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Occupational therapy led health promotion for older people: feasibility of the lifestyle matters programme
- Authors:
- MOUNTAIN Gail, et al
- Journal article citation:
- British Journal of Occupational Therapy, 71(10), October 2008, pp.406-413.
- Publisher:
- Sage
The aim of this feasibility study was to see if an occupation-based health-promoting intervention for community-living older people could be delivered successfully and also to provide some information to guide a future trial of clinical effectiveness. The participants' ages ranged from 60 to 92 years from a city in the North of England. Twenty-eight participants commenced the 8-month programme and 26 completed it; they have continued to meet independently following facilitator withdrawal. The participants were interviewed qualitatively before and after the 8-month programme. Additionally, pre-programme and post-programme measurements of cognition, depression, functional dependency and quality of life were conducted with each participant before and after the intervention. The post-intervention interviews illustrated the individualised benefits experienced by the participants, with greater self-efficacy being a significant theme. A comparison of the pre-intervention and post-intervention scores on the quantitative measures showed an upward trend on all dimensions of quality of life. The measurement of cognition, depression and dependency proved useful for screening purposes and for identifying individuals at risk, but not as an outcome measure. The delivery of the programme was feasible and its benefit to participants was observed, but there is a need for further research to test the intervention rigorously and to explore applicability in a range of settings.
The quality of long-term care for dementia: a survey of ward environments
- Authors:
- MOUNTAIN Gail, BOWIE Peter
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(12), 1995, pp.1029-1035.
- Publisher:
- Wiley
Presents the findings of a survey of long-stay wards for elderly demented patients. The quality of five aspects of ward environment was assessed, covering institutional practices, social/recreational input, reality orientation cues, ward condition and space availability. Of the 28 wards surveyed, two-thirds achieved high quality on one aspect but only two wards had high quality on three or more aspects. In contrast, 14% of the wards obtained low-quality scores on at least three aspects. A hospital trend was found for the variation in institutionalisation care practices. Concludes by drawing attention to the implications for staff training and for reprovision programmes.
A preventative lifestyle intervention for older adults (lifestyle matters): a randomised controlled trial
- Authors:
- MOUNTAIN Gail, et al
- Journal article citation:
- Age and Ageing, 46(4), 2017, pp.627-634.
- Publisher:
- Oxford University Press
Objectives: To test whether an occupation-based lifestyle intervention can sustain and improve the mental well-being of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants: 288 independently living adults aged 65 years or over, with normal cognition, were recruited from two UK sites between December 2011 and November 2015. Interventions: Lifestyle Matters is a National Institute for Health and Care Excellence recommended multi-component preventive intervention designed to improve the mental well-being of community living older people at risk of decline. It involves weekly group sessions over 4 months and one to one sessions. Main outcome measures: The primary outcome was mental well-being at 6 months (mental health (MH) dimension of the SF-36). Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness (de Jong Gierveld Loneliness Scale), assessed at 6 and 24 months. Results: Data on 262 (intervention = 136; usual care = 126) participants were analysed using intention to treat analysis. Mean SF-36 MH scores at 6 months differed by 2.3 points after adjustments. Conclusions: Analysis shows little evidence of clinical or cost-effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote well-being in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline. (Edited publisher abstract)