Occupational therapy and psychosis: POINTER feasibility study for a pragmatic clinical trial

JOANNE INMAN, Katrina Bannigan, Jacqueline Akhurst

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Introduction: The dearth of clinical trials of individualised occupational therapy with
people with a diagnosis of psychosis limits the evidence base globally for occupational
therapy practice. This study evaluated the feasibility of conducting a pragmatic clinical
trial. Method: Mixed methods design using a pragmatic perspective; two-centre, one group
pretest-posttest study at six months. POINTER Occupational Intervention
Specification captured routine individualised occupational therapy. Process evaluation
included recruitment, retention, intervention delivery, fidelity, adherence and outcome
measurement. Primary outcome was participation in activities of everyday life,
measured by: Time Use Survey, Participation Scale and Utrecht Scale for Evaluation
of Rehabilitation Participation. The Canadian Occupational Performance Measure
measured self-reported experience of and satisfaction with occupational performance.
The Short Form-36v2 Health Survey measured Health-related quality of life; a
secondary outcome. Participants’ experiences were explored using a questionnaire.
Intervention providers’ perspectives were investigated via the POINTER occupational
intervention log and focus groups.
Results: Recruitment was (20/36) and drop-out 20% (4/20). Fidelity was 77% and
adherence was good; POINTER had validity and utility. Outcome measurement was
acceptable to participants, indicating increased participation in activities of everyday
Conclusion: A larger clinical trial is merited; recruitment processes need further
exploration and outcome measurement needs refining.
Original languageEnglish
JournalBritish Journal of Occupational Therapy
Publication statusAccepted/In press - 9 Feb 2021


  • Clinical trials


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