Evidence-Based Practice in Long-Term Care: Facilitating Adaptation, Quality of Life, and Social Participation

Gayle Hersch, PhD, OTRHarriett Davidson, MA, OTR

Objectives•This presentation describes:1.findings from funded research utilizing

an occupation-based intervention to facilitate adaptation to long-term care;

2.benefits of an interdisciplinary approach to clinical research;

3.challenges encountered in implementing future studies.

How to Compose A Team

• Each discipline brings a different culture to the mix▫ OT, Nursing, Health

Economics• Each person brings a

different style to the mix▫ Social Styles

Driver Analytical Amiable Expressive (Merrill &

Reid)

Who? Interdisciplinary

How to Compose A Team

•Team purpose•Goals•Leadership•Communication•Cohesion•Mutual respect•Reflection (Lakhani et al.)

How? Attributes for Success

How to Compose A Team

•It is critical to determine expectations and resolve differences at the outset.

•Over time, members will come and go, especially graduate students.

•There is continuity of leadership, values, and expectations.

When? Continuity and Growth

How to Compose A Team

Findings from R21 Grant• This study investigated the effectiveness of an

occupation-based, cultural heritage intervention to improve adaptation to long-term care (LTC) relocation.

• Outcome measures of adaptation included quality of life, activity engagement, and social participation.

• The study demonstrated the effectiveness of a structured occupation-based, social group intervention. In addition, the study provided a picture of activity patterns, social relationships and contextual settings for newly admitted residents to LTC facilities.

Collaborative ModelOur collaborative model is represented by a flourishing tree, noted by the four constituents that serve as the roots; in turn, they are nourished by six concepts. Communication and collaboration are the core of the team effort. Discourse (lengthy exchange of ideas and thoughts), discovery (identifying something new or unique; learning something that was unknown before); a multi-perspective lens (heterogeneous viewpoints that can be adopted within a collaborative context); and team attributes (a quality given to a group, e.g. commitment, time) that produces successful and productive scholarly efforts.

Future Plans Future Challenges

•Sustainability of the intervention effect

•Translating research into practice

•Partnership with multiple sites

•Continued commitment of researchers’ participation

• Obtain research funds • Continue this line of

research • Recruit multiple sites

outside of Houston area.

• Offer multi-discipline graduate students research opportunities

• Develop a graduate course in interdisciplinary team work

Acknowledgments•We express our gratitude to our

colleagues, Anlee Birch-Evans, PhD, RN, Wyona Freysteinson, PhD, MN, and Kai-Li Tsai, PhD as well as our statistician, Dr. Amy Amspoker; TWU Research Director, Dr. Nancy Luca; and consultant, Dr. Geri Adler.

•We thank our graduate assistants, Kathryn Davis and Erin Peterson, for their efforts in compiling this presentation.

ReferencesHay, J., LaBree, L., Luo, R., Clark, F., Carlson, M., Mandel, D., & Azen, S.

P. (2002). Cost-effectiveness of preventive occupational therapy for independent-living older adults. Journal of the American Geriatrics Society, 50. 1381-1388.

Hersch, G., Hutchinson, S., Davidson, H., Wilson, C., Maharaj, T., & Watson, K. B. (2012). Effect of an occupation-based cultural heritage intervention in long-term geriatric care: A two-group control study. American Journal of Occupational Therapy, 66(2). 224-232.

Hutchinson, S., Hersch, G., Davidson, H. A., Chu, A. Y., & Mastel-Smith, B. (2011). Voices of elders: Culture and person factors of residents admitted to long-term care facilities. Journal of Transcultural Nursing, 20(10). 1-8. doi: 10.1177/1043659611414138

Lakhani, J., Benzies, K., & Hayden, K. A. (2012). Attributes of interdisciplinary research teams: A comprehensive review of the literature. Clinical and Investigative Medicine, 35(5). E260-E265.