Quality of subprocesses of Community Occupational Therapy in Dementia Programme performance in 54 Alzheimer's disease patients (German completers of the experimental intervention)
| Subprocesses | Performance* | Main problems | ||
| Good (%) | Poor | |||
| 01 | Receiving medical information | 52 (96) | 2 | Received wrong phone number or no detailed medical information |
| 02 | Making appointments with participants | 49 (91) | 5 | Participants had other appointments |
| 03 | Travelling to participants | 46 (85) | 8 | Long travel to patient's home (some >40 km) |
| 04 | Meeting the participants | 50 (93) | 4 | Participants forgot to cancel the date and were late or not at home |
| 05 | Contacting and providing confidence | 50 (93) | 4 | Patient was sceptic or abrasive |
| 06 | Informing about the procedure | 50 (93) | 4 | Patient could not understand procedure, misunderstood procedure as test for nursing home placement |
| 07 | Observing the time frame | 42 (78) | 12 | Participants (mainly carer) had a great need to tell and talk |
| 08 | Explaining clearly, responding to questions | 50 (93) | 4 | Patient could not understand the explanations, owing to communication deficits or mood swings |
| 09 | Mastering conflicts and problematic situations | 39 (72) | 15 | Patient had severe mood swings or additional cognitive deficits or was not aware of deficits; carer was overstrained, abrasive or placed sole responsibility on therapist; family conflicts existed for a long time |
| 10 | Interviewing patient with OPHI | 38 (70) | 16 | Patient was unable or hardly able to tell, had anomia or severe deficits in biographic memory or was disorientated |
| 11 | Observing patient activity with Volitional Questionnaire, if OPHI not done | 5 (71*) | 2 | Patient not motivated to demonstrate activities; *Volitional Questionnaire not necessary in 47 cases, because OPHI was done |
| 12 | Interviewing carer with Ethnographic Interview | 47 (87) | 7 | Carer had only little understanding of dementia or felt very burdened |
| 13 | Observing activities of patient and carer | 43 (80) | 11 | Patient did activity incompletely, was very passive or was fraught when being observed; carer was demanding or impatient |
| 14 | Setting therapy goals with patient and carer | 41 (76) | 13 | Participants negated need for change or could not specify goals |
| 15 | Defining occupational therapy problems | 43 (80) | 11 | Patient had no activity limitations; participants could not understand the relevance of problems; problems were very complex or became clearer only later during intervention or were related not to dementia but to depression or physical limitations |
| 16 | Educating patient in new skills and compensation capability | 25 (46) | 29 | Patient was not or hardly motivated in training, additional symptoms such as dyspraxia, depression, apathy, attention deficit disorder hampered the training; carer or family were not supportive |
| 17 | Adapting physical environment | 24 (44) | 30 | Participants refused or hesitantly accepted necessary adaptations |
| 18 | Adapting social environment | 25 (46) | 29 | Participants were reluctant to change social environment; informal social support or care services were lacking |
| 19 | Training of carer's competence in instruction and interaction | 32 (59) | 22 | Carer could not change behaviour as being very burdened or impatient or bound in firm habits; was not willing to take responsibility or was missing sessions |
| 20 | Training of carer's competence in problem solving | 29 (54) | 25 | Carer was not willing to undertake the responsibility of problem solving or not able to do so owing to high burden; carer would have needed more time or further support to undertake the responsibility for independent problem-solving |
↵* Number of cases, in which the performance of this subprocess was rated as unproblematic (=good) or problematic (=poor).
OPHI, Occupational Performance History Interview.