Browsing by Person "Forsyth, Kirsty"

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A Factor Analytic Study of the Model of Human Occupation Screening Tool of Hypothesized Variables
(2009) Kielhofner, G.; Fogg, Lou; Braveman, Brent; Forsyth, Kirsty; Kramer, Jessica; Duncan, Edward
The Model of Human Occupation (Kielhofner, 2008) postulates that occupational participation is influenced by volition, habituation, three skill areas, and the environment. The Model of Human Occupation Screening Tool (MOHOST) (Parkinson, Forsyth, Kielhofner, 2004) was developed to provide a broad assessment of the factors that influence a client's occupational participation. The purpose of this study was to ask whether there was evidence that the items of the MOHOST meaningfully cluster into these theoretical sub-constructs. Nine occupational therapists used the MOHOST with 166 clients in the US and the UK, and a series of confirmatory factor analyses (CFA) were conducted. The six-dimensional model fit better than the one-dimensional model, and the standardized coefficients also indicated that the items were well designed and captured each factor. The results of this study confirmed the hypothesis that the MOHOST contains six factors and provides further evidence of the validity of the MOHOST.
A multi-disciplinary framework and rapid assessment tool for developmental co-ordination disorder services.
(2009-08) Forsyth, Kirsty; Maciver, Donald; Howden, Stella; Owen, Christine; Shepherd, C.; Rush, Robert
A national study to investigate the clinical use of standardised instruments in autism spectrum disorder assessment of children and adults in Scotland
(Elsevier, 2016-07-07) Rutherford, Marion; McKenzie, Karen; McClure, Iain; Forsyth, Kirsty; O'Hare, Anne; McCartney, Deborah; Finlayson, Ian R.; Scottish Government
Background: There are few large scale studies about the nature and extent of the actual use of standardised assessments for Autism Spectrum Disorder diagnosis in clinical practice. This study compares and contrasts practice in diagnostic services for both adults and children. Method: We conducted an analysis of retrospective case notes from 150 cases (70 adult, 80 children) assessed for Autism Spectrum Disorder by 16 diagnostic services. Results: We found differences between adult and child services in staff training and use of standardised assessment during diagnosis. All child services had staff trained in and regularly using standardised assessments. Most adult services had staff trained in using instruments but only half used them regularly. Administration of standardised ASD assessments was ten times more likely in children than in adults (OR = 10.1; CI = 4.24, 24.0). Child services selected the ADOS as the standardised tool and Adult services selected the DISCO, with very little overlap. Decisions to administer standardised tools were not based on case complexity but rather the same process was applied to all referrals within a service. The three recommended components of assessment (clinical history, clinical observation and contextual information) were included for the majority of cases, although clinical observation was more frequently used with children than with adults. Conclusions: Based on the findings, we suggest a need for a wider range of appropriate assessments for use with adults, particularly those with an intellectual disability and for further research into the reasons behind the choices clinicians make during the assessment process. For child services in Scotland, there is a need for more training in use of current diagnostic interviews. Clinicians did not vary tools used based on complexity, suggesting that this is a notion still to be clearly defined and operationalised in clinical decision making about the use of standardised assessments.
A practice development programme to promote the use of the Model of Human Occupation: contexts, influential mechanisms and levels of engagement amongst occupational therapists
(College of Occupational Therapists, 2010-11) Melton, J.; Forsyth, Kirsty; Freeth, D.
This study evaluated a multifaceted, organisation-wide practice development (PD) programme in one National Health Service mental health and learning disabilities trust. Method: Individual differences in integrating the Model of Human Occupation in occupational therapists' daily practice were examined through in-depth qualitative, multimethod realistic evaluation. A stratified sample of all occupational therapists (n = 74) was achieved using a self-report survey. Semi-structured interviews at three time points, practice observation and documentation audit continued until saturation appeared highly likely and categories were well elaborated (n = 10). Findings: The findings indicated that environmental contexts, particularly the support of the immediate team, and the therapist's personal circumstances influenced MOHO use. The mechanisms that acted as catalysts for practice change were Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Know-how and Channelling Time. Four stages of MOHO integration, characterised as In the Hangar, On the Runway, Take-off and In the Air, were identified. Conclusion: Most studies of the uptake of PD treat people as relatively homogeneous, but they are not. Greater attention to individual differences, the mechanisms underpinning successful engagement and influencing contexts may result in better outcomes from PD investments. A degree of tailoring PD approaches to individual circumstances would be beneficial.
A psychometric study of the model of human occupation screening tool (MOHOST)
(2010-12) Kielhofner, G.; Fan, C-W; Morley, M.; Garnham, M.; Heasman, D.; Forsyth, Kirsty; Lee, S. W.; Taylor, R. R.
This study examined the psychometric properties of the Model of Human Occupation Screening Tool (MOHOST) using item response theory and classical test theory approaches for clients with psychiatric disorders. Data, including demographic variables and scores on the MOHOST and a version of the Health of the Nation Outcomes Scale, were retrieved from case records of 1039 adult psychiatric service users. Participants ranged in age from 18 to 102 and 57 were female and 43 were male. Most (94) were unemployed, retired, or receiving other education or training. The items that make up each of the MOHOST subscales demonstrated good discriminant validity and excellent goodness of fit showing that the items measured the MOHO constructs unidimensionally. All subscales were able to distinguish clients into at least three statistically distinct strata and showed convergence with an independent measure of functioning. Findings from this study must take into account implicit limitations associated with the use of Rasch analysis and classical test theory. At the same time, results did support use of the MOHOST for research and clinical purposes. The MOHOST demonstrated good construct validity, item separation reliability, and concurrent validity. As a measure of occupational participation, the MOHOST offers practitioners and researchers a valid and reliable measure of volition, habituation, communication/interaction skills, process skills, motor skills, and environmental influences on participation. 2010 Elsevier.
A Rasch analysis of the model of human occupation screening tool single observation form (MOHOST-SOF) in mental health
(SAGE, 2016-01) Maciver, Donald; Morley, M.; Forsyth, Kirsty; Bertram, N.; Edwards, T.; Heasman, D.; Rennison, J.; Rush, Robert; Willis, Suzie
Introduction This study examined the psychometric properties of the model of human occupation screening tool single observation form. Method Clinical records were extracted pre- and post-treatment for 152 mental health service users. Data were model of human occupation screening tool single observation form scores and demographics. We investigated the form using Rasch analysis; we also present an analysis of change over time. Results We identified four misfitting items and evidence of instability with respect to change over time. After anchoring to adjust for unstable estimates, it was possible to measure client change, and there were significant differences in scores pre-post treatment indicating client improvement in ability. Conclusion The study provides initial psychometric assessment of this version of the model of human occupation screening tool.
ACHIEVE - active in children's health: integrating evidence, valuing experience
(The Royal Society of Medicine Journals, 2012-06) Mulvanny, A.; Whitehead, Jacqueline; Forsyth, Kirsty; Maciver, Donald; Walsh, M.; Healthcare Improvement Scotland; Knowledge Transfer Partnership
The article discusses a study to develop a comprehensive procedure for continued assessment of children aged between of 0-18 years with attention deficit hyperactivity disorder (ADHD). The authors have designed a pathway incorporating 6 key performance indicators (KPIs) including a standardized classroom observation schedule, structured and equitable training opportunities and access to paediatric and Child and Adolescent Mental Health Services (CAMHS) occupational therapy where appropriate.
Activity analysis
(Elsevier, 2008) Kielhofner, G.; Forsyth, Kirsty
Adolescent psychosocial factors and participation in education and employment in young adulthood: A systematic review and meta-analyses
(Elsevier, 2021-07-30) Tayfur, Sumeyra N.; Prior, Susan; Singh Roy, Anusua; Irvine-Fitzpatrick, Linda; Forsyth, Kirsty
Adolescence is a critical period for successful transition into adulthood. This systematic review of empirical longitudinal evidence investigated the associations between adolescent psychosocial factors and education and employment status in young adulthood. Five electronic databases (MEDLINE, PsycINFO, CINAHL, ASSIA and ERIC) were searched. Meta-analysis was conducted by using odds ratios (OR) as our common effect size; a narrative synthesis of results was also completed. Of the 8970 references screened, 14 articles were included and mapped into seven domains, namely, behavioral problems, peer problems, substance use, prosocial skills, self-evaluations, aspirations and physical activity. The results showed that behavioral problems (overall OR: 1.48; 95% CI: 1.26–1.74) and peer problems (overall ORadj: 1.27; 95% CI: 1.02–1.57) were significantly associated with being out of education, employment and training (NEET) as young adults. Prosocial skills did not present a significant association (overall OR: 1.03; 95% CI: 0.92–1.15). Other domains were narratively synthesized. The role of substance use was less clear. Only a few studies were available for self-evaluations, aspirations and physical activity domains. Implications for research and practice are discussed.
Assessment of need and practice for assistive technology and telecare for people with dementia—The ATTILA (Assistive Technology and Telecare to maintain Independent Living At home for people with dementia) trial
(Elsevier, 2019-09-03) Forsyth, Kirsty; Henderson, Catherine; Davis, Lucy; Singh Roy, Anusua; Dunk, Barbara; Curnow, Eleanor; Gathercole, Rebecca; Lam, Natalie; Harper, Emma; Leroi, Iracema; Woolham, John; Fox, Chris; O'Brien, John; Bateman, Andrew; Poland, Fiona; Bentham, Peter; Burns, Alistair; Davies, Anna; Gray, Richard; Bradley, Rosie; Knapp, Martin; Newman, Stanton; McShane, Rupert; Ritchie, Craig; Talbot, Emma; Hooper, Emma; Winson, Rachel; Scutt, Bethany; Ordonez, Victoria; Nunn, Samantha; Lavelle, Grace; Howard, Robert
Introduction The objective of this study was to define current assistive technology and telecare (ATT) practice for people with dementia living at home.
Assessment: Choosing and Using Structured and Unstructured Means of Gathering Information
(Lippincott Williams & Wilkins, 2008) Kielhofner, G.; Forsyth, Kirsty; Kielhofner, G.
Assessments Combining Methods of Information Gathering
(Lippincott Williams & Wilkins, 2008) Forsyth, Kirsty; Kielhofner, G.; Kielhofner, G.
Assessments used with the Model of Human Occupation
(Slack Incorporated, 2007) Keller, J.; Kielhofner, G.; Forsyth, Kirsty; Hemphill-Pearson, B.
Assistive technology and telecare to maintain independent living at home for people with dementia: The ATTILA RCT
(NIHR, 2021-03) Gathercole, Rebecca; Bradley, Rosie; Harper, Emma; Davies, Lucy; Pank, Lynn; Lam, Natalie; Davies, Anna; Talbot, Emma; Hooper, Emma; Winson, Rachel; Scutt, Bethany; Montano, Victoria Ordonez; Nunn, Samantha; Lavelle, Grace; Lariviere, Matthew; Hirani, Shashivadan; Brini, Stefano; Bateman, Andrew; Bentham, Peter; Burns, Alistair; Dunk, Barbara; Forsyth, Kirsty; Fox, Chris; Henderson, Catherine; Knapp, Martin; Leroi, Iracema; Newman, Stanton; O'Brien, John; Poland, Fiona; Woolham, John; Gray, Richard; Howard, Robert
Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. This trial was set in 12 councils in England with adult social services responsibilities. Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01; = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12; = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group - control group difference: mean -£909, 95% confidence interval -£5336 to £3345) or in societal costs (intervention group - control group difference: mean -£3545; 95% confidence interval -£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval -0.204 to -0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events. A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants' health and social care or societal costs. Quality-adjusted life-years based on participants' EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire. Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial. Current Controlled Trials ISRCTN86537017.
Associations between adolescent psychosocial factors and disengagement from education and employment in young adulthood among individuals with common mental health problems
(Springer, 2022-03-11) Tayfur, Sumeyra N.; Prior, Susan; Singh Roy, Anusua; Maciver, Donald; Forsyth, Kirsty; Irvine-Fitzpatrick, Linda
Transition to adulthood can be a challenging developmental task for adolescents with common mental health problems and is linked to adverse outcomes such as ‘not in education, employment or training’ (NEET). This study investigated longitudinal associations between adolescent psychosocial factors (e.g., self-esteem, aspirations, bullying, physical activity) and later NEET status among individuals with common mental health problems (i.e., depression and anxiety). A secondary data analysis of the Next Steps cohort study was completed using waves 2 and 8. Psychosocial factors, mental health, and background characteristics were captured when participants were aged 15–16 years (wave 2) while still in compulsory education. The 12-item General Health Questionnaire was used to identify adolescents with common mental health problems. The study population consisted of 2224 participants (females 66.8%) of which 1473 (66.2%) were aged 15 years and 751 (33.8%) were aged 16 years in wave 2. The outcome was NEET status at ages 25–26 years (wave 8). The results showed that after adjusting for background characteristics, adolescent self-esteem, locus of control, bullying, physical activity, job aspirations, and attitudes to school predicted NEET status. Educational aspirations, substance use, and behavioural problems were not significantly associated with NEET status. These findings provide new insights into the role of adolescent psychosocial factors in the context of education and employment outcomes for youth at risk and highlight the necessity of targeted mental health support to improve life chances.
Carers’ involvement in telecare provision by local councils for older people in England: Perspectives of council telecare managers and stakeholders
(Cambridge University Press, 2019-10-08) Steils, Nicole; Woolham, John; Fisk, Malcolm; Porteus, Jeremy; Forsyth, Kirsty
This paper explores telecare manager and other ‘stakeholder’ perspectives on the nature, extent and impact of family and other unpaid/informal carers’ involvement in the provision of telecare equipment and services for older people. Data used in the paper are derived from a larger study on telecare provision by local councils in England. The paper aims to add to the growing evidence about carers’ engagement with electronic assistive technology and telecare, and considers this in the context of typologies of professionals’ engagement with carers. How carers are involved in telecare provision is examined primarily from the perspectives of senior managers responsible for telecare services who responded to an online survey and/or were interviewed in 2016 as part of a wider study. The perspectives of three unpaid carers were captured in a separate strand of the main study, which comprised more detailed case study interviews within four selected councils. Thematic and comparative analysis of both qualitative and quantitative survey data revealed the varied involvements and responsibilities that carers assumed during the telecare provision process, the barriers that they needed to overcome and their integration in local council strategies. Findings are discussed in the context of Twigg and Atkin's typology of carer support. They suggest that carers are mainly perceived as ‘resources’ and involvement is largely taken for granted. There are instances in which carers can be seen as ‘co-workers’: this is mainly around responding to alerts generated by the telecare user or by monitored devices, but only in those councils that fund response services. Though some participants felt that telecare devices could replace or ‘supersede’ hands-on care that involved routine monitoring of health and wellbeing, it was also acknowledged that its use might also place new responsibilities on carers. Furthermore, the study found that meeting carers’ own rights as ‘co-clients’ was little acknowledged.
Chapter 22: Applying the Model of Human Occupation to Individuals With Mental Health Conditions
(Wolters Kluwer, 2024) Melton, Jane C.; Harding, Becky; Cooper, John R.; Allen, Susan; Reed, Melissa; Forsyth, Kirsty; Prior, Susan; Maciver, Donald; Harrison, Michele; Raber, Christine; Quick, Laura
Communication and Documentation
(Lippincott Williams & Wilkins, 2008) Kielhofner, G.; Forsyth, Kirsty; Kielhofner, G.
Community‐based participation of children with and without disabilities
(Wiley, 2019-11-25) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, Kirsty
AIM To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities.
Defining the environment to support occupational therapy intervention in mental health practice
(SAGE, 2015-05-01) Harrison, Michele; Angarola, Rocco; Forsyth, Kirsty; Irvine, Linda
More than 450 million people have been estimated to have mental health disorders worldwide with many more experiencing mental health challenges, according to the World Health Organization. People with mental health challenges can find their environments not supportive of their engagement in meaningful daily activities of self-care, work and leisure. While occupational therapists value having an understanding of how the environment impacts on a person's occupational participation, it has been argued that the concept has been poorly defined. The Model of Human Occupation provides a clinically useful definition of the environment. Moreover, the Model of Human Occupation provides clinical assessments and outcome measures that measure how the environment facilitates occupational participation. The Author(s) 2015.