Occupational therapy in nursing and residential care settings: A description of a randomised controlled trial intervention

This article describes an occupational therapy intervention for stroke that was provided as part of a randomised controlled trial in order to evaluate the effects of the intervention of an occupational therapist in a nursing and residential home setting. The intervention was developed and described to enable it to be reproduced in further evaluations, as recommended by the Medical Research Council's guidelines for clinical trials. Initially, the published evidence was reviewed and advice was sought to identify the process, content and recording methods needed to treat clients in a care home setting. This resulted in a clearly defined, evidence-based treatment package and a predetermined recording system. Sixty residents received occupational therapy: the mean number of visits was 8.5 and the mean total time per participant was 4.7 hours. During 508 visits, the majority of time was spent on activities of daily living training and mobility practice (40%), followed by assessment and goal setting (31%), communication with residents, staff, relatives and other agencies (15%), adaptive equipment (10%) and the treatment of impairments (4%). It is possible to develop evidence-based targeted occupational therapy interventions to be used in the context of a controlled clinical trial. Further work is required to examine the validity of the recording methods and the reproducibility of the intervention.