Document Type
Presentation
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Publication Date
12-13-2025
Keywords
heart failure, self-care, health management, occupational therapy, acute care, social determinants of health, clinical guidelines, rapid review
Abstract
Heart failure (HF) significantly affects individuals’ ability to perform daily activities and sustain quality of life, with disproportionate impact on older adults and marginalized populations due to structural inequities embedded in Social Determinants of Health (SDoH). Although self-care is central to HF management, occupational therapy (OT) remains underrepresented in acute care HF intervention research and clinical guidelines. This doctoral capstone project conducted a rapid review, following Cochrane Rapid Review methodology, to inform the development of preliminary Acute Care Occupational Therapy Clinical Practice Guidelines for Heart Failure Self-Care and Health Management. A comprehensive search of MEDLINE (PubMed), CINAHL, and Scopus, developed in collaboration with a Graduate Medical Education Librarian, yielded 4,824 records; 41 studies met criteria for data extraction, quality appraisal, and synthesis. Interventions were predominantly educational, nurse-delivered, and grounded in behavior change techniques such as teach-back, self-monitoring, and action planning. Across 87 primary outcomes, 66.7% demonstrated statistically significant improvement, most commonly in HF self-care behaviors, symptom recognition, and treatment adherence. Alignment with the Occupational Therapy Practice Framework (OTPF-4) was strong, with 72% of studies addressing OT-related domains explicitly or implicitly, while SDoH integration remained limited, most often reflecting education and literacy factors. Guided by the Ecological Model for Health Promotion (EMHP), findings underscore the multilevel contextual influences shaping HF self-care and highlight opportunities for OT practitioners to initiate and reinforce evidence-based interventions within acute care. The resulting recommendations provide a foundation for OT-inclusive clinical practice guidelines aimed at improving self-care capacity, enhancing health equity, and reducing preventable HF readmissions.
Synopsis
This doctoral presentation focuses on the results of a rapid review of acute care self-care interventions for heart failure patients within the scope of practice of occupational therapists, examining whether these interventions address social determinants of health. Additionally, the findings can serve as a foundation for developing clinical practice guidelines for occupational therapists in acute care settings who work with patients with heart failure. The findings support brief interventions of less than 1 hour with the patient and/or caregiver, using health literacy-sensitive written materials.
Acknowledgments
Special thank you to members of the rapid review team: Caroline Cameron, OTD, OTR/L; Megan Drollinger, MS, OTR/L; Jessica Aisello, OTD, OTR/L; Kasey Walker, OTS
Recommended Citation
Cook, MS, OTR/L, Alan K., "From Evidence to Action: A Rapid Review to Support Acute Care OT Guidelines for Heart Failure Self-care" (2025). Post-Professional Occupational Therapy Doctorate Culminating Presentations. Paper 30.
https://jdc.jefferson.edu/otppdcpresentations/30
Language
English
Comments
Presentation: 26:52
Presentation completed in partial fulfillment of a Post Professional Occupational Therapy Doctorate degree at Thomas Jefferson University.