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Occupational Therapy and Arts Therapies

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/25

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Author: search.filters.author.Kielhofner, G.Has files: Yes

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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.
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    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.
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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.
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    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.
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    Developing the Occupational Self Assessment: the use of Rasch analysis to assure internal validity, sensitivity and reliability.
    (College of Occupational Therapists, 2009-03) Kielhofner, G.; Forsyth, Kirsty; Kramer, Jessica; Iyenger, Anita
    This paper reports the results of three studies that examined the internal validity, sensitivity and reliability of the Occupational Self Assessment (OSA), a self-report of Occupational Competence and Value for occupational performance and participation (Baron et al 2006). All three studies used a Rasch measurement approach to explore the psychometric properties of iterative versions of the OSA. The first study showed that the 'Myself' Occupational Competence and Values items constituted a unidimensional construct, but did not discriminate optimally between participants. The results also suggested that the two 'My Environment' scales did not contain enough items to exhibit adequate measurement properties. Next, the rating scales were changed from three-point to four-point categories. The second study examined these changes and provided evidence to support the use of a four-point Occupational Competence scale. The Values rating scale was further revised because sensitivity did not improve. The third study confirmed that the OSA items in combination have good internal validity and measure the unidimensional constructs of Occupational Competence and Values. Further, both four-point rating scales resulted in improved person separation, indicated increased sensitivity, and could be used in a consistent manner by 90% of participants with a range of disabilities from a variety of contexts. The College of Occupational Therapists Ltd.
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    The Occupational Self Assessment: Stability and the Ability to Detect Change over Time
    (2010) Kielhofner, G.; Dobria, Lidia; Forsyth, Kirsty; Kramer, Jessica
    The Occupational Self Assessment (OSA) was designed to guide collaborative treatment planning and measure client-reported change to document therapy outcomes. This study examined the stability of the OSA and its ability to detect changes in reported Competence and Values. The OSA was administered twice to 112 participants with disabilities 58 to 650 days apart. A Rasch rating scale model was used to analyze the data and determine the stability. Competence and Values items were stable over time. The Competence rating scale was used by participants in the same manner at both administrations. However, the Values rating scale was used differently at time 2; participants were less likely to use the Values rating scale category More important at time 2. Thirty-two percent and 49% of participants had significantly different measures at time 2 on Competence and Values scales, respectively. This study lends support for the use of the OSA as a client-reported outcome measure.