This study aimed to examine the involvement of occupational therapists in the development of intermediate care services in England. A non-experimental survey design was employed and a postal questionnaire was sent to 414 members of the specialist section of the College of Occupational Therapists: Older People. Quantitative and qualitative data from the 159 respondents was analysed using descriptive statistics and content analysis respectively. Results indicate that the occupational therapists in this study were heavily involved in the development of intermediate care services. This included the creation and monitoring of integrated equipment stores and in the extension of their role to include intermediate care coordination. Intermediate care provision for older people with mental health problems was seen to be an area requiring further development. The National Service Framework for older people continues to provide opportunities for occupational therapists working to further develop and shape services for this growing sector of society.
There is a need for occupational therapists to establish a range of outcome measures that can measure change effectively. The aim of this study was to identify effective methods of measuring the functional performance of individuals who had experienced a stroke and had been discharged from a rehabilitation ward. Measures with recorded validity and reliability and in clinical use were selected. The measures were the Barthel Index (Shah version), Nottingham Extended Activities of Daily Living scale, Motricity Index (Upper and Lower Limb), Rivermead Mobility Index and Nine-Hole Peg Test. Assessments were carried out at the point of discharge from hospital and 6 months later. Responsiveness was analysed using effect size and relative efficiency statistics. The practicality (feasibility) was established by comparing completion rates. The Nottingham Extended Activities of Daily Living scale and the Rivermead Mobility Index were found to be more responsive than the Barthel Index and Lower Limb Motricity Index respectively and to be practical after discharge from hospital. The Nine-Hole Peg Test was found to be more responsive than the Upper Limb Motricity Index but less practical. The analysis suggested that some measures are more suitable than others for tracking change in function after discharge from hospital for a wide case mix of people who have experienced a stroke.
Philp (2003) outlined the fundamental role that occupational therapists could have in implementing the National Service Framework (NSF) for Older People and reforming services for older people (Department of Health 2001). A research project was undertaken, which aimed to investigate the views of occupational therapists about the implementation of the policy in order to identify the key areas and issues that have had an impact on practice. The research design was qualitative and took the form of focus groups. The focus group data were analysed using a long-table analysis method (Krueger and Casey 2000), which identified five key themes: a raised profile of older people's services, a changing delivery of services, a revisiting of occupational therapy core skills, assessment and resource allocation. The emerging themes suggested that the NSF for Older People has had an impact on the practice of the occupational therapists involved in the focus groups.
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