Occupation-based interventions to improve occupational performance and participation in the hospital setting: a systematic review

Abstract

Purpose

To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting.

Methods

Five databases were searched from 2000–2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted.

Results

Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included (n = 1646 participants). Results indicate good evidence to support occupation-based interventions to improve occupational performance and participation outcomes in inpatient rehabilitation; it is unclear whether they are more effective than any control/alternative intervention. Research in the acute and mental health hospital settings were scarcer. Understanding the benefits of occupation-based interventions was enhanced through qualitative results including improving independence and confidence to discharge home, increasing motivation for therapy, connecting with others, and peer-based learning.

Conclusions

Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance.

Implications For Rehabilitation

• The use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting.

• There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer.

• Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience.

Keywords:

• Acute
• mental health
• rehabilitation
• activities of daily living
• occupational therapy

Acknowledgments

The authors acknowledge Mr Murray Turner, Librarian, University of Canberra, Canberra, Australia, for his support and guidance in the development of a search strategy for this systematic review.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This systematic review received no specific grant from any funding agency in the public, commercial, or non-for-profit sectors. GW was supported by the Commonwealth through the Australian Government Research Training Program Scholarship throughout the duration of this study.