IMPACT OF OCCUPATIONAL THERAPY ON FUNCTIONALITY AND SAFE DISCHARGE IN CHRONIC RESPIRATORY DISEASE–RELATED PNEUMONIA: A CASE STUDY
通过一例71岁间质性肺病合并肺炎患者的案例，展示了职业治疗在肺康复中通过能量节约策略和环境适应改善日常生活活动能力，并帮助患者安全出院回家。
Introduction: Community-acquired pneumonia (CAP) in patients with interstitial lung diseases is frequently associated with symptomatic deterioration and functional decline with loss of autonomy. Occupational Therapy (OT) plays a fundamental role in Pulmonary Rehabilitation, intervening in dyspnoea management, energy conservation and adaptation of basic activities of daily living (BADL). Clinical Case Description: A 71-year-old retired female, previously independent in BADL, living on the third floor without a lift. Medical history included non-fibrotic hypersensitivity pneumonitis (HP) and previously diagnosed asthma since childhood with frequent exacerbations, and chronic partial respiratory failure, requiring long-term oxygen therapy (LTOT) (2 L/min at rest and 6 L/min on exertion). She was hospitalized in November 2025 with bilateral CAP Initially, limitations in performing BADL were identified and the physical and home environment were assessed. The patient’s goal was to be discharged to her home.. In the occupational performance assessment, the patient required continuous oxygen at 6 L/min to perform BADL, presenting a Functional Independence Measure (FIM) score of 84/126, SpO2 of 92% with 6L/min, heart rate of 109 bpm, blood pressure of 85/54 mmHg and a modified Borg scale score of 4–5/10. OT intervention focused on the teaching and training of energy conservation strategies, environmental adaptation and reorganization of occupational patterns. Improvements were observed in dressing and undressing, with greater integration of energy conservation strategies and reduced perceived effort during task performance. Assistive devices were recommended, enabling the patient’s goal of returning home to be met according to her needs, with support from the Integrated Community Care Team (ECCI). Conclusions: This case highlights that OT intervention, centered on functionality, dyspnoea self-management and contextual adaptation, is crucial in Pulmonary Rehabilitation and in planning a safe discharge. It reinforces the essential role of OT within the multidisciplinary team in inpatient settings and in transition to home.