Table 5 - uploaded by Eva Ejlersen Waehrens
Content may be subject to copyright.
Contexts in source publication
Context 1
... interviews were performed by occupational therapists, who had received written instructions as well as a one-hour introduction to the ADL-I. All data were re-coded from X marks into numbers to prepare for Rasch analysis (Table 5). Numbers were based on the lowest category marked on the scale for each of the ADL tasks (e.g. if the participant had marked both "spends extra time" = 4 and "need verbal or physical assistance" = 1 for the ADL task "prepare a hot meal", the mark was recoded into the score of "1" for that task). ...
Context 2
... collapsing the seven categories of the common ADL-Q and ADL-I rating scale into a 4-category rating scale structure, the evaluation of the psychometric properties of the rating scale revealed no category or threshold disordering in the rating scale and no rating scale misfit, indicating sound psychometric properties in both instrument formats. The categories of the final rating scale were 3 = competent (original categories 6 and 5), 2 = minimally inefficient (original categories 4 and 3), 1 = moderately inefficient (original categories 2 and 1) and 0 = deficient (original category 0) (see Table 5). ...
Context 3
... person separation indicies of 3.40 and 3.09 for ADL-Q and ADL-I respectively indicated that the items separated the persons into at least four different ability levels (Table 6) (119). MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE <more> PERSONS <more> PERSONS <more> PERSONS <more> PERSONS <rare> <rare> <rare> <rare> 8 + + +| | | | -5 + + + -5 <less <less <less <less> LESS ABLE LESS DIFFICULT ITEMS <frequent> > LESS ABLE LESS DIFFICULT ITEMS <frequent> > LESS ABLE LESS DIFFICULT ITEMS <frequent> > LESS ABLE LESS DIFFICULT ITEMS <frequent> PERSONS PERSONS PERSONS PERSONS Figure 2. ADL- I Map of the Location of Persons and Items MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE MEASURE MORE ABLE MORE DIFFICULT ITEMS MEASURE <more> <more> <more> <more> PERSONS <rare> PERSONS <rare> PERSONS <rare> PERSONS <rare>| | | | -6 + + + -6 <less> <less> <less> <less> LESS ABLE LESS DIFFICULT ITEMS <frequent> LESS ABLE LESS DIFFICULT ITEMS <frequent> LESS ABLE LESS DIFFICULT ITEMS <frequent> LESS ABLE LESS DIFFICULT ITEMS <frequent> PERSONS ...
Citations
... Hence, TMO and PEO support the client-centred reasoning during delivery of the programme. The ADL-Interview (ADL-I) [48][49][50] is used for evaluating the client's self-reported ADL ability. ADL-I is a standardised evaluation tool, used by OTs, to describe and measure self-reported ADL ability [48][49][50], in terms of physical effort and/or fatigue, efficiency, safety, and independence (ADL-I Performance), i.e. quality of ADL task performance. ...
... The ADL-Interview (ADL-I) [48][49][50] is used for evaluating the client's self-reported ADL ability. ADL-I is a standardised evaluation tool, used by OTs, to describe and measure self-reported ADL ability [48][49][50], in terms of physical effort and/or fatigue, efficiency, safety, and independence (ADL-I Performance), i.e. quality of ADL task performance. The AMPS [40,41] is a standardised observation-based evaluation tool used by OTs to measure the client's observed ADL ability in terms of physical effort and/or fatigue, efficiency, safety and independence i.e. quality of ADL task performance. ...
... The AMPS [40,41] is a standardised observation-based evaluation tool used by OTs to measure the client's observed ADL ability in terms of physical effort and/or fatigue, efficiency, safety and independence i.e. quality of ADL task performance. ADL-I [48][49][50] and AMPS [40,41] are generic instruments to be applied across diagnoses. GAS [42,43] is a tool for defining and monitoring individual goals. ...
Background
Chronic conditions are associated with problems related to performance of activities of daily living (ADL) stressing a need to develop and evaluate intervention programmes addressing such problems. Hence, the ABLE programme was developed, and its feasibility evaluated. Implementing intervention programmes in community-based rehabilitation settings requires understanding of how the programme works in various contexts. Applying a realist evaluation approach, the aim of this study was to identify and evaluate interactions between contexts, mechanisms, and outcomes in the ABLE 2.0, to confirm, refine, or reject aspects of the initial programme theory.
Methods
Realist evaluation using qualitative data collected in the ABLE 2.0 randomised controlled trial (n = 78). Based on the ABLE 2.0 initial programme theory, qualitative realist interviews were conducted among receivers (n = 8) and deliverers (n = 3) of the ABLE 2.0 in a Danish municipality. Transcripts were coded, and context-mechanism-outcome configurations were extracted and grouped into contiguous themes. Results were then held up against the initial programme theory.
Results
Four contiguous themes were identified including a total of n = 28 context-mechanism-outcome configurations: building a foundation for the entire intervention; establishing the focus for further intervention; identifying and implementing relevant compensatory solutions; and re-evaluating ADL ability to finalise intervention. Overall, the ABLE 2.0 initial programme theory was confirmed. The evaluation added information on core facilitating mechanisms including active involvement of the client in the problem-solving process, a collaborative working relationship, mutual confidence, and a consultative occupation-based process using compensatory solutions. Several contextual factors were required to activate the desired mechanisms in terms of supportive management, referral procedures encouraging the problem-solving process, delivery in the client’s home, skilled occupational therapists, and clients feeling ready for making changes.
Conclusions
The ABLE 2.0 represents a coherent problem-solving occupational therapy process, applicable across sex, age, and diagnoses with the potential to enhance ADL ability among persons with chronic conditions, when delivered as part of community-based rehabilitation services. Knowledge about the interactions between contextual factors, mechanisms, and outcomes in the ABLE 2.0 is central in case of future implementation of the programme in community-based rehabilitation settings.
Trial registration
The trial was prospectively registered on www.ClinicalTrials.gov (registration date: 05/03/2020; identifier: NCT04295837) prior to data collection that occurred between August 2020 and October 2021.
... In addition, participants perceived quality of ADL task performance is assessed at baseline and endpoint using the activities of daily living interview. 48 Affective symptoms are assessed using HDRS-17 and YMRS at baseline and after the intervention. Participants in the intervention group are further assessed after 3 months of the intervention using FAST, HDRS-17 and YMRS. ...
Introduction:
Affective disorders are associated with impaired overall functioning and quality of life (QoL). Despite different medical and psychological treatment options, the prognosis remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting patient groups with impaired functioning. This study aims to improve functioning and QoL in patients with affective disorders using a comprehensive 360° intervention.
Methods and analysis:
Affective disorders: eliminate WArning signs And REstore (AWARE) functioning is a randomised, controlled, parallel-group design study. Participants will be 120 outpatients, men or women, aged 18-65 years, with a diagnosis of bipolar disorder or major depressive disorder. Inclusion requires an objectively rated impaired functioning defined as a score ≥11 according to the Functioning Assessment Short Test. Participants will be randomised to 6-month AWARE intervention or treatment as usual (TAU). The AWARE intervention is a 360° multimodal intervention based on the International Classification of Functioning Brief Core Set for bipolar and unipolar disorder targeting functioning.The primary outcome is improvement of observation-based activities of daily living (ADL) ability using Assessment of Motor and Process Skills. Secondary outcomes are changes from baseline to endpoint in functioning, QoL, stress, cognition and physical health.Our hypothesis is that the AWARE treatment in comparison with TAU will improve observed ability to perform ADL, patients self-perceived level of functioning and QoL.Status: currently recruiting patients.
Ethics and dissemination:
Ethical approval has been obtained from The Regional Ethics Committee in the Capital Region of Denmark. All patients will be provided oral and written information about the trial before informed consent is obtained. The study results will be disseminated by peer-review publications. If the present AWARE intervention shows beneficial effects, the goal is to use it as a template for future interventions addressing disability in patients with affective disorders as well as for patients within other diagnostic categories.
Trial registration number:
NCT04701827; Clinicaltrials.gov.
... The problem-solving process serves as a structure for ABLE V.2.0, including to evaluate ADL ability based on both self-report and observation; and to involve the client in setting goals, clarifying reasons for the identified ADL task performance problems, and in finding solutions 40 . ABLE V.2.0 consists of a maximum of eight sessions including ADL assessment, using the ADL-Interview (ADL-I) 41 and AMPS 38 39 (session 1); goal setting, using Goal Attainment Scaling (GAS), 42 43 and clarification of reasons for ADL task performance problems (session 2); intervention sessions focused on adaptation by employing a combination of intervention components to improve ADL task performance (sessions 3-7); and re-evaluation of overall ADL ability (final session). The nine intervention components 30 are organised according to the Person-Environment-Occupation model. ...
... 41 45 Moreover, ADL-I is used to measure the client's perceived satisfaction with the quality of performance for each of the 47 ADL tasks, using a 4-point ordinal satisfaction scale ranging from 'very satisfied' to 'very dissatisfied' (ADL-I satisfaction). 41 To measure changes in self-reported quality of ADL task performance and satisfaction, the 47 ordinal quality of performance and satisfaction scores are transformed into overall linear (interval scale) measures of selfreported quality of ADL task performance and satisfaction, adjusted for the difficulty of the ADL tasks, based on Rasch measurement methods. 41 The measures are expressed in logits (log-odds probability units). ...
... 41 To measure changes in self-reported quality of ADL task performance and satisfaction, the 47 ordinal quality of performance and satisfaction scores are transformed into overall linear (interval scale) measures of selfreported quality of ADL task performance and satisfaction, adjusted for the difficulty of the ADL tasks, based on Rasch measurement methods. 41 The measures are expressed in logits (log-odds probability units). 14 41 Previous studies indicate that ADL-I can be used to generate valid and reliable linear measures of selfreported quality of ADL task performance among persons living with chronic conditions, 11 13 41 and furthermore, that the instrument is sensitive to change in older persons receiving a home-based reablement programme. ...
Introduction
The need to develop and evaluate interventions, addressing problems performing activities of daily living (ADL) among persons with chronic conditions, is evident. Guided by the British Medical Research Council’s guidance on how to develop and evaluate complex interventions, the occupational therapy programme (A Better everyday LifE (ABLE)) was developed and feasibility tested. The aim of this protocol is to report the planned design and methods for evaluating effectiveness, process and cost-effectiveness of the programme.
Methods and analysis
The evaluation is designed as a randomised controlled trial with blinded assessors and investigators. Eighty participants with chronic conditions and ADL problems are randomly allocated to ABLE or usual occupational therapy. Data for effectiveness and cost-effectiveness evaluations are collected at baseline (week 0), post intervention (week 10) and follow-up (week 26). Coprimary outcomes are self-reported ADL ability (ADL-Interview (ADL-I) performance) and observed ADL motor ability (Assessment of Motor and Process Skills (AMPS)). Secondary outcomes are perceived satisfaction with ADL ability (ADL-I satisfaction); and observed ADL process ability (AMPS). Explorative outcomes are occupational balance (Occupational Balance Questionnaire); perceived change (Client-Weighted Problems Questionnaire) and general health (first question of the MOS 36-item Short Form Survey Instrument). The process evaluation is based on quantitative data from registration forms and qualitative interview data, collected during and after the intervention period. A realist evaluation approach is applied. A programme theory expresses how context (C) and mechanisms (M) in the programme may lead to certain outcomes (O), in so-called CMO configurations. Outcomes in the cost-effectiveness evaluation are quality-adjusted life years (EuroQool 5-dimension) and changes in ADL ability (AMPS, ADL-I). Costs are estimated from microcosting and national registers.
Ethics and dissemination
Danish Data Protection Service Agency approval: Journal-nr.: P-2020-203. The Ethical Committee confirmed no approval needed: Journal-nr.: 19 045 758. Dissemination for study participants, in peer-reviewed journals and conferences.
Trial registration number
NCT04295837
... Until recently, an ADL instrument, based on self-report, focused on the quality of performance and providing linear measures, was not available. Consequently, the ADL-Interview (ADL-I) was developed [8,11]. ...
... ADL-I data can be used to generate an overall linear measure of self-reported quality of ADL task performance. Similar to the AMPS, Rasch measurement methods have been employed to develop the ADL-I [11]. So far, the ADL-I has been applied in research studies among various diagnostic groups e.g. ...
Background
Since the number of persons diagnosed with multi-morbidity is increasing, there is a need for generic instruments to be able to assess, measure and compare ADL ability across diagnoses. Accordingly, the ADL-Interview (ADL-I) was developed to be used in rehabilitation research and clinical practice. The aim of this study was to investigate if the ADL-I can be used to provide valid and reliable ADL ability measures across gender and diagnostic groups.
Methods
ADL-I data were extracted from an existing research database on persons with chronic conditions including medical, rheumatological, oncological, neurological, geriatric and psychiatric diagnoses. Data were analysed based on Rasch Measurement methods to examine: the psychometric properties of the rating scale; ADL item and person fit to the Rasch model; if the difficulty of the ADL tasks differs across gender and diagnostic groups, and if the ADL-I provides precise and reliable measures of ADL ability.
Results
Data on n = 2098 persons were included in the final analysis. Initial evaluation of the 0–3 rating scale revealed threshold disordering between categories 1 and 2. After removal of 16 underfitting items, the variance explained by the Rasch dimension increased from 54.3 to 58.0%, thresholds were ordered, but the proportion of persons with misfitting ADL-I measures increased slightly from 8.7 to 9.1%. The person separation index improved slightly from 2.75 to 2.99 (reliability = 0.90). Differential test function analysis, however, supported that the 16 underfitting items did not represent a threat to the measurement system. Similarly, ADL items displaying differential item functioning across gender and diagnoses did not represent a threat to the measurement system. The ADL items and participants were well distributed along the scale, with item and person measures well targeted to each other, indicating a small ceiling effect and no floor effect.
Conclusions
The study results overall suggest that the ADL-I is producing valid and reliable measures across gender and diagnostic groups among persons within a broad range of ADL ability, providing evidence to support generic use of the ADL-I.
Trial registration
N/A.
... Several outcome measurements planned for application in the full-scale ABLE RCT were already evaluated for appropriateness in the feasibility study [23], but some remained to be tested: ADL-Questionnaire (ADL-Q) [36], Occupational Balance Questionnaire (OBQ11) [37], and five questions specifically constructed for this study, named Client Weighted Problems questionnaire (CWP) (Additional file 2). Appropriateness was evaluated by counting the number of relevantly and fully answered ADL-Q, OBQ11 and CWP questionnaires at baseline and post-intervention. ...
... ADL-Q is a standardised evaluation tool to describe and measure self-reported quality of ADL task performance [36], in terms of physical effort and/or fatigue, efficiency, safety and independence. The persons report their perceived ADL ability for each of 47 ADL tasks using seven response categories: (a) I perform the task independently without use of extra time or effort and without risk; (b) I perform the task independently, but I use helping aids; (c) I perform the task independently, but it takes me extra time; (d) I perform the task independently, but I use extra effort/get tired; (e) I perform the task independently, but there is a risk that I might injure myself; (f) I need assistance from someone but do participate; and (g) the task is performed by others for me-I cannot participate actively. ...
... mark both c and d if they spend extra time and get tired). Finally, ratings for personal ADL tasks should be based on ADL task performances within the past 24 h and for instrumental ADL tasks within the past 7 days [36]. ...
Background
The ABLE intervention was developed to enhance the ability to perform activities of daily living (ADL) tasks among persons living with chronic conditions. ABLE is a generic, home-based, individualised, 8-week occupational therapy intervention program, developed to be delivered in Danish municipalities. In a previous study, the feasibility of ABLE was evaluated in terms of content and delivery. In this pilot study, the remaining feasibility aspects of a randomised controlled trial including (i) trial procedures (recruitment and retention), (ii) randomisation, (iii) adherence to program, (iv) feasibility of additional outcome measurements, and (iv) access to information on usual occupational therapy were evaluated.
Methods
The study was conducted in a Danish municipality, using a two-armed parallel randomised controlled design, planning a recruitment strategy including 20 persons living with one/more chronic conditions and experiencing problems performing ADL. The following progression criteria were used to determine if a future full-scale randomised controlled trial was feasible: (i) recruitment (50% met the eligibility criteria) and retention (80%), (ii) randomisation (80% accepted randomisation, procedure was executed as planned), (iii) adherence to program (100% followed the treatment protocol), (iv) outcome measurements (80% of the participants delivered relevantly and fully answered questionnaires), and (v) usual occupational therapy (extraction of needed information was successful).
Results
Due to the COVID-19 pandemic, the study was truncated resulting in limited but sufficient data to answer most of the study questions. (i) Eighteen of 37 eligible persons (48.6%) were recruited; of those treated ( n = 6), all remained (100%); (ii) 18 accepted randomisation (100%), and procedure was effective; (iii) ABLE was delivered with adherence (100%); (iv) 92.3–100% of the participants gave relevant and complete answers in two of three questionnaires; and (v) needed information on usual occupational therapy was extractable in seven of nine aspects.
Conclusions
Proceeding to full-scale trial is recommendable; however, a few adjustments on outcome measurements, inclusion criteria and extraction of information on usual occupational therapy are needed.
Trial registration
The study was registered at ClinicalTrials.gov (Identifier: NCT04295837 ) on December 5th, 2019. Retrospectively registered.
... To determine the relevance of a generic intervention addressing ADL task performance problems, it is essential to examine similarities and differences of these problems in individuals with various chronic conditions. Typically, assessment of ADL ability involves determining the level of independence, but a more complete evaluation of the quality of ADL task performance also involves the person's use of time, amount of physical effort and/or fatigue, as well as potential safety risks (Waehrens, 2010). Several studies have investigated such aspects of the quality of ADL task performance perceived by persons living with chronic conditions (Norberg et al, 2008;Daving et al, 2009;Hariz and Forsgren, 2011;Waehrens et al, 2012;Bendixen et al, 2014;Lindahl-Jacobsen et al, 2015;Nielsen and Waehrens, 2015). ...
... All data were obtained from an existing research database at the ADL unit of the Parker Institute, Bispebjerg og Frederiksberg Hospital. The database contains anonymised data on self-reported quality of ADL task performance using the ADL-Interview (ADL-I) (Waehrens, 2010;EE Waehrens, unpublished data, 2011). Data were collected between 2007 and 2016 by occupational therapists, trained in administering the ADL-I, among client groups in various settings (eg hospitals, municipalities and research units). ...
... The ADL-Interview (ADL-I) (Waehrens, 2010;EE Waehrens, unpublished data, 2011;Waehrens et al, 2012) is an occupational therapy evaluation tool developed to describe and measure the quality of ADL task performance based on self-report. When administering the ADL-I, individuals are asked to evaluate the quality of their performance in 47 ADL tasks, including 31 tasks related to PADL and 16 tasks related to IADL. ...
Background/aims
To design intervention programmes addressing activities of daily living task performance problems in individuals with chronic conditions, more knowledge about the types of challenges these individuals experience is needed. The aim of this study was to examine the types of activities of daily living tasks, as well as the types of problems related to the quality of task performance, that individuals with chronic conditions report and determine similarities and differences in four diagnostic sub-groups.
Methods
Data on self-reported quality of activities of daily living task performance were collected among 593 individuals with rheumatological disease, incurable cancer, chronic obstructive pulmonary disease and schizophrenia, using the ADL-Interview. Activities of daily living tasks most frequently reported as problematic were identified within each sub-group. Sub-group profiles were generated to identify similarities and differences in quality of performance.
Results
Participants reported problems performing similar types of activities of daily living tasks across diagnostic sub-groups, especially within instrumental activities of daily living. Moreover, participants mainly reported a decreased quality of performance in terms of using extra time and/or increased physical effort while performing personal activities of daily living.
Conclusions
As individuals across four chronic conditions reported somewhat similar problems related to activities of daily living task performance, generic activities of daily living interventions addressing these problems seem appropriate, especially interventions addressing problems related to use of extra time and increased effort.
... It is individually tailored based on baseline evaluations and implemented at sites, where the clients typically perform ADL tasks (e.g., home or local area) with the tools and materials usually used [24]. The program consists of session 1: first meeting and occupational therapy evaluation; evaluation of ADL ability based on interview (ADL-I) [31] and observation (AMPS) [32,33]; session 2: goal setting (GAS) [34,35] and clarification of reasons for ADL task performance problems; sessions 3-7: interventions aiming at enhancing ADL ability, based on the compensatory model of OTIPM [24], e.g., teaching new ways of doing, using adaptive equipment/assistive technology, modifying physical/social environments. During the intervention sessions, the OT employ one or more of nine optional intervention components organized in a "tool box" according to the PEO model [23] (Fig. 1). ...
... Data on ADL ability (ADL evaluations) To explore mechanisms of actions, data on ADL ability were gathered to determine the proportion of clients obtaining clinically relevant improvements in ADL ability and the extent to which intervention components contributed to goal attainment. Data on ADL ability comprised self-reported and observed ADL ability measured at baseline and post intervention using ADL-I [31], AMPS [32,33], and GAS [34,35]. ...
... The ADL-I [31] is a standardized evaluation interview used by OTs to describe and measure self-reported quality of ADL task performance in 47 ADL tasks in terms of physical effort and/or fatigue, efficiency, safety, and independence. During the interview, the person rates the perceived quality of performance. ...
Background
The “A Better everyday LifE” (ABLE) intervention was developed to accommodate the need of a program addressing ability to perform activities of daily living (ADL) in persons with chronic conditions living at home. During intervention development, it is necessary to evaluate relevant aspects of the feasibility of a program. Thus, the aim was to evaluate the feasibility of content and delivery of ABLE version 1.0.
Methods
A one group pre- and post-test design was applied. Thirty persons with chronic conditions, two occupational therapists (OTs), and five occupational therapy students (OTSs) participated. ABLE 1.0 is an 8-week program consisting of ADL evaluation (session 1); goal setting and reasons for ADL problems (session 2); intervention (sessions 3–7); and re-evaluation (final session), conducted in the clients’ home-setting and local area. Sessions 1–4 and the final session was mandatory.
To evaluate the feasibility of content and delivery, the OTs, after each session, reported on applied intervention component(s), time-use, needed equipment, adjustments, meaningfulness, confidence, progress toward goal attainment, and side effects using registration forms. The clients reported on progress toward goal attainment, meaningfulness, and satisfaction. Clinically relevant improvements in ADL ability were identified using the ADL-Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS). Goal attainment was evaluated using the Goal Attainment Scaling (GAS).
Results
Twenty clients (67%) completed ABLE 1.0 and received four sessions (median = 4, range 4–7) each lasting between 30 and 94 min. Most frequently applied component was “Changing habits related to task performance”. Generally, OTs reported having the needed equipment. Deviations from the manual were made by omission of GAS and AMPS and less than mandatory number of sessions per client. The OTs reported confidence in delivering the program and the clients perceived the program as meaningful and satisfying, and experienced progress toward goal attainment. Goal attainment was found in 52% of the goals. Sixteen (80%) clients obtained clinically relevant improvements in self-reported or observed ADL ability.
Conclusions
The content and delivery of ABLE 1.0 was feasible. However, the study revealed a need to adjust the recruitment procedure and make minor changes in the intervention manual. A pilot randomized controlled trial (RCT) study is recommended.
Trial registration
The study was registered at ClinicalTrials.gov with registration no. NCT03335709 on November 8, 2017.
... For example, walking or mobility is often described as ADL and is examined and evaluated in terms of underlying body functions by means of the six-minute walk test [38], step counters or accelerometer [39,40]. This contradicts ADL defined as tasks relevant to the unique context and individual to perform on a day-to-day basis that cover basic needs such as eating, staying clean and being appropriately dressed, as well as more complex tasks relevant for independent living such as transportation, cooking, shopping, cleaning and washing [10,[41][42][43]. Everyday life activities refer to a multitude of daily activities in which people engage [10], and activities that 'people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life' [44]. ...
Purpose
Evidence regarding everyday life activities in people living with COPD is limited. Such evidence can improve our understanding when designing interventions for pulmonary rehabilitation that aim at increasing or maintaining participation in these activities. The aim of this study was to describe how people living with COPD experience and manage everyday life activities.
Materials and Methods
The sample comprised four males and four females with an age ranging from 65–87 years. Participants were interviewed in their own homes regarding experiences of performing and managing everyday life activities. Data were transcribed verbatim and analysed using content analysis.
Results
Findings from this study comprised the theme “Juggling to manage everyday life activities with COPD” and three categories representing the elements of this theme: (1) consequences of COPD symptoms, (2) adjustment of activities, and (3) contextual aspects.
Conclusion
This study found the participants with COPD juggling the management of everyday life activities. The juggle generated a manageable daily life, which came at the expense of making deliberate choices and prioritizing everyday life activities that were necessary for participation in valued and engaging activities in order to maintain health and well-being.
•
Implications for Rehabilitation
• People living with COPD experience a complex juggling between the consequences of COPD symptoms and contextual aspects when managing everyday life activities.
• The participants had largely accepted their disease and adjusted to their situation.
• The disease was still described as frustrating and generated less focus on making deliberate choices and prioritizing everyday life activities that are necessary for participation in valued and engaging activities.
• Health professionals need to support people living with COPD in making deliberate choices in order to continue participating in valued and engaging everyday life activities as they affect health and well-being.
• Pulmonary rehabilitation should focus more on supporting participation in social relations and on using everyday technologies.
... For data gathering, the standardized ADL-Interview (ADL-I) 33 was used as it is found to be reliable and valid, 34 also in persons with COPD. 3 ADL-I is an occupational therapy assessment instrument that measures the quality of ADL performance based on self-reporting during interviews. 34 The participants were asked to rate their performance on 47 ADL tasks that related to both personal ADL (PADL) and instrumental ADL (IADL). When rating the performance of each task, the answer was based on a seven-category (a-g) rating scale reflecting efficiency, effort/fatigue, safety and independence. ...
... 5 These procedures are described in detail elsewhere. 5,29,34,39,46 Categorical variables were presented as frequencies and percentages (%), while continuous variables (selfreported ADL performance, ADL motor ability, ADL process ability and ET use) were tested and met criteria for normality. These variables were presented as mean, standard deviations (SD) and minimum/maximum scores. ...
... Both evaluations are important when planning client-centred interventions, as they also take into consideration which ADL tasks that are relevant and important for the client to manage in his/her everyday life. 34,35 The statistically significant moderate relationship between self-reported ADL performance and ET use indicates that the ability to perform ADL is related to individuals' ability to use ET; however, as expected, the relationship is not complete as they are different constructs. Accordingly, the tasks reported in the ADL-I are related to both PADL and IADL tasks at home and in society, including tasks where ETs may be involved (eg, read/write on the computer, talk on the phone, transportation using an electronic travel card, cooking on the stove or by using the oven, washing in the washing machine, vacuuming, shopping on the internet or using a selfscanner). ...
Purpose
There have been calls for more knowledge of activities of daily living (ADL) performance in order to address interventions in pulmonary rehabilitation effectively. Everyday technology (ET) has become an integrated dimension of ADL, impacting the ways in which ADL is performed. To improve everyday functioning and quality of life, the use of ADL and ET use needs to be evaluated and addressed effectively in interventions. Therefore, the aim of this study was twofold: 1) to explore the quality of ADL performance, and 2) to investigate the relationship between observation and self-reported ADL performance and ability to use everyday technologies in people living with COPD.
Methods
This cross-sectional study involved 84 participants aged 46–87 years. Participants were recruited through healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were collected using standardized assessments that investigated different ADL perspectives: self-reported ADL tasks and ET use, observed motor and process ability, and need for assistance. Data were analysed and presented using descriptive statistics and Pearson’s correlation coefficient.
Results
The most affected ADL tasks were mobility within or outside the home, lower dressing, bathing, pedicuring, cooking, shopping, cleaning and washing clothes. New insights into the quality of ADL performance in people living with COPD were presented in terms of detailed ADL motor skills and ADL process skills, as well as the predicted need for support to function in the community. Moreover, new insights into the relationship between observation and self-reported ADL performance (r=0.546, p<0.01; r=0.297, p<0.01) and between ADL performance and self-perceived ability to use ET (r=0.524, p<0.01; r=0.273, p<0.05; r=0.044, p=0.692) were presented.
Conclusion
Overall, the knowledge from the present study is valuable for focusing interventions that address challenging ADL performance and ET use through relevant and realistic activities. The ability to use ET is important to evaluate and target pulmonary rehabilitation.
... ADL-I is a standardised interview developed to describe and measure quality of performance of self-care and household activities (termed activities of daily living, ADL) based on self-report (Waehrens, 2010;Waehrens, Bliddal, Danneskiold-Samsøe, Lund, & Fisher, 2012 In this study, ADL-I data were used to describe self-reported quality of performance on each activity for groups of male and female participants and to generate overall linear measures of single participants' self-reported quality of ADL performance. ADL-I can be used to generate valid and reliable linear measures of self-reported quality of ADL performance in persons with long term and/ or chronic disease (Bendixen, Waehrens, Wilcke, & Sørensen, 2014;Nielsen & Waehrens, 2015;Waehrens et al., 2012). ...
... (Linacre, 2009). Detailed information about procedures related to generating ADL-I ability measures can be found elsewhere (Waehrens, 2010). ...
Objective
This study aimed at exploring everyday activities of people with advanced cancer living at home: which everyday activities they perform; perceived and observed quality of performance of self‐care and household activities; which activities they would like to be able to perform; and determine any gender differences.
Methods
Outpatients (n = 164) with advanced cancer were recruited from Danish oncology units. Data were based on medical hospital records, standardised questionnaires, a 1‐day diary, standardised interviews and standardised observations. All data were subject to descriptive and statistical analyses.
Results
More than 95% of the study sample was classified in ECOG performance status 1 and 2. Compared to population‐based norms, the participants reported lower levels of global health and quality of life, as well as lower physical and role functioning. Across gender, participants spent the majority of the day involved in self‐care and leisure activities. They reported to perform self‐care independently without risk, although 60% reported problems with mobility. While heavy household activities were reported as most problematic, participants prioritised support to engage in more active leisure and social activities.
Conclusion
People with advanced cancer experience problems related to performance of and engagement in everyday activities indicating a need for palliative rehabilitation services.