Research Article
Issue Date: May/June 2020
Published Online: April 17, 2020
Updated: April 30, 2020
Adapting Strategy Training for Adults With Acquired Brain Injury: A Feasibility Study in a Chinese Population
Yen-Nung Lin; Chao-Yi Wu; Pei-Chun Yeh; Yi-Hsuan Wu; Wan-Chi Lin; Elizabeth R. Skidmore; Feng-Hang Chang
Author Affiliations
  • Yen-Nung Lin, MS, MD, is Associate Professor, Graduate Institute of Injury Prevention and Control, College of Public Health; Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine; and Chair, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
  • Chao-Yi Wu, MS, OTR/L, is Doctoral Candidate, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
  • Pei-Chun Yeh, BS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
  • Yi-Hsuan Wu, MS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
  • Wan-Chi Lin, MS, OTR/L, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
  • Elizabeth R. Skidmore, PhD, OTR/L, is Chair and Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, and Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
  • Feng-Hang Chang, ScD, OTR/L, is Associate Professor, Graduate Institute of Injury Prevention and Control, College of Public Health, and Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Taipei Medical University, Taipei, Taiwan; fhchang@tmu.edu.tw.
Article Information
Neurologic Conditions / Rehabilitation, Participation, and Disability / Research Articles
Research Article   |   April 17, 2020
Adapting Strategy Training for Adults With Acquired Brain Injury: A Feasibility Study in a Chinese Population
American Journal of Occupational Therapy, April 2020, Vol. 74, 7403205130. https://doi.org/10.5014/ajot.2020.035923
American Journal of Occupational Therapy, April 2020, Vol. 74, 7403205130. https://doi.org/10.5014/ajot.2020.035923
Abstract

Importance: Before introducing strategy training into a cross-cultural (Chinese) context, it is necessary to evaluate its feasibility.

Objective: To examine the feasibility of applying strategy training to improve participation outcomes of rehabilitation patients in Taiwan and evaluate the potential intervention effects.

Design: A single-group, repeated-measures study.

Setting: Rehabilitation outpatient settings.

Participants: A convenience sample of adults (N = 20) with a primary diagnosis of acquired brain injury (ABI) and with cognitive impairment received the intervention and were assessed before and after it.

Intervention: The participation-focused strategy training intervention, a modified version of the strategy training intervention, was provided to participants in 1–2 sessions weekly for a total of 10–20 intervention sessions.

Outcomes and Measures: Feasibility indicators, Participation Measure–3 Domains, 4 Dimensions (PM–3D4D), and Canadian Occupational Performance Measure (COPM).

Results: Eighteen participants completed 100% of the scheduled intervention sessions. Participants had very good engagement in the intervention sessions with sufficient comprehension. Participants reported moderate to high satisfaction. Positive score changes were observed for the PM–3D4D (d = 0.46–1.25) and COPM scales (d = 1.82 and 2.12).

Conclusions and Relevance: This study demonstrated the feasibility of delivering participation-focused strategy training in Taiwan to people with cognitive impairment after ABI. The preliminary evidence also showed that participants who received the strategy training intervention had positive changes in participation outcomes and in performance of their self-identified goals. On the basis of this study’s findings, a larger clinical trial is warranted to evaluate the efficacy of the strategy training intervention.

What This Article Adds: Participation-focused strategy training is feasible and acceptable for Taiwanese community-dwelling adults with cognitive impairment after ABI. However, because strategy training is quite different from traditional rehabilitation delivered in Taiwan, additional instructions and discussion among the therapist, client, and caregiver may be needed before the intervention is provided.