Date Presented 04/20/2023
This quasi-experimental study completed at six skilled nursing facilities (SNFs) found statistically significant improvements in self-care utilizing an evidence-based group protocol that included fine motor, cognition, strength, flexibility, balance, and occupational components.
Primary Author and Speaker: Melissa K Luchynsky
Contributing Authors: Katie Ashbaugh, Amber Bowser, Emily Campisi, Morgan Gleixner, Byron Heinbach, Allison Snak
PURPOSE: A new payment model enables OTs working in skilled nursing facilities (SNFs) to provide up to 25% of treatment (tx) in group settings despite limited research in this area. Researchers inquired, will patients participating in individual and group tx sessions in SNFs have the same/better or worse functional outcomes than those receiving only individualized OT? Are patients satisfied with this approach?
DESIGN: This quasi-experimental, two-tailed research study recruited patients with orders for group and individualized OT sessions in six SNFs. Data mining enabled formation of a comparison group with similar baseline characteristics receiving only 1:1 sessions.
METHOD: An a priori power analysis revealed a need for 74-148 participants to achieve data saturation. Six researchers completed literature reviews on fine motor, balance, strength, cognition, flexibility, and occupation-based activities to develop an evidence-based group protocol which they provided up to 1x/week for a maximum of 10 weeks. Researchers extracted CARE Item Set data from 85 experimental participants’ OT eval and d/c reports and administered a Likert-based satisfaction survey to the experimental group after an individual and group session. Data analyzed using a two-tailed t-test to compare scores.
RESULTS: N=85 (24 males, 61 females; age range 51-96 y/o). CARE Item scores showed a statistically significant improvement in self-care (p-value=0.0069) and a nonsignificant improvement in functional mobility (p-value=0.5887) for experimental vs comparison group. Experimental group: 60% of participants satisfied with 1:1 tx, 76% satisfied with group tx.
CONCLUSION: Replacing one 1:1 tx session per week with an EBP OT group session yielded same or better improvements in self-care performance when compared to those receiving only 1:1 sessions. Group participants had the same or better satisfaction with group. OTs may use findings to make informed clinical decisions about group use in SNF settings.
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