The measurement properties of the Occupational Circumstances Interview and Rating Scale - Sweden (OCAIRS-S V2)

Abstract

Aim: This paper reports the measurement properties of the Occupational Circumstances Assessment Interview and Rating Scale - Sweden (OCAIRS-S V2). The OCAIRS is a semi-structured interview and rating scale designed to capture, in detail, a person's occupational participation. The English version 4.0 has been translated into Swedish. The psychometric properties of the Swedish version are unknown. Methods: Eleven Swedish occupational therapists working in mental health completed 38 OCAIRS-S (V2) assessments in addition to linking videotapes. A total of 60 clients were, therefore, entered into the analysis. Many-faceted Rasch analysis was used to analyse the data. Results and conclusions: Results supported internal, construct, and person response validity of the OCAIRS-S (V2). Inter-rater reliability was established. The scale was shown to discriminate between people who were living in the community. In addition, the results indicate a need to explore the skill items.     

Exploring the reasons why adolescents participate in physical activity and identifying strategies that facilitate their involvement in such activity

Background: Prompted by the dramatic rise in obesity and the decline in physical activity of adolescents aged 11–15 years, this study explored, from the participants’ viewpoints, the influences contributing to the engagement of adolescents in physical activities and the strategies facilitating their participation in physical activities. Methods: An interpretive qualitative methodology was used involving 13 adolescents in three separate activity‐based focus groups. Results: The findings describe the personal abilities of the participants and the health benefits, psychological, emotional and environmental factors influencing participation in physical activity. Findings endorse the use of supportive, enjoyable and skill‐appropriate approaches to physical activity intervention. Conclusions: Implications for occupational therapy include promoting physical activities as aspects of occupations to improve the health and well‐being of adolescents through engagement in such activities.     

Travelling by urban public transport: exploration of usability problems in a travel chain perspective

Travelling is an important precondition for other occupations, and to support travelling for people with functional limitations in-depth information about usability problems in urban public transport is needed. Therefore, the aim of this study was to explore usability problems in public transport in a travel chain perspective focusing on the physical environment and inherent aspects of it. Service Route travellers were contacted on board buses and a strategic sample of 20 persons participated in focus group interviews. The participants were used to travelling but the results demonstrated that they faced a broad range of usability problems when travelling. By analysing the usability problems in a travel chain perspective, several aspects of the personal, environmental, and occupational components in usability problems were elucidated. The results provide a structure for further analysis of usability problems in urban public transport, in research as well as in practice. Knowledge about the usability problems different groups of people experience when travelling increases knowledge of the environmental impact on occupational performance and how to design supportive traffic environments for people with functional limitations.     

Ability in daily activities after early supported discharge models of stroke rehabilitation

More knowledge is needed about how different rehabilitation models in the municipality influence stroke survivors’ ability in activities of daily living (ADL). Objectives: To compare three models of outpatient rehabilitation; early supported discharge (ESD) in a day unit, ESD at home and traditional treatment in the municipality (control group), regarding change in ADL ability during the first three months after stroke. Methods: A group comparison study was designed within a randomized controlled trial. Included participants were tested with the Assessment of Motor and Process Skills (AMPS) at baseline and discharged directly home. Primary and secondary outcomes were the AMPS and the modified Rankin Scale (mRS). Results and conclusions: Included were 154 participants (57% men, median age 73 years), and 103 participants completed the study. There were no significant group differences in pre–post changed ADL ability measured by the AMPS. To find the best rehabilitation model to improve the quality of stroke survivors’ motor and process skills needs further research. Patients participating in the ESD rehabilitation models were, compared with traditional treatment, significantly associated with improved ADL ability measured by the mRS when controlling for confounding factors, indicating that patients with social needs and physical impairment after stroke may benefit from ESD rehabilitation models.     

Use of time in childhood and adolescence: A literature review on the nature of activity participation and depression

Despite a philosophical belief in the health benefits of balanced participation in everyday activities, occupational therapists have devoted scant research attention to the relationship between mental health and activity participation in childhood and adolescence. Time use studies offer valuable insights into this relationship. In this literature review the methodologies employed in time use studies are described, and empirical findings linking depression to the distribution of time to leisure, productive and self-care activities, and sleep are then outlined. The relevance of findings to occupational therapy assessment and intervention is discussed. Therapists are challenged to further research the area, as gaining thorough knowledge of young people's time use has implications for both professional practice and broader public health policy.     

Introducing the Occupational Balance Questionnaire (OBQ)

Abstract

Objective: The concept of occupational balance is frequently used in occupational therapy but the fact that it has been defined and measured differently is a limitation. This article introduces the Occupational Balance Questionnaire (OBQ), which focuses on satisfaction with the amount and variation of occupations. It consists of 13 items measured on six-step ordinal scales. It has shown good content validity in a sample of 21 occupational therapists but other psychometric properties have not been investigated. The aim was to investigate the OBQ regarding internal consistency, test–retest reliability, and floor/ceiling effects. Methods: The OBQ was administered twice to a sample selected through convenience sampling. Internal consistency was investigated by Cronbach's alpha and test–retest reliability analysed with Spearman's Rho correlation for the total score and weighted kappa on each item. Potential floor/ceiling effects were explored by checking for the percentage of participants who scored lowest and highest. Results: The results demonstrated that the OBQ has good internal consistency (Cronbach's alpha 0.936) and sufficient test–retest reliability (Spearman's Rho for the total score was 0.926) and, thus, seems stable over time. No floor or ceiling effect was detected. Conclusions: The OBQ therefore showed promising reliability, although further instrument development studies to examine its construct validity are required.     

Time use, tempo and temporality: Occupational therapy's core business or someone else's business

A primary assumption underlying occupational therapy intervention is that peoples' use of time, or their participation in activities, is related to their overall well-being and quality of life. However, the translation of this assumption into occupational therapy practice often is not only invisible, but it is becoming increasingly difficult to sustain in current health care practices. This paper outlines current research and literature related to relationships between peoples' time use, tempo and temporality, and their well-being, and will discuss implications for occupational therapy theory, practice and research.     

Exploring the therapeutic environment for older women with late-life depression: An examination of the benefits of an activity group for older people suffering from depression

This study examines a therapeutic activity group that was developed over a period of 4 years by occupational therapists, and includes components of psychosocial treatment. The study was designed to identify the benefits of the group activity for members and to identify whether members' expectations of attending the group are the same as (or different to) the health professionals' expectations of the benefits for group members. The Model of Occupational Spin-off is applied as the theoretical basis for the study. Group members completed a specialised questionnaire and two standard assessments. Health professionals completed a separate, but similar, questionnaire. The results were analysed by using statistical tests and confirmed that the expectations of group members and health professionals are not significantly different.     

Reliability and internal consistency of the Danish version of Loewenstein Occupational Therapy Cognitive Assessment 2nd Edition (LOTCA-II/D)

Abstract

Objective: To evaluate the intra-rater and inter-rater reliability and internal consistency of the Danish version of the Loewenstein Occupational Therapy Cognitive Assessment, second edition (LOTCA-II/D), an instrument designed to assess and evaluate cognitive functioning. Methods: A reliability study was conducted at neurological acute care and rehabilitation units at three Danish hospitals. Fifty-four neurological patients participated in the study. Patients were tested with LOTCA-II/D by occupational therapists, and video recordings were made for reliability assessments. Intra-rater assessments were performed at least two weeks after the first assessment, and all occupational therapists were blinded to previous assessments. Intra-rater and inter-rater reliability were evaluated using percentage agreement and weighted kappa. Internal consistency was evaluated using Cronbach’s alpha, and floor and ceiling effects were evaluated by calculating the proportion of observations in minimum and maximum categories of subtests. Results: The results showed a lack of intra-rater and inter-rater reliability and a large variation of agreement due to a substantial ceiling effect. Internal consistency was below the acceptable value in half of the cognitive areas. Conclusion: The study found that LOTCA-II/D is not reliable in acute clinical practice, and it could thus not be validated for use in this setting.     

Impact on Participation and Autonomy (IPA): Psychometric evaluation of the Persian version to use for persons with stroke

Abstract

The aim of this study was to evaluate the psychometric properties of the Persian version of the Impact on Participation and Autonomy questionnaire (IPA-P) to use for persons with stroke. A total of 102 persons diagnosed with first-ever stroke participated in this cross-sectional study. The psychometric properties were evaluated using a Rasch rating scale model. The results showed that IPA-P could not measure perceived participation as one unidimensional construct according to the criteria, but supported two different but related constructs. Performance-based participation consisted of 19 items including three IPA domains: autonomy indoors, family role, and autonomy outdoors. Social-based participation consisted of seven items from the social relations domain. The results provided evidence of internal scale validity, person response validity, and sensitivity for each of the two constructs of IPA-P. In conclusion, the results supported the psychometric properties of two constructs of perceived participation in the Persian sample tested. However further evaluation of psychometric properties of the IPA is needed in a variety of diagnoses and in other cultural backgrounds.     

The Concurrent Validity of Three Visual Perception Tests Used with Adults

Objective. Visual perception is a skill area commonly assessed by occupational therapists. Three newly revised tests of visual perception include the Developmental Test of Visual Perceptual Skills (Non-Motor)-Adolescent and Adult (DTVP-A), the Motor-Free Visual Perception Test-Third Edition (MVPT-3), and the Test of Visual Perceptual Skills-Third Edition (TVPS-3). The aim of this study was to investigate the concurrent validity of these three adult visual perceptual tests. Methods. Fifty healthy participants, aged 18–55 years, completed the DTVP-A, MVPT-3, and TVPS-3. Spearman rho correlation coefficients were used to evaluate the relationships among the three tests. Results. The total scale score correlations for the DTVP-A, MVPT-3, and TVPS-3 ranged from 0.39 to 0.51. Conclusion. The three tests exhibited a moderate level of correlation, supporting the concurrent validity of the DTVP-A, MVPT-3, and TVPS-3.     

An examination of the psychometric properties of the occupational identity questionnaire for community-living elderly who require care

IntroductionAuthors created an Occupational Identity Questionnaire Provisional version (OIQ-P) to assess occupational identity for elderly individuals. The purpose of this study was to examine the psychometric properties of the OIQ-P.MethodsParticipants included 135 (42 males) elderly who lived locally and required care or support. OIQ-P was evaluated in terms of structural validity, criterion validity and internal consistency.ResultsBased on the results of an exploratory factor analysis and confirmatory factor analysis, an OIQ with a factor structure of 3 factors and 14 items was created. Rasch rating scale model revealed that 14 participants and 1 item did not fit the goodness of fit, nevertheless, the overall result was good. Spearman''s rank correlation coefficient indicates that there was a law correlation between OIQ and the occupational identity scale of the Occupational Performance History Interview Version 2. In terms of internal consistency, the person separation index and person separation reliability coefficient were 2.30 and 0.84, respectively.ConclusionThis study confirmed the structural validity, criterion validity and internal consistency for the OIQ. To enhance the clinical utility of the OIQ, it is necessary to examine the interpretability and conduct an intervention study using the OIQ.     

Exploring experiences of “participation” among individuals living with chronic pain

The aim of this paper is to advance our understanding of participation and its relation to occupation, by analysing the daily occupational experiences of six men and women living with chronic pain. Open-ended interviews are used in conjunction with a constant comparative method of analysis. The findings are thematically presented as: “taking initiative and making choices”, doing something physical”, “doing something social”, and “doing something for others”. Furthermore, a short vignette is presented in which the authors attempt to juxtapose theoretical constructs with individual experiences in order to illustrate another level of contextual richness of the data. Methodological implications are discussed in relation to the findings, analytic presentation, and previous research.