Occupational therapy in acute care: Predictors of occupational competence and hospital readmission

Simple item page
dc.contributor.advisorBowyer, Patricia
dc.creatorTkach, Melanie Morriss
dc.creator.orcid0000-0002-7972-3265
dc.date.accessioned2020-07-30T19:12:01Z
dc.date.available2020-07-30T19:12:01Z
dc.date.created2020-05
dc.date.issued5/19/2020
dc.date.submittedMay-20
dc.date.updated2020-07-30T19:12:01Z
dc.description.abstractPURPOSE: This dissertation explored predictors of occupational competence and hospital readmission for individuals with chronic health conditions in acute care. It also investigated occupational therapists’ perspectives on the implementation of standardized assessments in the hospital. METHODS: Individuals with an admitting diagnosis of Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, Coronary Artery Bypass Graft, Total Hip Arthroplasty, Total Knee Arthroplasty, and Pneumonia (n = 52) were evaluated with measures of self-care function, environmental impact, functional cognition, and occupational competence. A phone call or medical records review was conducted 30-40 days after discharge to obtain hospital readmissions data. A feasibility group was conducted with occupational therapists who work in acute care (n = 3); they completed measures of assessment acceptability, appropriateness, and feasibility for the standardized assessments utilized in the study. RESULTS: Self-care function was a significant positive predictor of occupational competence (β = 0.43, p = 0.01), and environmental impact was a significant negative predictor (β = -0.38, p = 0.01) of occupational competence. These variables accounted for 24% of the variance in occupational competence. Occupational competence was a significant negative predictor of hospital readmission (OR = 0.81, p = 0.02), and functional cognition was a significant positive predictor of hospital readmission (OR = 2.19, p = 0.04). Relationships between other predictors and outcome variables failed to reach significance. Therapists rated the Activity Measure of Post-Acute Care (AM-PAC) as the most acceptable, appropriate, and feasible measure for acute care, but results should be interpreted with caution. CONCLUSIONS: Self-care function and environmental impact predict occupational competence in individuals with chronic health conditions, whereas occupational competence and functional cognition predict hospital readmission for this population. These variables should be considered in occupational therapy evaluations and treatments to promote optimal client outcomes. Based on therapist perceptions, the AM-PAC may be a reasonable measure to assess outcomes in acute care. Results demonstrate that occupational therapists have the knowledge, skills, and tools needed to promote positive outcomes for individuals with chronic health conditions in acute care. Further research is needed to improve the generalizability of results and examine the efficacy of standardized measures in this setting.
dc.format.mimetypeapplication/pdf
dc.identifier.urihttps://hdl.handle.net/11274/12312
dc.language.isoen
dc.subjectOccupational therapy
dc.subjectAcute care
dc.subjectOccupational competence: Hospital readmission
dc.subjectThe model of human occupation
dc.titleOccupational therapy in acute care: Predictors of occupational competence and hospital readmission
dc.typeThesis
dc.type.materialtext
thesis.degree.departmentOccupational Therapy
thesis.degree.disciplineOccupational Therapy
thesis.degree.grantorTexas Woman's University
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Philosophy

Files

Original bundle

Now showing 1 - 1 of 1
Thumbnail Image
Name:
TKACH-DISSERTATION-2020.pdf
Size:
3.79 MB
Format:
Adobe Portable Document Format
Download

License bundle

Now showing 1 - 2 of 2
No Thumbnail Available
Name:
LICENSE.txt
Size:
1.85 KB
Format:
Plain Text
Description:
Download
No Thumbnail Available
Name:
PROQUEST_LICENSE.txt
Size:
5.84 KB
Format:
Plain Text
Description:
Download

Collections

School of Occupational Therapy
2020 Theses and Dissertations