Table 5 Summary of findings of stage one and two, and implications for intervention
Sub-study | Finding | Implication for intervention |
|---|---|---|
Stage one | ||
Systematic review | No intervention found to improve occupational performance following discharge from hospital | Development of a new intervention |
Literature review of psychosis and occupational performance | Problems with cognitive functioning, performance skills and knowledge, process skills | Intervention to address these areas by including the following: Assessment of volition, habituation and performance. Activity grading Developing self-knowledge of Occupational performance to enable ongoing work towards long-term goals post intervention. |
Social and physical environmental barriers | Assessment of home environment Environmental enhancements and considerations | |
Meaningful Occupations | Identification of meaning of occupations through assessment and service user led goal setting | |
Routine | Assessment of routine included in the intervention Activity grading | |
No problems specific to post discharge have been identified. | Study needed to identify new information regarding occupational performance following discharge from hospital to inform the intervention. | |
Focus groups with service users and clinicians | Slowly picking up daily life again | Intervention to be provided over 4Â months Intervention to include Activity grading |
Importance of therapeutic use of self | Use a model of therapeutic use of self in the intervention | |
Balancing a focus between basic self-care and long-term goals | Stepped level of intensity to support basic self-care post discharge followed by longer term goals regarding leisure Developing self-knowledge of occupational performance to continue working towards long-term goals post intervention. | |
Building a picture of the future whilst on the ward | Start intervention prior to discharge from hospital | |
Reluctance to be more independent | Use of MOHO to increase motivation for occupation, and occupational performance Assessment of occupational performance Development of self-knowledge and self-management of own occupational performance | |
Barriers to accessing leisure activities | Assessment of occupational performance included in the intervention Intervention to take place in relevant community venue Use of Interest Checklist | |
Managing meals | Use of strategies to overcome physical barriers in home environment Use of activity grading as a component | |
Stage two | ||
Identifying/developing theory | Model of human occupation identified | Assessment tools based on MOHO to be used as required within intervention. |