Developing and Implementing an Occupation-Based Practice Service Delivery Model for Stroke Survivors in a Rural Thai Community Rehabilitation Center: Mixed Methods Feasibility Study.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Developing and Implementing an Occupation-Based Practice Service Delivery Model for Stroke Survivors in a Rural Thai Community Rehabilitation Center: Mixed Methods Feasibility Study.
Συγγραφείς:	Suwan S; Occupational Therapy Department, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroros Rd., Sripoom Subdistrict, Mueang District, Chiang Mai, 50200, Thailand, 66 846160504, 66 53936042., Kaunnil A; Occupational Therapy Department, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroros Rd., Sripoom Subdistrict, Mueang District, Chiang Mai, 50200, Thailand, 66 846160504, 66 53936042., Munkhetvit P; Occupational Therapy Department, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroros Rd., Sripoom Subdistrict, Mueang District, Chiang Mai, 50200, Thailand, 66 846160504, 66 53936042., Apikomonkon H; Occupational Therapy Department, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroros Rd., Sripoom Subdistrict, Mueang District, Chiang Mai, 50200, Thailand, 66 846160504, 66 53936042., Sriphetcharawut S; Occupational Therapy Department, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroros Rd., Sripoom Subdistrict, Mueang District, Chiang Mai, 50200, Thailand, 66 846160504, 66 53936042.
Πηγή:	JMIR formative research [JMIR Form Res] 2026 Sep 21; Vol. 10, pp. e91118. Date of Electronic Publication: 2026 Sep 21.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: JMIR Publications Country of Publication: Canada NLM ID: 101726394 Publication Model: Electronic Cited Medium: Internet ISSN: 2561-326X (Electronic) Linking ISSN: 2561326X NLM ISO Abbreviation: JMIR Form Res Subsets: MEDLINE
Imprint Name(s):	Original Publication: Toronto, ON, Canada : JMIR Publications, [2017]-
Ιατρικοί όροι (MeSH):	Stroke Rehabilitation/methods , Stroke Rehabilitation/standards , Occupational Therapy/methods , Occupational Therapy/standards , Survivors/statistics & numerical data , Survivors/psychology, Rural Population/statistics & numerical data ; Rehabilitation Centers/organization & administration ; Rehabilitation Centers/statistics & numerical data ; Quality of Life/psychology ; Humans ; Male ; Feasibility Studies ; Female ; Middle Aged ; Thailand ; Aged ; Adult ; Qualitative Research ; Stroke
Περίληψη:	Background: Occupation-based practice (OBP) has been demonstrated to enhance occupational performance and goal attainment in stroke rehabilitation. However, existing evidence is predominantly derived from hospital-based settings, with limited investigations into OBP implementation in community contexts. In Thailand, particularly in rural areas, there remains a need to establish effective OBP service delivery models and to evaluate their outcomes across diverse client populations receiving community-based rehabilitation services. Objective: This study aimed to develop an OBP service delivery model for community-based stroke rehabilitation in the Doi Lor community, Chiang Mai Province, Thailand, and to evaluate its effects on occupational performance, goal attainment, and quality of life among community-dwelling stroke survivors. Additionally, the study explored the occupational therapist's experience and perceptions of implementing the model, particularly the practicality of implementation in long-term community-based occupational therapy services. Methods: This study used an embedded mixed methods feasibility design comprising a 1-group pretest-posttest intervention study and a qualitative descriptive interview. An OBP service delivery model for community-based stroke rehabilitation was developed based on the Dynamic Model of Occupation-Based Practice; the Occupational Therapy Practice Framework, Fourth Edition; and evidence-based stroke rehabilitation principles. The model was implemented by a trained occupational therapist with 7 stroke survivors at a rural community rehabilitation center over 14 sessions spanning 7 weeks. Quantitative outcomes were assessed before and after the intervention using the Canadian Occupational Performance Measure, goal attainment scaling, and the World Health Organization Quality of Life-Brief Version. Qualitative data were collected through a semistructured interview with the occupational therapist to explore experiences of implementing the OBP service delivery model. Results: In the quantitative analysis, participants demonstrated statistically significant improvements in occupational performance and satisfaction as measured by the Canadian Occupational Performance Measure (P=.02), higher levels of goal attainment on the goal attainment scaling (P=.02), and improved overall quality of life as assessed by the World Health Organization Quality of Life-Brief Version (P=.02). Qualitative findings from the occupational therapist interview indicated 2 themes, including facilitating client-centered outcomes through OBP implementation and enhancing professional confidence and supporting the practical implementation of OBP in community-based practice. The occupational therapist described the model as practical and feasible and reported increased confidence in delivering occupation-based interventions. The findings also highlighted the potential applicability of the model within long-term, community-based occupational therapy services. Conclusions: This preliminary study suggests that an OBP service delivery model grounded in therapist preparation, client-centered goal setting, and outcome-focused intervention may support improvements in occupational performance, goal attainment, and quality of life among stroke survivors receiving community-based rehabilitation. This approach may contribute to strengthening long-term stroke care, particularly in rural communities where access to hospital-based rehabilitation services is limited. (© Sorasak Suwan, Anuchart Kaunnil, Peeraya Munkhetvit, Hataichanok Apikomonkon, Sarinya Sriphetcharawut. Originally published in JMIR Formative Research (https://formative.jmir.org).)
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Contributed Indexing:	Keywords: community-based rehabilitation; occupation-based practice; occupational therapy; service delivery; stroke
Entry Date(s):	Date Created: 20260921 Date Completed: 20260921 Latest Revision: 20261003
Update Code:	20261004
PubMed Central ID:	PMC13592663
DOI:	10.2196/91118
PMID:	42766796
Βάση Δεδομένων:	MEDLINE

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ISSN:	2561-326X
DOI:	10.2196/91118