Term
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Definition
occupational therapy practice model
used to systematically identify performance skills and patterns, environments and individual patient factors that are impacting occupational adaptation |
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Definition
help to generate an occupational profile
identify problem skills
develp an explanation of the patients' circumstances |
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when individuals maintain patterns of occupational participation within the environments that reflect their sense of who they are as occupational beings
involves the construction of a positive occupational identity and achieving occupational competence over time |
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Term
| three levels of doing in occupational engagement |
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Definition
occupational participation
occupational performance
occupational skill
these are different levels which one can examine doing |
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Term
| occupational participation |
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Definition
refers to engagement in work, play or activities of daily living that are desired and necessary for well-being according to a person's sociocultural context.
It is influenced by environmental and cultural contexts as well as by individual patient factors such as motivation and motor capacities. |
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Term
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Definition
requires a discrete set of purposeful actions that arise during our engagement in goal-directed activities
These are observable actions or skills that are a function of the interaction between the environment and an individual's personal characteristics.
EXAMPLE:
motor, process, communication and interaction skills associated with making a sale to a customer include manipulating money, sequencing actions to ring up the purchase on the register and speaking with the customer. |
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| evaluate a patient's participation, performance and skill so that the therapist can best identify the level of doing that is causing a patient difficulty. |
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| individual's sense of personal effectiveness while performing an activity |
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personal causation
values-importance and worth attached to an activity
interests |
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| during volitional process an individual: |
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anticipates what engagement in the activity will be like
chooses to begin or terminate an activity based on interests, values and sense of control
experiences that engagement in a variety of ways
interprets and makes sense of his or her actions and experiences |
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| is ongoing and shapes an individual's future engagement in occupations. |
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preserve a way we have learned to do something from earlier performance in a given environment and allow performance to be more efficient and more effective.
things we do without thinking about them |
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| help determine the manner and content of our actions and the types of things that are done-they partition our time. |
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| supported by the state of ones physical and mental components as well as the subjective experience of living within one's body. |
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this is self explanatory but the book says:
each environment impacts an individual in a different way depending on that person's volition, habituation and performance capacity |
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allow rapport and a greater understanding of a patient's histroy and concernes
Occupational Performance History Interview (OPHI-II)
Occupational Circumstances Assessment Interview and Rating Scale (OCAIRS) |
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| Occupational Performance History Interview (OPHI-II) |
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Definition
semi-structured historical interview
Rasch measurement
convert ordinal patient ratings to interval measures
provides therapist with individual patient measure and error.
patient can reflect and actively construct meaning from past and current occupational participation
Therapists guides using questions to elicit narratives from the patient.
The narratives enable individuals to integrate their past, present, and future into a coherent whole.
The info the therapist and patient gather during the interview is then used to complete three rating scales and plot a life history. |
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Term
| organization of the OPHI-II |
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Definition
questions grouped according to three MOHO concepts:
Occupational Identity
Occupational competence
Occupational settings (environment)
Each has a 4 point rating scale of occupational fnctioning and items about past and current occupational participation |
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| Occupational Identity Section of OPHI-II |
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Definition
captures a person's sense of self as an occupational being and level of self awareness through the following items:
has personal goals and projects
identifies a desired occupational lifestyle
expects success
accept responsibility
appraises abilities and limitations
has commitments and values
recognizes identity and obligations
has interests
felt effective(in the past)
found meaning/satisfaction in lifestyle (in past)
made occupational choices |
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| Occupational Competence Scale in the OPHI-II |
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Definition
reflects ones ability to maintain a routine, actualize an identity and meet demands and responsibilities
Items include:
maintains satisfying lifestyle
fulfills role expectations
works toward goals
meets personal performance standards
organizes time for responsibilities
participates in interests
fulfilled roles (in past)
maintained habits (in the past)
achieved satisfaction (in the past) |
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| Occupational Settings Scale in the OPHI-II |
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Definition
captures the influence of the physical and social environment on a person's occupational participation
encompasses a range of everyday environments in which individuals participate in work, play or ADL as reflected in :
home-life occupational forms
major productive role occupational forms
leisure occupational forms
home-life social groups
major productive role social groups
leisure social groups
home-life physical space, objects and resources
major productive role physical space, objects and resources
leisure physical space, objects and resources |
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| other uses for the OPHI-II |
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Definition
| while the ratings help to identify factors contributing to problems in occupational adaptation, therapists can also use the keyforms to obtain instantaneous patient measures to monitor progress and evaluate intervention success |
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| what happens if therapist is unable to rate a patient on an item in the OPHI-II? |
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Definition
sometimes this will happen due to its irrelevance to a person's particular situation or lack of adequate information.
The therapist can visually inspect the patterns of ratings using the keyform to approximate a patient measure |
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| final step in completing the OPHI-II |
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Definition
plotting of the patient's life history narrative
Drawing out a plot line that reflects the narratives elicited from the patient during the interview
the slopes are helpful when planning intervention goals and patients report finding them motivational and helpful for understanding life histories |
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| final step in completing the OPHI-II |
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Definition
plotting of the patient's life history narrative
Drawing out a plot line that reflects the narratives elicited from the patient during the interview
the slopes are helpful when planning intervention goals and patients report finding them motivational and helpful for understanding life histories |
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Term
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Definition
25 years of development
the first version confirmed that there was acceptable inter-rater and test retest reliability
construct validity
internal validity proven in 6 languages
revisions were made to improve the interview process
psychometric analysis of the test using Rasch measurement theory revealed that there were 3 underlying constructs of occupational adaptation; as a result the three subscales of occupational competence, occupational identity and the occupational environment were created. |
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| OCAIRS-The Occupational Circumstances Assessment Interview and Rating Scale |
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Definition
semi structured interview
qualitative and quantitative info
developed by Kaplan and kielhofner
provides three semi-structured interview formats, designed for use in physical rehabilitation, mental health and forensic mental health
they are administered and therapists then use the info. to rate patients on 12 items using a shared 4 point rating scale |
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Term
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Definition
1. roles
2. habits
3. personal causation
4. values
5. interests
6. skills
7. short-term goals
8. long term goals
9. interpretation of past experiences
10. physical environment
11. social environment
12.readiness for change |
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| major difference between OCAIRS and OPHI-II |
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Definition
OCAIRS can be completed in 20-30 minutes
can systematically identify factors impacting occupational participation while providing the therapist with an opportunity to understand a patient's perception of current circumstances |
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items rated according to how it facilitates, allows, inhibits or restricts occupational participation
each rating has descriptive statements to assist the therapist in making a rating decision.
THEY ALLOW THE THERAPIST TO SPEND TIME REFLECTING ON THE PATIENT RATHER THAN ON RESEARCHING THE INTENDED MEANING OF THE ITEM.
therapist makes a rating based on the available info and the item's overall impact ont he patient's occupational participation.
can use the summary form to indicate the need for OT intervention |
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Definition
inter-rater reliability
OCAIRS scores have shown to discriminate between patients who are in need of occupational therapy services and those who are not as well as between those with varying severities of psychiatric disorder.
recognized as cross-cultural assessment of Occupational functioning. |
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| when the OT understands how the volitional process works what can be drawn from observing? |
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Definition
| interests, values, and a person's sense of causation when person engaged in both familiar and unfamiliar occupations. |
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| used to assess the volition of individuals who are unable to communicate their sense of volition due to significant limitations in cognitive, verbal or physical ability |
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| two types of info yielded by VQ |
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Definition
understanding of a person's inner motives
corresponding sense of personal causation, interests and values and info. about how specific environments enhance or attenuate that sense of volition |
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Definition
takes from 5-30 minutes
therapists uses professional skills and provides visual, verbal or physical support as needed.
Seeks to reveal how confident someone feels doing an activity, how important the activity is and how enjoyable the activity is:
shows curiosity
initiates actions/tasks
tries new things
shows pride
seeks challenges
seeks additional responsibilities
tries to correct mistakes
tries to solve problems
shows preferences
pursues an activity to completion/accomplishment
stays engaged
invests additional energy/emotion/attention
indicates goals
shows that an activity is special or significant |
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| what to do if you observe a patient in two different settings and volition differs across the settings |
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Definition
should consider how the environmental characteristics differ across the settings
This way you can identify the interests and values of a patient who is unable to verbally share info and also describe the environments that are most supportive and motivating |
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Term
| psychometric properties of the VQ |
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Definition
confirmed theory of volitional development in stages
stage1:exploration stage-tries to do things in order to discover capacities, interests and values
stage
2: competence stage-individual begins to practice these capacities and to work toward goals.
3. Final stage: volitional achievement-new challenges are sought and accomplished
good content validity
sensitive to detect different levels of volition for different patients
Kielhofner warned that those using it should be familiar with MOHO concepts an the Remotivation process-intervention based on the VQ and volitional development |
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| Assessment of Communication and Interaction Skills (ACIS) |
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Definition
formal observational tool
designed to measure performance in occupational forms within a social group
can help to determine strengths and weaknesses in interacting and communicating with others in the course of daily occupations
developed for use in wide range of settings
Observations done in places of importance to the client and relevant to their life |
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Term
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Definition
no standardized situations, the ACIS does not adjust scores for the type of social group or task in which the person is observed.
Instead a format exists for classifying the context of observation and its degree of approximation to the kind of everyday social situations the patient performs or wants to perform
Single scale that consists of 19 skill items divided into three communication and interaction domains
physicality
information exchange
relations
rated on a 4 point scale with focus on impact of skills on both the progression of the social interaction and the occupational form and the impact on other persons with whom the patient interacts |
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Term
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Definition
comes with a detailed manul to instruct and guide the therapist in its use. It provides criteria and examples.
therapist begins by interviewing the patient (or family member) in order to ascertain appropriate and meaningful contexts in which to observe the patient.
The therapist then observes patients' communication and social interaction while engaging with others to complete an occupational form. Can be the group leader or a participant. Therefore can be administered during a session.
20-60 minutes
observation 15-45
ratings take 5-20 minutes depending on how detailed the therapist gets
best to try and do 1 patient per session |
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Definition
modest inter-rater reliability with first version
after revision there was evidence that the items worked well together to constitute a single scale of communication/interaction
study with those with wide range of psychosocial impairments, findings of a single valid measure of communication/interactions skills
consistent with large sample of raters |
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| The Occupational Self Assessment and the child occupational self-assessment |
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Definition
developed to assess the MOHO concepts of occupational competence and value for occupation through client self-report
OSA age 18+
COSA 8-18 years
two part self-report |
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| administration of the OSA and COSA |
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Definition
two part self-report
clients have a list of items that represent a range of everyday activities.
21 items on the OSA include "taking care of the place I live
identifying and solving problems and getting along with others
COSA has 25 items and cover typical activities in school, home and in the community.
first clients use a 4 point scale to rate how well they do each activity. (sense of occupational competence)
next clients use a 4 point scale to rate how important the activity is to them-reflects the value for the occupation wich is an aspect of occupational identity
client and therapist review the responses to identify areas that are a priority to the client. |
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| research and development of OSA and COSA |
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Definition
reliable and valid measures of client competence and value for occupation
OSA items work in a valid and reliable manner across culural, diagnostic and language differences
Can be used as an outcome measure
COSA valid and reliable assessment tool
items are valid for measures of competence and value for occupation |
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| assessments that use a variety of data gathering methods |
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Definition
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| The Model of Human Occupation Screening Tool (MOHOST) |
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Definition
developed by a therapist in busy acute care mental health unit
Occupation-based screening tool that allows a therapist to identify patient strengths and needs while formally documenting occupational therapy knowledge that often goes unrecognized.
flexible assessment
can gather info in variety of ways
intended to be used with variety of patients and settings
24 MOHOST items arranged into 6 main concepts
1. motivation for occupation
2. Pattern of occupation
3. communication and interaction skills
4. process skills
5. motor skills
6. environment
no terms of volition or habituation
uses more familiar words to convey ideas to patients, families and others.
4 point rating scale indicates how occupational participation is facilitated or restricted by patient or environmental factors.
other moho assessments encouraged with this one |
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| Research and development of MOHOST |
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Definition
can discriminate between patients with differing levels of occupational participation
validly represent the construct of occupational participation and can be used in a valid manner across a variety of intervention settings-community-based, forensic and acute mental health settings.
not proven psychometrically sound just yet. |
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