit that occupational therapy brought to their service.
Staff feedback indicated that staff are feeling supported in helping clients to achieve their goals and liked having the resource of an OT to help staff to improve the work they do with clients. Staff expressed satisfaction in seeing the clients achieve their goals and so felt satisfaction in their own roles.
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