Authors (including presenting author) :
LEUNG YY(1), JIM CH(2), CHIU PF(2), CHANG SPV(1), LAU CM(1), CHAN HM(2), SHUM SY(1), POON WKV(1), CHEUNG,CCJ(2), CHAN WH(2)
Affiliation :
(1)Occupational Therapy Department, Shatin Hospital (SH) (2)Occupational Therapy Department, Tai Po Hospital (TPH)
Introduction :
Occupational Therapist (OT) provides VR for patients with MI to facilitate recovery and community reintegration. Comprehensive work training and worker behaviour enhancement facilitate job attainment to fit job market demand. Standardization of VR program facilitates continuation of treatment and promotes the quality and efficiency of service delivery. In order to develop standardized assessments and training protocols, a cluster-based VR working group by Occupational Therapy Department of SH and TPH has been formed since October 2015.
Objectives :
1. To enhance the quality of service by standardizing VR programs 2. To facilitate clinical handover and audit 3. To promote patients’ work capacity and behavior to meet job market demand
Methodology :
8 work posts including clerical worker, cleansing worker, restaurant worker, shop assistant, packaging worker, security guard, warehouse worker & courier were identified based on the market need in open and supported employment. Standardized training protocols were developed for each work post with entry and exit criteria. Unique training work samples, knowledge and technical modules and cognitive training were designed. Pre and post assessments covered patients’ work behavior, job readiness, work capacity and cognitive function with respective outcome measures including the Chinese Work Personality Profile (CWPP), Lam Assessment of Employment Readiness Chinese Version (C-LASER), VALPAR Component Work Sample on Multi-level Sorting (V7) and Simulated Assembly (V8) and Montreal Cognitive Assessment Hong Kong Version (HK-MoCA). Patients’ employment status after program completion was also evaluated.
Result & Outcome :
53 patients were recruited to selected work post training since 2018. 23 have completed the programs, 19 were still undergoing training by Feb 2020 before the suspension of service due to pandemic. 11 of them had dropped out due to changes of mental state or work plan. Data were analyzed using SPSS version 21. Paired t-tests were applied to compare pre-post measurements. Significant increases in CWPP score (p=0.000), CLASER Contemplation Stage score (p=0.011), CLASER Action stage score (p=0.011), VALPAR score (i.e. V7 (p=0.000), V8 (p=0.000)) and MoCA score (p=0.000) indicated statistically significant improvement of patients’ work behavior, job readiness, work capacity and cognitive function respectively. For employment status, 65% of patients succeeded in open employment or supported employment, while 21% pursued further training. Among the successful employment discharge pathways, specific job training accounted for 74% of the vocational outcome. As an intra-cluster working group initiative, the outcomes are encouraging. Further outcome evaluation of the program with a larger sample is recommended for more robust evidence of program effectiveness.
