Feasibility of applying the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in a Danish municipal neurorehabilitation context

Abstract

Objective

This feasibility study examined the following aspects of applying Cognitive Orientation to daily Occupational Performance to stroke survivors: recruitment, dose, fidelity, perceived value, benefits, harms and potential outcomes.

Design

Single-group pretest–posttest design.

Setting

Danish municipal neurorehabilitation centre.

Subjects

Home-living stroke survivors aged 45 years or older, with a score of at least 20 on the Montreal Cognitive Assessment, referred from hospital or rehabilitation units. Participants identified at least two occupational performance issues.

Interventions

The Cognitive Orientation to daily Occupational Performance approach aims to improve occupational performance through a therapist-guided process focusing on problem-solving, strategy use, generalisation and transfer. Three occupational therapists delivered the intervention.

Main measures

Data on participant characteristics and feasibility aspects were collected using surveys, registration forms, interviews and performance-based measures. Occupational performance was assessed using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale.

Results

Of 65 invited stroke survivors, 20 (30.8%) were enrolled. Recruitment took longer than expected due to organisational factors. The intervention was delivered with high fidelity and was perceived as meaningful by both therapists and participants. Significant improvements (p < 0.001) were observed in occupational performance on the Canadian Occupational Performance Measure: performance (mean difference 2.98), satisfaction (mean difference 4.33) and on the Performance Quality Rating Scale (mean difference 2.69).

Conclusion

The intervention was feasible in this setting. A full-scale effectiveness study is warranted.