A Pilot Experimental Study of Adding the Copm To the Occupational Therapy Evaluation Process In the Swing-bed Division of A Rural Hospital Setting

Background: Extensive evidence is available on the efficacy of occupation-based practice for improving patient outcomes in hospital settings. There were no studies that took place specifically in the swing-bed division of rural hospital settings regarding occupation-based practice prior to the implementation of this study. Purpose: This study sought to determine whether the addition of the COPM would increase occupational performance and patient satisfaction for individuals treated in the swing-bed division of a rural hospital setting. Theoretical Framework: The Canadian Model of Occupational Performance and Engagement is the primary theory supporting this study, due to the emphasis placed on client-centeredness, spirituality, and occupational performance and engagement. Methods: The Capstone Project is a pilot experimental research design with a sample size of 4 participants who were randomly allocated to the experimental and control groups. Participants in the experimental group completed the COPM with treatment focused on goals identified in the COPM and participants in the control group received usual care. Outcome measures were administered during the initial encounter and prior to discharge comprised of the following: Barthel Index, patient satisfaction, and percentage of goals met. Participants in the experimental group participated in COPM assessment during the initial encounter and prior to discharge. Conclusions: Improvements in performance and satisfaction COPM scores occurred for participants in the experimental group, but were not minimally clinically significant. Both groups were overall satisfied with the occupational therapy services provided, with the control group reporting slightly higher ratings. No differences in percentage of goals met occurred between groups, due to participants in both groups meeting 100% of their goals. There was a significant difference in Barthel Index change scores between groups, with the control group exhibiting a ten-point increase in change scores, that could partially be attributed to lower initial Barthel Index scores