Transcript Evidence-Based Practice in Long

Evidence-Based Practice in LongTerm Care:
Facilitating Adaptation, Quality
of Life, and Social Participation
Gayle Hersch, PhD, OTR
Harriett Davidson, MA, OTR
Objectives
• This presentation describes:
1. findings from funded research utilizing an
occupation-based intervention to facilitate
adaptation to long-term care;
2. benefits of an interdisciplinary approach to
clinical research;
3. challenges encountered in implementing
future studies.
How to Compose A Team
Who? Interdisciplinary
• Each discipline brings a
different culture to the
mix
▫ OT, Nursing, Health
Economics
• Each person brings a
different style to the mix
▫ Social Styles
 Driver
 Analytical
 Amiable
 Expressive (Merrill & Reid)
How to Compose A Team
How? Attributes for Success
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Team purpose
Goals
Leadership
Communication
Cohesion
Mutual respect
Reflection (Lakhani et al.)
How to Compose A Team
When? Continuity and Growth
• It is critical to determine expectations and
resolve differences at the outset.
• Over time, members will come and go, especially
graduate students.
• There is continuity of leadership, values, and
expectations.
How to Compose A Team
Findings from R21 Grant
• This study investigated the effectiveness of an
occupation-based, cultural heritage intervention to
improve adaptation to long-term care (LTC) relocation.
• Outcome measures of adaptation included quality of life,
activity engagement, and social participation.
• The study demonstrated the effectiveness of a structured
occupation-based, social group intervention. In addition,
the study provided a picture of activity patterns, social
relationships and contextual settings for newly admitted
residents to LTC facilities.
Collaborative Model
Our collaborative model is
represented by a flourishing tree,
noted by the four constituents that
serve as the roots; in turn, they are
nourished by six concepts.
Communication and collaboration
are the core of the team effort.
Discourse (lengthy exchange of
ideas and thoughts), discovery
(identifying something new or
unique; learning something that
was unknown before); a multiperspective lens (heterogeneous
viewpoints that can be adopted
within a collaborative context); and
team attributes (a quality given to a
group, e.g. commitment, time) that
produces successful and productive
scholarly efforts.
Future Plans
Future Challenges
• Sustainability of the
intervention effect
• Translating research
into practice
• Partnership with
multiple sites
• Continued
commitment of
researchers’
participation
• Obtain research funds
• Continue this line of
research
• Recruit multiple sites
outside of Houston area.
• Offer multi-discipline
graduate students
research opportunities
• Develop a graduate
course in
interdisciplinary team
work
Acknowledgments
• We express our gratitude to our colleagues,
Anlee Birch-Evans, PhD, RN, Wyona
Freysteinson, PhD, MN, and Kai-Li Tsai, PhD as
well as our statistician, Dr. Amy Amspoker;
TWU Research Director, Dr. Nancy Luca; and
consultant, Dr. Geri Adler.
• We thank our graduate assistants, Kathryn Davis
and Erin Peterson, for their efforts in compiling
this presentation.
References
Hay, J., LaBree, L., Luo, R., Clark, F., Carlson, M., Mandel, D., & Azen, S. P.
(2002). Cost-effectiveness of preventive occupational therapy for
independent-living older adults. Journal of the American Geriatrics
Society, 50. 1381-1388.
Hersch, G., Hutchinson, S., Davidson, H., Wilson, C., Maharaj, T., & Watson, K.
B. (2012). Effect of an occupation-based cultural heritage intervention in
long-term geriatric care: A two-group control study. American Journal of
Occupational Therapy, 66(2). 224-232.
Hutchinson, S., Hersch, G., Davidson, H. A., Chu, A. Y., & Mastel-Smith, B.
(2011). Voices of elders: Culture and person factors of residents admitted
to long-term care facilities. Journal of Transcultural Nursing, 20(10). 1-8.
doi: 10.1177/1043659611414138
Lakhani, J., Benzies, K., & Hayden, K. A. (2012). Attributes of interdisciplinary
research teams: A comprehensive review of the literature. Clinical and
Investigative Medicine, 35(5). E260-E265.