Giving definition and structure to comfort

As an Occupational Therapist, Dr Anna Rose is used to solving problems. Which is why she focuses on how we define and measure comfort.

Anna Rose

An Occupational Therapist (OT) has a broad remit. Much like a GP they explore the whole person, rather than specialise in one area of health or the body – but unlike a GP, an OT brings the whole of a person’s surroundings into focus. “We look at both the physical and social environment,” Anna says. “And how that impacts on a person’s health and wellbeing.”

“As an OT you are continually faced with new challenges,” Anna says. “The health system is constantly challenged with new demands as people are living longer with more complex health conditions. As OTs, we tend to be creative people, and it’s this creativity that we bring to health care.”

Anna is passionate about bringing OT research into everyday research to bring the work into the allied health space. “We need to be measuring health outcomes and consider ‘what is the outcome that an OT contributes?’. This is where my current research is heading – looking at ‘comfort’ as an outcome of occupational therapy and where that sits with a mental health perspective.”

What is comfort?

“In my recent research, it’s clear there are physical aspects of comfort, but there’s also psychosocial aspects of comfort,” Anna says. “Because I’m a systems thinker, having an outcome of comfort might bring us more into the allied health space in terms of more preventative approaches to wellbeing.”

Comfort means exploring deeper into a person’s experience. “It’s not just about eliminating negative symptoms or focusing on the medical issues, but starting to think more about life-enriching experiences,” Anna says. “I think that’s where OT can have a big role in providing positive client outcomes.”

There has already been a lot of work around comfort, and it is seen as an outcome in other health areas. However, in OT, the word ‘wellbeing’ has tended to be preferred when considering client outcomes. “I’m currently working on a systematic review with a colleague at Colorado State University and we’re pulling together all the evidence that we can find about OT interventions that enhance client comfort,” Anna says.

“Nursing and medicine have already done a great deal of work in this space, so I’m trying to look at what OTs can bring to it. What is our intervention? How do we assess client comfort?”

Training the next generation

Anna’s workload is split between research, clinical and teaching – and she manages to bring a little bit of each to the other area. “I’m passionate about instilling life-long learning in my students, so I’m also passionate about problem-based learning,” Anna explains. “Our students are brought together to solve problems – and I do this by giving them a bit of systems thinking.”

“It’s about empowering students to understand the health system to effect positive change.”

Technology and OTs

Another of Anna’s projects involves exploring GPs and Telehealth. “The medical students I’m working with are exploring how GPs use telehealth: what are the barriers and how they currently link in with allied health services around chronic health management,” Anna says. “We’re doing a survey with GPs and asking them about how they link to other medical services as well.”

The COVID-19 pandemic saw a massive uptake in Telehealth appointments nationally, so Anna is keen to see how it has impacted its long-term implementation. “Thanks to technology, Telehealth has enabled access to healthcare, particularly for those in rural and remote regions,” Anna says.

“It will continue after COVID, but that’s very dependent on funding, so it’s important that there’s research to show the benefits of Telehealth. Because of COVID we’ve moved ahead five to ten years.”

“Technology and Telehealth gives us the power to educate, monitor and check in,” Anna adds. “It doesn’t work in every situation, but we need to know where it can have optimal impacts for clients and the health system.”

For people living with chronic diseases, Telehealth provides a solution to help them maintain independence while still offering the care and support they need. “Managing a chronic condition can be quite an exhausting thing for people to do over the long-term,” Anna says.

“Telehealth could be a valuable way to provide the additional care they need to ensure they have the skills and support required to monitor their signs and symptoms and seek care when they need it.”

Dying well

OTs also come to the fore in end-of-life care, enabling a positive experience for the patient, their family and carers. “Another aspect of comfort for end-of-life care can be going home to die,” Anna says. “Or it can be about ensuring that all your affairs are in order – that can bring a great deal of comfort to somebody.”

And this is where OTs come in. “I think OT has an excellent understanding of an untapped knowledge of the activities involved in dying,” Anna explains. “OTs can help people go home or stay at home to die by working with carers and health team members to determine the necessary supports.” This could involve modifying the home environment, or working out what kind of training may be required for a carer, so they can perform their caring role safely and effectively.”

Skills for life

Working with both physical skills and cognition is an OT’s greatest strength, but Anna admits it’s also a weakness. “We work in so many areas that sometimes people struggle to understand what we do.”

When we think of occupation we often think of our job, but that’s only one very small part of what an OT does. “It’s such a huge space and an often untapped skillset,” Anna says. “We’re providing skills for everyday living.”

“OTs give a practical level of support so people can live as independently as they wish,” Anna explains. “Often it’s about changing a task and simplifying it – so using tools such as jar openers to make life easier. We give people the tools, education and skills so they can learn new ways to do activities and maintain some level of confidence.”

“Practical support measures can make such a huge difference to people’s quality of life and their wellbeing.”

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