ABSTRACT:
THE EFFECT OF A COMPREHENSIVE OCCUPATIONAL THERAPY
INTERVENTION PROGRAMME ON THE OCCUPATIONAL PERFORMANCE OF
PEOPLE WITH RHEUMATOID ARTHRITIS, LIVING IN SOWETO.
C Dreijer du Plessis
Post-graduate student, University of the Witwatersrand, Johannesburg, South
Africa
Introduction: Rheumatoid Arthritis (RA) is a chronic disabling joint disease.
Empowering patients with RA to self manage the disease can lead to changes in
behaviour, pain or physical health and psychosocial health status. Limited
evidence exists for the efficacy of comprehensive Occupational Therapy (OT)
intervention for patients with RA in improving functional ability.
Objective: The primary objective of the study was to evaluate the impact of
comprehensive OT intervention on patients with RA in producing a sustained
improvement in patients' functional ability.
Methods: A prospective randomized control study over 4 months in which
patients with moderately disabling RA, following a week of in-patient rehabilitation
care, received either home visits and focus group care (group 1) or standard care
(group 2). Primary outcome measures included the modified Health Assessment
Questionnaire Disability Index (HAQ-DI), Disease activity score (DAS28) and SF-
36 scores.
Results: There were 29 and 22 patients in each group, respectively. The HAQ-DI
improved significantly in both groups following the 1 week in-patient care (p<0.05)
and there was a clinically significant difference between the groups at the 4
months follow-up visit. The SF-36 scores did not change significantly for group 1
while group 2 showed significant improvements in 5 of the 8 domains at four
months. However, group 2, had significantly worse SF-36 scores at baseline
compared to group 1. There was a significant improvement in disease activity with
the experimental group having 25% fewer tender joints. During the focus groups,the two main themes of "behavior and self management" and "problems that
interfere with occupational performance" emerged.
Conclusion: A comprehensive in-patient occupational therapy programme does
lead to sustained significant improvement in functional ability and Health related
quality of life (HR-QOL). Focus groups and home based intervention appears to
have a clinically significant impact on disease activity.
Key words: Rheumatoid Arthritis, Comprehensive Occupational Therapy
intervention, Home based intervention, Occupational Performance.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/4744 |
| Date | 08 April 2008 |
| Creators | Dreijer du Plessis, Carin |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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