Clinical Sciences/Health Conditions
Tomonori Takeda, PhD
Occupational Therapist
Niigata Minami Hospital
niigata, Niigata, Japan
Hiroaki Obata, PhD
Associate Professor
Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences.
Niigata, Niigata, Japan
Takayuki Inomata, PhD
Professor
Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences.
Niigata, Niigata, Japan
The efficacy of occupational therapy (OT) for patients with heart failure (HF) remains not fully elucidated. This study aimed to investigate the clinical effects of OT intervention on older patients with HF.
Design:
We conducted a comparative study involving HF patients aged ＞75 years with sufficient communication ability. Participants were divided into two groups based on the treatment management team: the PT group (managed by physical therapists alone without specific tools) and the OT group (managed by a team including an occupational therapist). The OT Group received goal setting and interventions based on the International Classification of Functioning, Disability and Health. Outcomes included Functional Independence Measure (FIM), EuroQOL-5 (EQ-5D-5L), Hospital Anxiety and Depression Scale (HADS), Interdependent Happiness Scale (IHS), and Satisfaction With Life Scale (SWLS). Comparisons were made at discharge using the Mann-Whitney U test.
Results:
The study included 18 patients in the PT group (84.1±6.3 years) and 24 in the OT group (85.6±6.0 years). Outcome scores at discharge for the PT and OT groups, respectively, were as follows: FIM (120.5 [110-126] vs. 125.0 [116-126], d=0.67), EQ-5D-5L (0.86 [0.32-1.00]vs. 0.89 [0.52-1.00], d=0.15), HADS-Anxiety (5.0 [0.0-9.0] vs. 4.0 [0.0-14.0], d=0.04), and HADS-Depression (7.0 [0.0-12.0]vs. 5.0 [1.0-13.0, d=0.47).Although differences were not statistically significant, effect sizes were suggesting clinical improvement in the OT group. Conversely, scores for subjective well-being (IHS and SWLS) were higher in the PT group (IHS: 33.0 [24.0-25.0] vs. 30.5 [15.0-44.0], d=0.59; SWLS: 24.5 [11.0-35.0] vs. 22.0 [7.0-34.0], d=0.46).
Conclusion:
Involvement of occupational therapists in HF management may contribute to improvements in ADL, health-related QOL, and psychological symptoms (anxiety/depression), as evidenced by the observed effect sizes. However, subjective well-being did not show similar improvement, suggesting the need for further investigation into factors influencing patient well-being.
