Occupational therapy with a patient after COVID-19: a case study

Uvod: COVID-19, virus, ki je leta 2019 izbruhnil v Wuhanu na Kitajskem in svet pahnil v pandemijo, povzroča koronavirusno bolezen, ki zaradi hitrega širjenja in posledično velikega števila obolelih ter mrtvih hromi življenje po celotnem svetu že vse od samega pojava. Številni ljudje se po preboleli okužbi srečujejo s fizičnimi, kognitivnimi in psihosocialnimi motnjami, kar precej vpliva na kvaliteto življenja, zato se je potreba po rehabilitacijski stroki še povečala. Namen: Namen diplomskega dela je prikazati delovnoterapevtsko obravnavo po ameriškem procesu, ugotavljati njeno učinkovitost po hujšem poteku COVIDA-19, podati evalvacijo končnega stanja in pripraviti uporabnika na odhod v domače okolje. Metode dela: Izvedena je bila študija primera 59-letnega moškega po COVID-19. Uporabnik je COVID-19 s hujšim potekom bolezni prebolel marca 2021. Rehabilitacija je trajala štiri tedne, delovnoterapevske obravnave pa so potekale od ponedeljka do petka, med trideset in petinštirideset minut na dan. Za lažji vpogled v napredek so bila uporabljena ocenjevanja: Kanadski test izvedbe okupacije, Funkcijska lestvica neodvisnosti, Analiza aktivnosti po spretnostih in vprašalnik o kakovosti življenja EQ-5D. Rezultati: Izboljšala se je ocena zadovoljstva in izvedbe po COPM. Napredek je bil viden pri ožjih dnevnih aktivnostih: oblačenju zgornjega dela, obuvanju nogavic in samostojnem opravljanju jutranje rutine. Pri lestvici FIM je pri končnem ocenjevanju prišlo do največjega napredka pri negi obraza, las in rok, oblačenju zgornjega dela telesa, umivanju telesa in uporabi stranišča. Na podlagi vprašalnika EQ-5D smo ugotovili, da je prišlo do izboljšanja na vseh področjih vprašalnika, minimalne težave je imel le še s hojo in opravljanjem vsakodnevnih aktivnosti. Pri AA se je napredek prav tako pokazal pri vseh motoričnih in procesnih spretnostih, ob končnem ocenjevanju so bile minimalne težave le še pri spretnostih sega, koordinira, manipulira, giblje tekoče, pomika, ohranja ritem, spremeni izvajanje in pridobi. Razprava in zaključek: Obravnava, prikazana po procesu AOTA, se je v naši študiji primera izkazala kot ustrezna in učinkovita, saj so bili cilji, ki so bili postavljeni pred pričetkom obravnav, doseženi. Uporabnik se je vrnil v domače okolje skoraj brez omejitev, samostojnost je bila dosežena pri večini vsakodnevnih aktivnostih.Introduction: COVID-19, the virus that broke out in Wuhan, China, in 2019 and plunged the world into a pandemic, is a coronavirus disease that has been affecting lives around the world since its inception, due to its rapid spread and the resulting high number of sick and dead. Many people experience physical, cognitive and psychosocial impairments after an infection, which have a significant impact on their quality of life, and the need for the rehabilitation profession has increased. Purpose: The aim of the diploma work was to present the occupational therapy treatment of a person in Laško health resort after COVID-19 following the American occupational process, to determine it’s effectiveness after severe COVID-19, to give an evaluation of the final state and to prepare the client for the life at home. The aim was to monitor progress throughout the rehabilitation, to demonstrate the use of the AOTA process in occupational therapy intervention and to demonstrate the effectiveness of the occupational therapy intervention. Methods: The research was carried out using a single case study of a 59-year-old man after COVID-19 reffered to occupational therapy. The client recovered from severe COVID-19 in March 2021. The rehabilitation lasted four weeks, with occupational therapy sessions from Monday to Friday, lasting between thirty and forty-five minutes a day. To facilitate insight into progress the Canadian Occuaptional Performance Measure, Functional Independence Measure, Activity analysis by skills and EQ-5D Quality of life questionnaire were used. Results: The COPM satisfaction and performance ratings have improved. Progress was seen in the narrower daily activities, i.e., putting on a top, putting on socks and doing the morning routine independently. On the FIM scale, the final assessment showed the greatest improvement in facial, hair and hand care, upper body dressing, body washing and toilet use. On the basis of the EQ-5D questionnaire, we have found that, here too, there has been an improvement in all areas of the questionnaire, with only minimal problems with walking and performing activities of daily living. AA also showed progress in all motor and process skills, with only minimal difficulties in the final assessment in reaching, coordinating, manipulating, fluency, shifting, maintaining rhythm, changing performance and retrieving. Discussion and conclusion: Occupational therapy following the AOTA process proved to be appropriate and effective in our case study, as the goals set before the treatment were achieved. The user returned to the home environment with almost no restrictions and independence was achieved in most daily activities