Article

OBJECTIVE: Evaluate the effectiveness of a training package to implement a
community occupational therapy program for people with dementia and their caregiver (COTiD). DESIGN: Cluster randomized controlled trial.
SUBJECTS: A total
of 45 service units including 94 occupational therapists, 48 managers, 80
physicians, treating 71 client-caregiver couples. INTERVENTIONS: Control
intervention: A postgraduate course for occupational therapists only.
EXPERIMENTAL INTERVENTION: A training package including the usual postgraduate
course, additional training days, outreach visits, regional meetings, and access
to a reporting system for occupational therapists. Physicians and managers
received newsletters, had access to a website, and were approached by telephone.
MAIN MEASURES: PRIMARY OUTCOME: The intended adherence of therapists to the COTiD
program. This was assessed using vignettes. SECONDARY OUTCOMES: clients' daily
functioning, caregivers' sense of competence, quality of life, and self-perceived
performance of daily activities of both clients and caregivers. Between-group
differences were assessed using multilevel analyses with therapist and
intervention factors as covariates. RESULTS: No significant between-group
differences between baseline and 12 months were found for adherence (1.58, 95% CI
-0.10 to 3.25), nor for any client or caregiver outcome. A higher number of
coaching sessions and higher self-perceived knowledge of dementia at baseline
positively correlated with adherence scores. In contrast, experiencing more
support from occupational therapy colleagues or having conducted more COTiD
treatments at baseline negatively affected adherence scores. CONCLUSION: The
training package was not effective in increasing therapist adherence and
client-caregiver outcomes. This study suggests that coaching sessions and
increasing therapist knowledge on dementia positively affect adherence. CLINICAL
TRIAL NUMBER: NCT01117285.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS