Authors (including presenting author) :
Luk HT, Wong HC
Affiliation :
Occupational Therapy Department, The Pamela Youde Nethersole Eastern Hospital
Introduction :
Early identification and management of Mild Cognitive Impairment (MCI) could attenuate the progression to dementia and slow down functional lost. Although outpatients continued to attend face-to-face individual assessment in Occupational Therapy Department, in-person group rehabilitation was suspended due to infection control measures in view of the emergence of COVID-19. Thus, a cognitive enhancement program using tele-rehabilitation approach was commenced in Jan, 2021 to evaluate the efficacy and obtain feedback of this new service mode.
Objectives :
(1) To evaluation the efficacy of a telecare-based rehabilitation of occupational therapy cognitive enhancement program on maintaining the cognitive and social function of psychogeriatric patients. (2) To obtain feedback from patients and carers over their experience of participating cognitive rehabilitation therapeutic group on ZOOM platform.
Methodology :
Two series of cognitive rehabilitation program were conducted in January and March 2021. 4 and 3 participants were included in each group respectively. The program consisted of three phrases: Phrase I - Outpatient recruitment (age >65, with MCI) who has attended face-to-face cognitive assessment within 3 months; Phrase II - Pre-assessment and ZOOM trial run; Phrase III – ZOOM Group commencement consisting six one-hour-session twice per week with a combination of cognitive training, psychoeducation and homework. Outcome evaluations included (1) Cognitive performance using HK-MoCA, (2) Mental Wellbeing using Patient Health Questionnaire (PHQ-9) and World Health Organization - Five Well-being index (WHO-5), (3) Daily life functioning using the Social and Occupational Functioning Assessment Scale (SOFAS).
Result & Outcome :
Results: Participants showed good motivation and attendance rate except one dropped out for post assessment. 66% showed improved or maintained cognitive performance reflected by HK-MoCA. A similar pre-test (20.66) and post-test (20.83) mean score was recorded. A lowered mean score (from 7.8 to 6) of the PHQ-9 and a higher mean score (from 13.5 to 15.7) of WHO-5 in post-assessment revealed improvement in general well-being. Better daily functioning was identified by SOFAS mean scores rising from 75 to 79.2. Most feedback that the group was beneficial in enhancing their knowledge in cognitive compensatory strategies and coping skills. The length of ZOOM session (1 hour) was commented to be appropriate. Conclusion: A hybrid mode of cognitive tele-rehabilitation program could be beneficial to maintain the cognitive function, mental well-being and daily living function of patients. Although psychogeriatric patients might not be experienced in handling electronic devices, timely support from caregivers and therapist could facilitate their participation and confidence.
