Article

OBJECTIVES: To identify interventions that aim to reduce dependency in activities
of daily living (ADL) in homecare service users. To determine: content;
effectiveness in improving ability to perform ADL; and whether delivery by
qualified occupational therapists influences effectiveness.
DATA SOURCES: The
Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL,
PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. REVIEW METHODS: We
included: randomised controlled trials, non-randomised controlled trials and
controlled before and after studies. Two reviewers independently screened studies
for inclusion, assessed risk of bias and extracted data. A narrative synthesis of
the findings was conducted. RESULTS: Thirteen studies were included, totalling
4975 participants. Ten (77%) were judged to have risk of bias. Interventions were
categorised as those termed 're-ablement' or 'restorative homecare' (n=5/13); and
those involving separate components which were not described using this
terminology (n=8/13). Content of the intervention and level of health
professional input varied within and between studies. Effectiveness on ADL: eight
studies included an ADL outcome, five favoured the intervention group, only two
with statistical significance, both these were controlled before and after
studies judged at high risk of bias. ADL outcome was reported using seven
different measures. Occupational therapy: there was insufficient evidence to
determine whether involvement of qualified occupational therapists influenced
effectiveness. CONCLUSION: There is limited evidence that interventions targeted
at personal ADL can reduce homecare service users' dependency with activities,
the content of evaluated interventions varies greatly.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS