The Outcomes of Seamless Self-care Training between Occupational Therapist and Nurse in Stroke Patients


  • Thitisakulchai P Department of Rehabilitation Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Dajpratham P
  • Kongsri N Division of Occupational therapy, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd., Bangkoknoi, Bangkok, Thailand 10700
  • Onkampa W Division of Occupational therapy, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd., Bangkoknoi, Bangkok, Thailand 10700
  • Rawainok K Department of Nursing Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd., Bangkoknoi, Bangkok, Thailand 10700


self-care, nursing care, occupational therapy, inpatient, stroke rehabilitation


Objectives: To investigate the outcomes of seamless self-care training to stroke patients by occupational therapists (OTs) and nurses.

Study design: Quasi-experimental research design.

Setting: Rehabilitation ward, Siriraj Hospital, Mahidol University.

Subjects: Thirty-five inpatients with first stroke, normal mental functions and age between 18 to 75 years old, were included in the study. All needed help in dressing and washing oneself activities.

Methods: Participants were divided into two groups.  The conventional group received self-care (dressing and washing oneself) training from OTs for 3 days; on day 4, OTs supervised them, thereafter nursing staffs were responsible for such activities in a traditional nursing care until day 14.  The experimental group received a “seamless self-care training”, in which OTs trained patients for 2 days, supervised them for the next 2 days, and the nursing staffs joined the OTs on day 4 to learn how to facilitate the patients and led the training until day 14. The primary outcome was a normalized gain of the self-care score.  Secon-dary outcomes were a modified Barthel index (MBI) score, self-efficacy, and patient satisfaction. The outcomes were evaluated at baseline (day 1) and after completing the training (day 14).

Results: After adjusting by normalized gain calculation, there were significantly more participants in the experimental group who achieved a higher gain level (0.7-1) than in the conventional group (p = 0.028). The experimental group had considerably higher self-efficacy for washing oneself activity after the training (p = 0.013) and were more satisfied with the training program than the conventional group. The MBI improved in both groups.

Conclusion: This seamless self-care training with good colla-boration between occupational therapists and nursing staffs during inpatient rehabilitation was proved to be effective in dressing and washing oneself training and promoting self-efficacy of stroke patients


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