Predictors of Occupational Competence in People Hospitalized with Chronic Conditions

Background: Chronic diseases limit participation in meaningful daily activities, roles, and routines, which can negatively impact occupational competence, a sense of self, and life satisfaction, especially when hospitalization is required to manage disease symptoms. Standardized measures of occupational competence and related functional, cognitive, and environmental factors may enhance occupational therapists’ ability to identify potential barriers to and make targeted recommendations for self- and health management in the community. Method: This cross-sectional study investigated occupational competence in patients hospitalized with chronic conditions. The participants completed measures of occupational competence, values, self-care function, environmental impact, and functional cognition while hospitalized. Results: The participants (n = 51) reported moderate to high levels of occupational competence. The overall regression model was significant. Values, self-care function, and environmental impact were significant predictors of occupational competence. Conclusion: Values, self-care function, and environmental impact predict occupational competence in people hospitalized with chronic conditions. Occupational therapists should incorporate standardized measures of occupational competence, values, self-care function, and environmental impact into current evaluation practices to support recommendations for follow-up care and community supports. Future research should include a larger sample that is more representative of an occupational therapy caseload and incorporate alternative measures of functional cognition to better measure this construct

Predictors of Hospital Readmissions for People with Chronic Conditions

Background: Hospital readmissions remain prominent in health care. Functional, cognitive, and environmental factors predict hospital readmissions but may not be thoroughly measured or addressed prior to discharge. Method: In this cross-sectional study, people hospitalized with chronic conditions completed measures of self-care function, functional cognition, occupational competence, and environmental impact. They also participated in a phone call or medical records review to identify hospital readmissions within 30 days of discharge. In a group session, occupational therapists who work in acute care completed acceptability, appropriateness, and feasibility measures for the standardized assessments administered to hospital participants. Results: Occupational competence and functional cognition were significant predictors of hospital readmissions. Therapists rated the Activity Measure of Post-Acute Care (AM-PAC) as the most acceptable, appropriate, and feasible measure for acute care. Conclusions: Occupational competence and functional cognition are predictors of hospital readmissions in people with chronic conditions. Occupational therapists in acute care should consider supplementing current evaluation practices with standardized measures of functional cognition and occupational competence to identify client needs objectively and initiate post-acute referrals that help clients discharge home successfully. Standardized measures, such as the AM-PAC may be feasible in acute care. Further research on the efficacy of standardized measures in this setting is needed