Evaluation of Occupational Therapy Pre-Discharge Home Visit Information Leaflets for Older Adults
Atwal, Anita, Luke, Alexandra, Plastow, Nicola, British Journal of Occupational Therapy
Occupational therapy pre-discharge home visits involve taking patients to their home for a short period of time and assessing their ability to perform some occupations of daily living within their own environment (Atwal et al 2008a). Previous research found dissatisfaction with aspects of the occupational therapy pre-discharge home visit in acute care settings. Some older adults found the home visit experience demoralising, daunting and anxiety provoking because of weak communication, poor preparation and their lack of involvement in decision making (Atwal et al 2008b). The home visit process, therefore, depends upon good information exchange between the patient, carer, therapist and other agencies. A Cochrane review recommended the use of both verbal and written health information when communicating with patients (Johnson et al 2003).
Information leaflets are a form of written health information that may enhance the communication between patients and professionals (Clerehan et al 2005). To do this, they need to take into account the specific needs of their recipients (Mountain and Pighills 2003). However, three Australian studies found that occupational therapy leaflets were not designed specifically to meet the needs of older adults (Sharry et al 2002, Griffin et al 2006, McKenna and Scott 2007). Furthermore, information leaflets that discount the specific needs of older adults may not have the desired positive effect on patient outcomes (Paul et al 2003, Marshall and Williams 2006, Freemantle et al 2008). Despite this, a literature search using Medline and Cinahl (1990-2010) found that, within occupational therapy, there were no research studies that explored the quality of information leaflets for older adults in the United Kingdom (UK). A match between written information and the literacy skills of older adults is one aspect of information sheet quality (Sharry et al 2002, Griffin et al 2006, McKenna and Scott 2007). The aims of this research were:
1. To determine what proportion of health care organisations used printed home visit leaflets as part of the occupational therapy home visit process with older adults in acute care
2. To analyse the readability and quality of home visit information leaflets provided by occupational therapists working with older adults in acute care.
The study occurred in two phases and over 3 months, from March 2010 to June 2010.
Phase 1: A survey to investigate the use of home visit information leaflets
An email survey was used to identify the number of UK health organisations providing information for older adults on pre-discharge home visits in acute care. The survey tool was piloted with seven postgraduate occupational therapists. One hundred and seventy-one acute health care trusts were identified via the internet. Twenty-three did not have acute care services for older adults. A further 36 had no contact details available on the internet.
In total, 112 surveys were sent to occupational therapists working in acute care services with older adults. The participants received two email reminders. Participants were asked about the use of a pre-discharge information leaflet within occupational therapy practice, whether it was perceived to be effective, whether the tool had been evaluated, and how it had been formulated. The questions were devised from existing good practice checklists (see Table 1). Occupational therapists were also requested to send the researchers a home visit information leaflet, if one was used.
Eleven occupational therapists responded to the survey. Of these, six provided home visit information leaflets as part of their response; however, only five were suitable for analysis. Due to the inadequate (10%) response rate, it was not possible to determine the proportion of health care organisations that used home visit information leaflets within acute care with older adults. …