Occupational Performance Coaching for Stroke Survivors

Study Description

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Brief Summary:

Participation in valued activities following stroke is a recognized problem. Efficient and effective interventions to address this problem have not yet been established although the literature provides direction as to the needs of stroke survivors and important parts of interventions to address these needs. Occupational Performance Coaching (OPC) is an emerging approach to enabling occupational performance or participation in valued activities that includes these important parts of interventions. The primary goal of OPC is ability and satisfaction with participation in chosen activities, while promoting a client's ability to address future problems with participation. OPC has been successfully used with parents and their children in addressing problems with participation.

OPC has not been explored among adults who have experienced a stroke. For this study OPC-Stroke (OPC adapted for stroke survivors) will be tested to explore its potential effectiveness for increasing participation as well as how feasible and acceptable the research methods are. Sixteen participants who receive OPC-Stroke will be compared with sixteen who do not using measures of participation, goal achievement, well-being, self-efficacy and cognition. Those who receive OPC-Stroke will also be interviewed about their experience of the treatment.

Condition or disease	Intervention/treatment	Phase
Stroke	Other: OPC-Stroke; Other: Usual care	Not Applicable

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Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	21 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Single (Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	Occupational Performance Coaching for Stroke Survivors: A Novel Patient-centered Intervention to Improve Participation in Personally Valued Activities
Study Start Date :	February 2013
Actual Primary Completion Date :	February 2015
Actual Study Completion Date :	March 2015

Arms and Interventions

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Arm	Intervention/treatment
Experimental: OPC-Stroke, Usual care; OPC-Stroke - 10 weekly sessions of goal setting followed by problem solving process	Other: OPC-Stroke; Occupational therapy coaching intervention Other: Usual care; Usual community care
Usual care; Usual care - Follow-up by physician and possible receipt of home care services	Other: Usual care; Usual community care

Outcome Measures

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Primary Outcome Measures :

1. Change in Reintegration to Normal Living Index score [ Time Frame: Baseline, average of 14 weeks, and 6 months ]
   Measurement of change in level of participation from baseline to immediately post-intervention(average of 14 weeks) and to 6 months.

Secondary Outcome Measures :

1. Change in Canadian Occupational Performance Measure scores [ Time Frame: Baseline, average of 14 weeks, and 6 months ]
2. Change in Hospital Anxiety and Depression Scale score [ Time Frame: Baseline, average of 14 weeks, and 6 months ]
   Measure of change in overall well-being
3. Change in Goals Systems Assessment Battery - Directive Functions Indicators score [ Time Frame: Baseline, average of 14 weeks, and 6 months ]
   Measure of change in goal self-efficacy
4. Change in Montreal Cognitive Assessment score [ Time Frame: Baseline, average of 14 weeks, and 6 months ]
   Measure of change in cognition

Other Outcome Measures:

1. Participant experience of intervention [ Time Frame: Average of 14 weeks for intervention group only ]

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• first hospitalization with a diagnosis of stroke (previous experience of adjustment to stroke may influence outcomes),
• discharge from acute care hospital, inpatient rehabilitation or outpatient occupational therapy to a non-institutionalized setting,
• FIM scores at rehabilitation discharge of at least 3 for expression, comprehension, memory and problem-solving (to ensure potential participants' ability to participate in coaching process) and
• live within the City of Ottawa.

Exclusion Criteria:

• Those discharged from acute or inpatient rehabilitation and are referred to outpatient stroke rehabilitation for occupational therapy will be excluded until they complete their outpatient occupational therapy (due to potential overlap of client goals while in outpatient occupational therapy)
• have other degenerative neurological diagnoses (such as Parkinson's, Multiple Sclerosis) or
• have a current major depressive or psychotic disorder.

Contacts and Locations

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Locations

Canada, Ontario
Ottawa Hospital
Ottawa, Ontario, Canada, K1H 8L6
Bruyere Continuing Care
Ottawa, Ontario, Canada, K1N 5C8

Sponsors and Collaborators

Ottawa Hospital Research Institute

University of Ottawa

Investigators

Principal Investigator:	Dorothy Kessler, M. Sc.	University of Ottawa

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Kessler D, Egan M, Dubouloz CJ, McEwen S, Graham FP. Occupational Performance Coaching for Stroke Survivors: A Pilot Randomized Controlled Trial. Am J Occup Ther. 2017 May/Jun;71(3):7103190020p1-7103190020p7. doi: 10.5014/ajot.2017.024216.

Kessler DE, Egan MY, Dubouloz CJ, Graham FP, McEwen SE. Occupational performance coaching for stroke survivors: a pilot randomized controlled trial protocol. Can J Occup Ther. 2014 Dec;81(5):279-88.

Responsible Party:	Dorothy Kessler, PhD Candidate, Ottawa Hospital Research Institute
ClinicalTrials.gov Identifier:	NCT01800461 History of Changes
Other Study ID Numbers:	20120844-01H
First Posted:	February 27, 2013
Last Update Posted:	October 20, 2015
Last Verified:	October 2015

Keywords provided by Dorothy Kessler, Ottawa Hospital Research Institute:

Participation; Occupational Therapy; Valued Activities

Additional relevant MeSH terms:

Stroke; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases	Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases