Primary care occupational therapy: an occupation-based approach for veterans with chronic conditions

Abstract

When people are healthy, they are able to accomplish with relative ease what they set out to do, such as going to work, traveling, meeting with friends, and taking care of their personal necessities. However, once chronic illness becomes a factor in a person’s life, he or she is faced with limitations in the ability to perform daily activities, take care of health needs and participate in life activities. More effort is required for everyday activities, leading to abandonment of previously enjoyed routines and further declines in health and quality of life (Erlandsson, 2013a). In response to the complex, dynamic, and often unpredictable care requirements of individuals with one or more chronic conditions, newer primary care delivery models were developed to improve health management and reduce costs (Sevick et al., 2007). The expectation is that these interprofessional team–based models are the best way to address the needs of persons with multiple chronic conditions (Piette et al., 2011). However those charged with providing primary care based on these models have been unable to expand beyond disease-based episodic approaches and healthcare delivery is thus perceived as inadequate in fully serving this growing population (Fortin et al., 2013). The author developed and implemented occupation-based occupational therapy (OT) services and the VA Everyday Matters workshop to demonstrate that OT should be included as a vital component of a primary care effort aimed at meeting the complex needs of Veterans with chronic conditions. Health behavior theory and occupational therapy models informed the role of OT in primary care and the development of the workshop. The use of an occupation-based approach represents an innovative change in how health promotion is conceptualized and delivered in the traditional primary care setting. The immediate and long-term outcomes of this project will have important implications for occupational therapy practice and will contribute to a growing body of knowledge about the health promoting effects of occupation. Findings from the program evaluation will be disseminated throughout the VA and will inform the continued development of innovative ways occupational therapy and primary care can partner to optimize function and quality of life for at-risk Veteran populations.