Therapeutics
Tastuya Kaneno, PhD
Associate Professor
Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University
Arakawa-ku, Tokyo, Japan
Tamami Aida, PhD
Professor
Mejiro University Graduate school of rehabilitation
Saitama-shi, Saitama, Japan
The criteria and challenges for introducing instrumental activities of daily living (IADL) training in convalescent rehabilitation wards remain unclear. This study aimed to identify factors prioritized by occupational therapists (OTs) and examine their relative importance (RI).
Design:
This study used a nationwide cross-sectional survey. An anonymous questionnaire survey was distributed to occupational therapy managers from 1,000 convalescent rehabilitation wards across Japan. Based on previous studies, six criteria for introducing IADL training and eleven related challenges were developed. Using the best–worst scaling method, participants were asked to select the best (most important) and worst (least important) items, and the RI was calculated from the best–worst counts. For item presentation, ten blocks of three items for criteria and 11 blocks of five items for challenges were prepared using a balanced incomplete block design. The demographic and facility characteristics were also assessed. Ethical approval was obtained from the institutional review board.
Results:
Valid responses were obtained from 339 respondents. For IADL training criteria, the highest priorities were “patients’ and families’ wishes (RI=100%)” and “planned practice after home discharge (RI=92%),” while “physical functions such as motor, cognitive, and sensory abilities (RI=36%)” and “independence in basic ADL (RI=33%)” were rated the lowest. Regarding challenges, “insufficient time and opportunities for practice in real-life settings (RI=100%)” and “gaps between patients’ and families’ expectations (RI=69%)” were major barriers, whereas “workload and practical hurdles (RI=25%)” and “infection control restrictions (RI=15%)” were rated the lowest.
Conclusion:
OTs in Japanese convalescent rehabilitation wards place greater importance on client-centered practice and preparation for post-discharge life than on physical functions. Addressing time constraints and discrepancies between patients and their families is essential for the effective implementation of IADL training.
