Tailoring the model of creative ability to patients with diabetic foot problems

Abstract

Motivation is recognised as an important factor in the treatment of any patient.1,2 Motivation is also recognised as the cornerstone of occupational therapy.2,3 In recent history there has been an increase in the number of people diagnosed with diabetes and its complications, including diabetic foot complications.4-8 Motivation has been identified as a factor contributing to the treatment outcomes of a person with diabetic foot complications, and an assessment into the level of motivation is recommended.6,9-12 A review of the literature in the field revealed that this assessment of motivation has not been sufficiently investigated. The Model of Creative Ability provides a framework within which to assess motivation and principles with which to treat a client, based on the level of motivation.1-3 The purpose of this study was thus to investigate whether occupational therapy treatment, tailored to the level of motivation, for patients with diabetic foot complications, has more positive treatment outcomes than occupational therapy that is not tailored. An experimental pre-test-post-test-design with an experimental and a control group was used to conduct the research. Change in ulcer size and change in quality of life score were the two dependant variables that were measured both pre- and post-test. Subjects were assessed using the Reintegration to Normal Living Index to obtain a quality of life score. A wound tracing was done to determine the ulcer size, and the Creative Participation Assessment was used to establish the level of motivation and thus tailor the occupational therapy treatment that the subjects received. Subjects in the experimental group then underwent three months of tailored occupational therapy, whereas subjects in the control group continued to receive occupational therapy as usual for the same time period. At the end of the three month treatment period, the subjects were reassessed using the same assessments that were used pre-test. These results were then analysed statistically, to determine if a statistically significant difference occurred between the experimental and control groups with regards to the dependant variables. In spite of the small sample size, the results of the research indicate a positive trend towards occupational therapy treatment that is tailored to a client’s level of motivation. Copyright