Content area
Full Text
OBJECTIVE. This systematic review examined the effectiveness of health promotion, management, and maintenance interventions within the scope of occupational therapy to improve occupational performance and quality of life (QOL) and decrease health care utilization for community-dwelling older adults.
METHOD. Thirty-eight articles representing 36 studies were included in the review. Articles were published 2008-2015 and described studies of participants with a mean age of 65 or older who were living in the community.
RESULTS. Strong evidence supports the use of group, individual, or a combination of group and individual interventions to improve occupational performance. Group interventions were also effective at improving QOL. The evidence was insufficient that any of these interventions decreased health care utilization.
CONCLUSION. Addressing health promotion, management, and maintenance is within the scope of occupational therapy practice and has been shown to improve occupational performance and QOL for older adults. Implications for practice and future research are discussed.
The number of older adults engaging in health promotion, management, and maintenance programs has increased over past decades. More than 90% of older adults are currently living with at least one chronic condition, and about 75% live with multiple chronic conditions (National Council on Aging, 2016). Multiple chronic conditions in older adults are associated with decreased health-related quality of life (QOL; Barile et al., 2013) and decreased occupational performance (Barstow, Warren, Thaker, Hallman, & Batts, 2015). In 2010, 86% of all health care spending in the United States went to treatment of adults living with one or more chronic medical conditions (Agency for Healthcare Research and Quality, 2010; Centers for Disease Control and Prevention, 2016).
Health promotion, maintenance, and management interventions are important for older adults, especially considering the adverse effects of chronic conditions on QOL, occupational performance, and health care costs. However, some people with chronic conditions have difficulty following through with selfmanagement health promotion recommendations (Spaling, Currie, Strachan, Harkness, & Clark, 2015). Occupational therapy practitioners are important members of health care teams working with people with multiple chronic conditions, supporting them to engage in self-management activities (Leland, Fogelberg, Halle, & Mroz, 2017). Practitioners can assist clients in establishing, restoring, and maintaining self-management techniques with a focus on health-promoting routines and habits (American Occupational Therapy Association [AOTA], 2014).
A previous review of the...