Authors (including presenting author) :
Lau CM, Yeung HY, Chow KY, Law ST, Chang SPV, Yue SY
Affiliation :
Occupational Therapy Department, Shatin Hospital
Introduction :
Computerized Cognitive Training was recognized as an important intervention for patients with mental illnesses to improve cognitive and functional performance. To consolidate the cognitive rehabilitation service for adult psychiatric patients by standardizing the training modalities & protocol, CCTP was developed.
Objectives :
To evaluate the effectiveness of CCTP in Occupational Therapy Department (OTD) for patients in Adult Psychiatric Day Hospital (PDH)
Methodology :
A pilot program was conducted in May - Dec 2018 with 27 participants being recruited. Pre & post assessment with convenient sampling was conducted at OTD in adult PDH of Shatin Hospital. Patients with subjective cognitive complaints or impaired cognitive functions were recruited to receive the 8-lessons CCTP. In each lesson, participants would be prescribed with 4 to 5 training apps in tablet computer and received training under supervision for 45 minutes. Assessment tools included Hong Kong Montreal Cognitive Assessment (HK-MoCA), Brief Assessment of Prospective Memory (BAPM) and Reaction Time Test. Satisfaction Survey was collected after CCTP to gather subjective comments on the program effectiveness.
Result & Outcome :
18 participants completed CCTP in this pilot program. The mean age of the participants was 50. There were 56% of female and 44% of male. 61% of participants were suffered from schizophrenia and 39% were suffered from mood disorder. 94% of the participants were unemployed. After attending CCTP, patients had shown improvement in their cognitive performance with overall mean score of HK-MoCA increased by 10%. There is statistically significant difference between pre & post HK-MoCA score (t=-3.613, p=0.002). There is also improvement in the reaction time and the BAPM score and the overall mean scores were reduced by 22% & 20% respectively. Both test showed statistical difference results with Reaction Time Test (t=2.177, p=0.044) and BAPM (t=2.316, p=0.033). 29% of the discharged participants could obtain Open Employment after rehabilitation. Participants were highly motivated and satisfied with the program. From the satisfaction survey, the mean score of subjective improvement on cognitive functions was 3.67/4 (SD=1.54) and the mean score of volition to continue training was 3.68/4 (SD=1.20). CCTP improved cognitive functions of adult patients with mental illness significantly in this pilot program. To maximize and investigate the long-lasting effect of CCTP, a longitudinal study with home training elements could be implemented to maintain or enhance cognitive and occupational functioning in the community after discharge.
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