Development and analysis of group intervention in occupational therapy for elderly with mild neurocognitive disorder

Alves, Maria Carolina Almeida; Almeida, Maria Helena Morgani de; Exner, Camila; Toldrá, Rosé Colom; Batista, Marina Picazzio Perez

doi:10.4322/2526-8910.ctoAO1865

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Original Article • Cad. Bras. Ter. Ocup. 28 (1) • Jan-Mar 2020 • https://doi.org/10.4322/2526-8910.ctoAO1865 copy

Development and analysis of group intervention in occupational therapy for elderly with mild neurocognitive disorder¹ 1 According to the research norms proposed by the Conselho Nacional de Saúde of Brazil, the research project was approved by the Comitê de Ética da Faculdade de Medicina da Universidade de São Paulo under the opinion of approval nº. 402/13, on 09/10/2013.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

The rapid advance of the aging process contributes to the increase of chronic-degenerative diseases, such as Mild Neurocognitive Disorder (MND). Elderly with MND may present difficulties in performing instrumental activities of daily living and social participation, in addition to a higher conversion rate for dementias, compared to healthy elderly individuals.

Objective

To describe and analyze a group intervention in Occupational Therapy with elderly with probable MND.

Method

Prospective, quantitative, quasi-experimental study of “before and after” conception. A total of two interventions were carried out at the University Hospital of the Universidade de São Paulo, in 2014 and 2015. Each intervention covered 8 meetings and had the participation of 11 elderly. Dynamics were used to sensitize the tasks and cognitive abilities most affected in the elderly with MND and to share compensatory mnemonic strategies. For the analysis of the interventions, the instruments were applied before and after: Rivermead Memory Behavior Test; Pfeffer's Questionnaire and Subjective Memory Complaints Questionnaire. For intragroup statistical analysis, we used the Shapiro-Wilk and the non-parametric Wilcoxon tests.

Results

There was a statistically significant change in total score of all the instruments applied. Thus, it showed the improvement of cognitive performance, improvement of ability in instrumental activities performance that involve more directly cognitive abilities and reduction of subjective complaints of memory of participants.

Conclusion

Intervention is a potent resource for the intervention of the occupational therapist with the elderly with MND, favoring independence in daily occupations, reduction of memory complaints and improvement in cognitive performance.

Keywords:
Occupational Therapy; Mild Neurocognitive Disorder; Activities of Daily Living; Cognition; Rehabilitation

OCCUPATION		MNEMONIC TASKS AND COGNITIVE SKILLS
SOCIAL PARTICIPATION		Remembering faces and names
		Keeping abreast of events and surroundings
		Remembering appointments
INSTRUMENTAL ACTIVITIES OF DAILY LIVING	Home Management	Keeping and finding objects
	Financial Management	Remembering to pay bills
	Community Mobility	Planning route, moving in community ensuring leaving and returning home
	Going shopping	Remembering shopping items
	Preparing Meal	Properly planning, preparing and serving meals
	Communication management	Paying attention and giving a message received
	Health management and maintenance	Remembering to take prescribed medicine

Social and demographic variables	N	%
Sex
Female	8	72,72%
Male	3	27,27%
Age Group (years old)
60-79 years old	9	81,81%
80 or more	2	18,18%
School level
Illiterate	0	0%
Up to 04 years	4	36,36%
4- 8\9 years	4	36,36%
9- 11 years	2	18,18%
Higher Education	1	9,09%

RIVERMEAD
Item	Before	After	p
Item	Md [IQR]	Md [IQR]	p
1	0 [0-1]	1 [0-2]	0.068
2	1 [0-1]	1 [0-1]	0.18
3	1 [0-1]	2 [1-2]	0.005
4	2 [0-2]	2 [2-2]	0.26
5	1 [0-2]	2 [1-2]	0.084
6	2 [0-2]	2 [2-2]	0.063
7	1 [0-2]	2 [1-2]	0.163
8	2 [0-2]	2 [1-2]	0.603
9	2 [0-2]	2 [2-2]	0.238
10	2 [1-2]	2 [2-2]	0.705
11	2 [2-2]	2 [2-2]	0.317
12	2 [2-2]	2 [2-2]	0.317
Total score	14 [10-20]	20 [17-21]	0.008

PFEFFER
Item	Before	After	p
Item	Md [IQR]	Md [IQR]	p
1	0 [0-0]	0 [0-0]	0.157
2	0 [0-1]	0 [0-1]	0.705
3	0 [0-1]	0 [0-0]	0.157
4	0 [0-0]	0 [0-0]	0.317
5	1 [0-1]	0 [0-1]	0.317
6	1 [0-1]	0 [0-1]	0.046
7	1 [0-1]	0 [0-1]	0.038
8	1 [0-1]	0 [0-0]	0.011
9	0 [0-1]	0 [0-0]	0.083
10	1 [0-1]	0 [0-0]	0.025
11	0 [0-0]	0 [0-0]	0.317
Total score	6 [4-7]	2 [0-3]	0.015

MAC-Q
Item	Before	After	p
Item	Md [IQR]	Md [IQR]	p
1	4 [3-5]	3 [3-4]	0.063
2	4 [3-5]	3 [3-4]	0.063
3	4 [3-5]	3 [1-4]	0.048
4	4 [3-4]	4 [2-5]	0.565
5	3 [3-4]	3 [3-4]	0.157
6	10 [8-10]	6 [4-8]	0.024
Total score	27 [24-31]	24 [17-27]	0.013

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

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[1] Author’s Contributions

Maria Carolina Almeida Alves - Lead author. She contributed in all stages of the work, in the manuscript writing and its critical revision. Maria Helena Morgani de Almeida - Professor responsible for coordinating the research project approved by the Programa Institucional de Bolsas de Iniciação Científica. Contributed in all stages of preparation and development of the final research report, in addition to the manuscript writing and its critical review. Camila Exner - She contributed to the conception and design of the research project, especially regarding the structuring and conduct of the group and data analysis and interpretation. Contributed to the manuscript writing and critical review. Rosé Colom Toldrá - She contributed especially in outlining the introduction and justification of the work and data discussion. She contributed to the article writing and critical review. Marina Picazzio Perez Batista - Co-responsible for coordinating the research project. She contributed at all stages of preparation and development of the final research report and conducted the final review of the report. She contributed to all stages of manuscript writing and carried out the final revision. All authors approved the final version of the text.