Mind-body interventions utilized by an occupational therapist in a medical intensive care unit: An exploratory case study

Abstract

The medical intensive care unit (MICU) presents a challenging environment within the health care arena. Patients in the MICU are at risk for occupational deprivation, due to a lack of opportunities for purposeful movements and activities, which further impedes recovery.Occupational deprivation occurs when people are not afforded equal opportunities to participate in desired occupations. Mind-body interventions might be a tool for occupational therapists to use a preparatory method to improve patients' physical and psychological health, leading to increased performance and participation in occupations while in the MICU. The purpose of this study was to explore the use of mind-body interventions delivered by an occupational therapist in a MICU. The patient in our case study was within normal ranges for all physiological and mental status variables during the mind-body interventions. Therefore, this study demonstrates that it is feasible for an occupational therapist with proper training and credential to elicit mind-body interventions in this setting, with this patient.iii ACKNOWLEDGMENTS I would like to express my deep gratitude to the many individuals who have helped me through this process. First and foremost, I would like to recognize my mentor, Dr. Arlene Schmid, for her incredible guidance, encouragement, and patience over the past two years.Thank you for your support, for challenging me, and for helping me fall in love with research. I would like to thank Amanda Hoffman, for her dedication to research and to the profession of occupational therapy, for her advice and support, and most importantly for being flexible and willing to take on this project. Your help in every aspect of this thesis was imperative for success. I would like to thank Lindsay Laxton and Katie Freeman for their time, support, and feedback during this process. I also owe great thanks to my committee members, Dr. Matt Malcolm and Dr. Doug Coatsworth; their feedback, guidance, and insight was hugely influential in this process. I would like to thank my colleagues Megan Roney and Kristin Turner for their encouragement, advice, and enjoyment. Working with you ladies was a pleasure. I would like to thank my family for their continual support of this thesis, and in every aspect of my life. Lastly, I would like to thank the Department of Occupational Therapy at Colorado State University and the University of Colorado Hospital for providing me the opportunity to be involved in this project.

A atuação do terapeuta ocupacional em Unidade de Terapia Intensiva: uma revisão sistemática

“…Contudo, entre as publicações não incluídas, há relatos de atuação do terapeuta ocupacional no contexto de UTI sobre outros aspectos da PICS, como: ansiedade (Provancha-Romeo et al, 2019), delírium/confusão mental (Álvarez et al, 2017) e qualidade de vida (Daniels et al, 2018) -que carecem de exploração subsequente. Se fossem incluídos, esses achados aumentariam o leque de práticas do terapeuta ocupacional com pacientes graves na UTI aqui demonstrados.…”

“…Sobre a atividade do terapeuta ocupacional com pacientes na UTI, a literatura especializada da área aponta atuações que culminam no autocuidado, abordagens cognitivas, dispositivos de adaptação e posicionamento no leito, estendendo-se à mobilização precoce (Provancha-Romeo et al, 2019). Deste último, um recente levantamento de intervenções de terapeutas ocupacionais na UTI caracterizou as atuações relacionadas à mobilização precoce como as mais demandadas, seguida de intervenções cognitivas e ambientação (Costigan et al, 2019).…”

Integrative therapies in intensive care units: A scoping review

“…The use of integrative therapies in ICUs was investigated in eight quantitative studies (Feeney et al, 2017;Hayes & Cox, 1999;Madineh et al, 2017;Matsumoto-Miyazaki et al, 2018;Nicola et al, 2019;Ozlu & Bilican, 2017;Papathanassoglou et al, 2018;Salamati et al, 2017;) and five reviews (Erdogan & Atik, 2017;Jagan et al, 2019;Lee & Higgins, 2010;Richards et al, 2003;Tracy & Chlan, 2011; Table 1). Three case studies (Kreindler et al, 2014;Provancha-Romeo et al, 2019;Yalindag-Ozturk et al, 2011; Table 3) and one conference paper abstract (Hathaway et al, 2014;…”

Lineamientos del Colegio Colombiano de Terapia Ocupacional para la atención hospitalaria aguda y subaguda de pacientes con COVID-19

“…Las y los pacientes con cuadros graves y críticos requieren de intervención en UCI y UCI-intermedio, demostrando no solo un deterioro en su salud física y mental, sino también un cambio abrupto en sus actividades básicas de la vida diaria y en su desempeño social adaptativo, lo que conlleva a desequilibrio ocupacional 12 (Gonçalo et al, 2020) y privación ocupacional 13 (Provancha-Romeo et al, 2019). Dado el tratamiento médico intensivo que reciben algunos pacientes con COVID-19, incluida la ventilación pulmonar prolongada, la sedación y el 12 El desequilibrio ocupacional ocurre en dos niveles: individual y social.…”

“…13 Se entiende como privación ocupacional a la exclusión de la participación en ocupaciones significativas, que promueven la salud o que son necesarias para la persona, debido a fuerzas más allá del control del individuo (Whiteford, 2000). Las barreras que contribuyen a la privación ocupacional incluyen: inmovilidad, privación y sobrecarga sensorial, ventilación mecánica, debilidad adquirida en la UCI, agitación, estrés y delirio (Provancha-Romeo et al, 2019). Tabla 1.…”