Browsing by Person "Heasman, D."

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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.
Impact of using the Model of Human Occupation: A survey of occupational therapy mental health practitioners' perceptions
(2012-09) Lee, S. W.; Kielhofner, G.; Morley, M.; Heasman, D.; Garnham, M.; Willis, Suzie; Parkinson, S.; Forsyth, Kirsty; Melton, J.; Taylor, R. R.
Aim: While little is known about how occupational therapists perceive the use of occupation-focused theory in their practice, evidence indicates that it has been called for in the profession. To date, the Model of Human Occupation (MOHO) is the most widely used model internationally. The aim of this study is to document practitioners' perceptions of how using MOHO impacted on their practice. Methods: A descriptive study using an Internet-based survey study design was conducted with 429 therapists in six National Health Service (NHS) trusts in the UK. Results: Of the 429 therapists, 262 completed the survey, for a response rate of 61.07%. Most were female (85.5%) with a varying range of years of experience. Most worked in community and/or inpatient mental health settings; 92.1% responded that they use MOHO as their primary model. Therapists reported using MOHO moderately to greatly improve their assessment, goal setting, and conduct of relevant interventions as well as professional identity as an OT in their mental health occupational therapy practice. Conclusion/Implications: This study examined therapists' perceived impact of using an occupation-focused model in mental health practice. The findings of this study provided promising results. Findings suggest that the utilization of MOHO increases service for clients and professional stature and identity for therapists. 2012 Informa Healthcare.
Mental health payment-by-results clusters and the model of human occupation screening tool
(2013-12) Lee, S. W.; Forsyth, Kirsty; Morley, M.; Garnham, M.; Heasman, D.; Taylor, R. R.
In the United Kingdom, payment for mental health services follows a system of payment-by-results. A mental health clustering tool, classifying individuals into clusters based on service needs, was developed as a broad-based means of planning care packages. It is yet unknown whether payment-by-results clusters will be reflective of the occupational needs of service users. To evaluate the relationship between service users' membership in service need clusters and occupational groupings based on outcomes from an independent measure on participation and engagement in self-care, productivity, and leisure (Model of Human Occupation Screening Tool [MOHOST]), retrospective medical record data were gathered from 675 service users with a range of psychiatric disorders from two organizations in England. Using six subscales of the MOHOST, the two-step cluster analysis identified occupational groupings. Then the multivariate analysis of variance was used to examine whether the mean scores of the six MOHOST subscales were significantly different across the occupational groupings. Finally, participants' membership in the payment-by-results clusters was compared to their membership in the occupational groupings. Participants fell into one of three levels: high-, middle-, or low-functioning occupational groups. These groups did not bear direct relationships with the individual payment-by-results clusters. This suggests that the mental health clustering tool and the MOHOST are likely targeting different characteristics in the service users. Copyright American Occupational Therapy Foundation.
The development of care pathways and packages in mental health based on the model of human occupation screening tool
(College of Occupational Therapists, 2011-06) Lee, S. W.; Morley, M.; Taylor, R. R.; Kielhofner, G.; Garnham, M.; Heasman, D.; Forsyth, Kirsty
Purpose: Payment by Results (PbR) was recently introduced to mental health care in England. The system allocates service users to one of 20 clusters and will provide funding based on cluster membership, rather than on block contracts. Occupational therapists are challenged to define care packages for each of the clusters. Method: To facilitate their development, this study identified the occupational profiles of service users in each cluster based on measures offered by the Model of Human Occupation. The study used existing data from the clinical records of 625 service users from two organisations, collected through use of the Mental Health Clustering Tool and the Model of Human Occupation Screening Tool. Results: Across the sample, service users showed greatest problems with habituation, followed by volition and process skills. Qualitatively distinct occupational profiles were identified across the clusters. Service users with non-psychotic problems showed the least interference with occupational participation; those in clusters involving psychosis showed moderate levels of interference; and those in clusters involving cognitive impairment demonstrated the most difficulty with occupational participation. Conclusion: These findings provide an important evidence base for thinking about the occupational needs of service users within the various PbR clusters and the corresponding services that might be offered. The College of Occupational Therapists Ltd.