Person-Centered Occupational Therapy in Older Adults

Overview

This study was designed to investigate the effects of a person-centered occupational therapy approach on quality of life and occupational balance among community-dwelling older adults. The study is a randomized controlled trial utilizing semi-structured interviews and self-report measures. The target population consists of individuals aged 65 years and older living in Istanbul. The sample size was calculated using G\*Power software, indicating a minimum of 77 participants per group, for a total of 154 participants. Considering potential attrition, a total sample of 170 participants is planned. Data will be collected using a Sociodemographic Information Form, the Mini-Mental State Examination (MMSE), the Occupational Performance History Interview-II (OPHI-II), Goal Attainment Scaling (GAS), the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD), and the Activity-Role Balance Questionnaire. Cognitive eligibility will be assessed using the MMSE, and individuals scoring 24 or higher will be included in the study. Through the OPHI-II, participants' life histories, roles, habits, and experiences related to daily activities will be explored, and individualized goals will be identified based on the information obtained. These goals will subsequently be structured using the Goal Attainment Scaling method. Participants will be randomly allocated to either the intervention group or the control group. Participants in the intervention group will receive person-centered occupational therapy sessions delivered via telerehabilitation, while those in the control group will continue their usual daily routines without additional support. At the end of the study, outcomes related to quality of life and occupational balance will be compared between groups. The findings are expected to provide evidence regarding the role of a person-centered occupational therapy approach in supporting participation in daily life activities among older adults.

The global increase in the older adult population has highlighted the importance of interventions that support healthy aging, participation in meaningful activities, and quality of life. Aging is often accompanied by changes in physical, cognitive, and social functioning that may negatively affect participation in daily activities, occupational balance, and overall well-being. Occupational therapy aims to support individuals in maintaining participation in meaningful occupations and adapting to age-related changes in daily life. Person-centered occupational therapy is an approach that emphasizes the individual's values, preferences, life experiences, goals, and priorities throughout the therapeutic process. By focusing on personally meaningful activities and roles, this approach seeks to enhance engagement, autonomy, and quality of life. Despite the growing recognition of person-centered care in geriatric practice, there remains limited evidence regarding the effectiveness of person-centered occupational therapy interventions delivered through telerehabilitation among community-dwelling older adults. The present study aims to investigate the effects of a person-centered occupational therapy approach on quality of life and occupational balance in community-dwelling older adults. Participants aged 65 years and older will be recruited from the community and screened for eligibility. Cognitive status will be evaluated using the Mini-Mental State Examination (MMSE), and individuals scoring 24 or above will be eligible to participate. At baseline, participants will complete a Sociodemographic Information Form, the Occupational Performance History Interview-II (OPHI-II), the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD), and the Activity-Role Balance Questionnaire. Through the OPHI-II, participants' occupational histories, life experiences, daily routines, habits, roles, environmental contexts, and occupational participation patterns will be explored. Based on the information obtained during the interview, individualized goals will be collaboratively established with each participant and structured using the Goal Attainment Scaling (GAS) methodology. Following baseline assessment, participants will be randomly assigned to either the intervention group or the control group. Participants in the intervention group will receive person-centered occupational therapy sessions delivered via telerehabilitation. The content of these sessions will be individualized according to each participant's occupational history, identified needs, personal goals, daily routines, meaningful activities, and environmental circumstances. The sessions will focus on supporting participation in meaningful activities, improving occupational balance, strengthening role engagement, promoting social participation, enhancing self-management strategies, and facilitating adaptations within the participant's daily environment when necessary. Participants in the control group will continue their usual daily routines and will not receive person-centered occupational therapy during the study period. Upon completion of the intervention period, all participants will be reassessed using the WHOQOL-OLD, Activity-Role Balance Questionnaire, and Goal Attainment Scaling. The primary outcome of the study is quality of life as measured by the WHOQOL-OLD. Secondary outcomes include occupational balance and goal attainment. The findings are expected to contribute to the evidence base regarding the effectiveness of person-centered occupational therapy delivered through telerehabilitation and provide guidance for occupational therapy services aimed at supporting healthy aging and participation among older adults living in the community.