PTE Journal Club: May

 I am really enjoying attending these journal club meetings. I have more confidence in my knowledge with understanding medical terminology and studying scholarly articles. For this Journal Club meeting, we reviewed the article "Home-Based Occupational Therapy for Adults with Dementia and their Informal Caregivers: A Systematic Review". This systematic review investigated whether home-based occupational therapy interventions for adults with dementia and their informal caregivers optimized care recipients' performance of daily occupations and reduced caregiving burden and improved caregivers' sense of competence. The participants included community dwelling adults with dementia and their informal caregivers. People such as family or friends who provide care without being paid for their services were included. This was a systematic review of 20 studies reported in 22 articles. They used a customized data extraction form. They had a primary reviewer who screened all titles and abstracts. There was a disagreement between reviewers resolved through discussion with a third reviewer. The independent variable was home based OT intervention. The dependent variable is performance in daily activities for adults with dementia and caregiving burden and sense of competence for informal caregivers. The main findings included moderate evidence supported interventions provided jointly for adults with dementia and their informal caregivers using a combination of intervention strategies. Evidence from this review underscores the importance of using multifaceted intervention approaches provided jointly to promote performance in daily occupations for adults with dementia and improve caregiving capabilities for their informal caregivers. I determined that the study was not valid and reliable because it is not replicable and not generalizable. A limitation was that the included studies used different terms for similar outcomes - for example, ADLs versus self-care. Also, some studies used author-developed outcome measures with unknown external validity and generalizability. There was variability in the reporting of types and stages of dementia. Most studies examined ADLs, IADLs, or both without describing specific activities, thereby limiting their generalization to clinical practice. A strength of the study was that it adds support for the use of home-based OT interventions and they provided high quality of evidence. Some future recommendations are that future empirical research is needed to investigate the efficacy of multifaceted intervention approaches for specific types of dementia (e.g., vascular dementia) and at particular stages of dementia (e.g., mild, moderate) to offer sound evidence supporting clinical decisions for occupational therapy practitioners. Also, it would be good to have a clearer definition for occupation therapy practitioners. The frames of references that went along with this article include PEO Model, Ecology of Human Performance, MOHO, and COPM. Occupational performance can be enhanced for adults with dementia when compensatory intervention strategies are embedded within their daily routines. I have enjoyed learning about these topics and plan to continue to attend journal meetings to enhance my skills more and have lively discussions with my peers.