Wetenschappelijk Tijdschrift voor Ergotherapie

Purpose: Describing and evaluating the characteristics, expectations, experiences, and participation of the seniors involved in implementing the preventive Healthy and Active Ageing programme in different contexts.
Methods: The implementation of the programme is evaluated from an action research approach. Quantitative and qualitative data collection was conducted by using various measurement instruments, individual and focus group interviews.
Results: In total, 66 seniors participated in the programme in 7 different groups. Significant differences in characteristics appeared both between and within the groups. After the course, most of the seniors involved expressed to be (highly) satisfied. Meaningful issues from their perspective were: mutual identification, information, learning from one another, consciousness-raising, support, stimulus, contact and communication.
Conclusion: The diversity within and between the groups of seniors putted high demands on the competencies of an occupational therapist in a group facilitator’s role to fine-tune the basic programme to a specific context and to the expectations and characteristics of the group.

Existing instruments that measure upper-limb capacity after stroke are often not suitable for patients without dexterity. Some instruments only aim to measure dexterity, while others measure capacity as well as basic arm function. The Stroke Upper Limb Capacity Scale (SULCS) is a new measurement instrument that consists entirely of capacity tasks involving the arm and hand and is suitable for mildly to severely affected patients. In this article, the development of the SULCS as well as its clinimetric properties are presented. The results show that the SULCS is a strong hierarchical scale with good reliability and validity. The SULCS can be scored fast and easily with the use of start-and-stop rules.

Frail elderly have an increased risk for development of adverse outcomes. How can we identify community-dwelling frail elderly and which interventions can support them to perform meaningful activities? This thesis shows that postal screening questionnaires based on a multifactorial approach to frailty do have potential, but their diagnostic values are too low. Frail older clients were positive about an innovative interdisciplinary programme supporting self-management in performance of meaningful activities. Elements of the programme are screening, assessment, team meetings, setting of goals and action plan and a flexible toolbox with 5 interventions. The general practitioner and the practice nurse comprise the core team that can be extended by other professionals such as the occupational and physical therapist. The professionals assessed the programme as acceptable and deliverable, supporting them to focus on prevention and interdisciplinary cooperation. The screening procedure and self-management support of the programme need consideration before further implementation.

With the ageing population, the number of older people in the Netherlands will continue to increase. Furthermore, more and more older people want to live independently as long as possible. To facilitate living independently and participation, so called ‘integrated service areas’ (woonservicegebieden) have been developed. In these community areas, optimal conditions have been created for housing with care and welfare facilities.
Aim: This article describes how older people, living in integrated service area Zeevang, perceived opportunities for participation. In addition, implications for occupational therapy are outlined.
Method: The study was part of a larger study. For this qualitative study, eighteen semi-structured vulnerable older people living in the service area Zeevang were interviewed. Data analysis was performed using data sets with a pre-established coding format that was developed in the larger study.
Results: Three key themes emerged: ‘define choices’, ‘cosy neighbourhood’ and ‘social cohesion’.
Conclusion: The older people in our study perceived their opportunities for participation as positive, there was social cohesion and they perceived a sense of security in the community. In addition, the infrastructure was organized in a way that made social activities easily accessible and approachable. In addition, the tuning of care and services in the integrated service area permitted the respondents to be in control of the organization of care and services around them.