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Briskie-Semeniuk P, Bier N, Couture M, Vachon B, Belchior P. Describing Occupational Therapy Practice for Evaluating Older Adults with Cognitive Impairments. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2138676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Patricia Briskie-Semeniuk
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
| | - Nathalie Bier
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada
- Centre de recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Quebec, Canada
| | - Mélanie Couture
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre for Research and Expertise in Social Gerontology (CREGRÉS), Côte Saint-Luc, Quebec, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montréal, Quebec, Canada
| | - Patricia Belchior
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
- Centre de recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Quebec, Canada
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Yu STS, Brown T, Yu ML, Andrews H. Association between Older Adults' Estimated Length of Hospital Stay and Cognitive Performance. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1449162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Sze Tim Sonia Yu
- Department of Occupational Therapy, School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Mong-Lin Yu
- Department of Occupational Therapy, School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences Monash University – Peninsula Campus, Frankston, Victoria, Australia
| | - Hanna Andrews
- Casey Hospital, Monash Health, Berwick, Victoria, Australia
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Stigen L, Bjørk E, Lund A. The conflicted practice: Municipal occupational therapists' experiences with assessment of clients with cognitive impairments. Scand J Occup Ther 2018; 26:261-272. [PMID: 29489422 DOI: 10.1080/11038128.2018.1445778] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The practice of Norwegian occupational therapists (OTs) in municipal practice is a little explored area and with the Coordination Reform Act from 2012, Norwegian OTs in municipal practice have received responsibilities concerning clients with cognitive impairments. The aim of this study was to explore municipal OTs experiences with assessment of clients with cognitive impairments. METHOD Fourteen individual interviews with OTs who worked with clients with cognitive impairments, were conducted. An inductive thematic analysis, using text condensation and coding, was performed. RESULTS The results revealed three themes; power of occupation, advantages and disadvantages of assessments used and the need for competencies within municipal services. The participants emphasized using observation in the assessment process and reflected on pros and cons of the standardized assessment tools they used. They expressed a need for competence development, although it was difficult to prioritize to do so. CONCLUSION This study illustrated a conflicted practice related to choices OTs make in their practices. They valued the importance of working occupation based, however, they chose to use impairment based standardized assessments. They expressed a need to engage in professional development, but due to heavy workloads, the limited power they experienced and lack of knowledge, this was difficult.
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Affiliation(s)
- Linda Stigen
- a Department of Health Science , NTNU, Norwegian University of Science and Technology , Gjøvik , Norway
| | - Evastina Bjørk
- a Department of Health Science , NTNU, Norwegian University of Science and Technology , Gjøvik , Norway
| | - Anne Lund
- b Department of Occupational Therapy, Prosthetics and Orthotics , Oslo and Akershus University college , Oslo , Norway
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Conti J. Cognitive assessment: A challenge for occupational therapists in Brazil. Dement Neuropsychol 2017; 11:121-128. [PMID: 29213503 PMCID: PMC5710680 DOI: 10.1590/1980-57642016dn11-020004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/24/2017] [Indexed: 12/02/2022] Open
Abstract
Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. OBJECTIVE The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. METHODS The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. RESULTS The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). CONCLUSION There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice.
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Affiliation(s)
- Juliana Conti
- Occupational Therapy Division of the Hospital das
Clínicas/Sao Paulo University, São Paulo, SP, Brazil
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Stigen L, Bjørk E, Lund A, Cvancarova Småstuen M. Assessment of clients with cognitive impairments: A survey of Norwegian occupational therapists in municipal practice. Scand J Occup Ther 2017; 25:88-98. [PMID: 28049384 DOI: 10.1080/11038128.2016.1272633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND With the Coordination Reform Act initiated in 2012, Norwegian occupational therapists in municipal practice have been given responsibilities concerning clients with cognitive impairments. With emphasis on supporting best practice, the aim was to investigate the practice of Norwegian municipal occupational therapists (OTs) in their assessment of clients with cognitive impairments. METHOD An online questionnaire was used to collect data from 497 of 1367 OTs in Norwegian municipalities (RR = 36%) Results: The most frequently used methods were informal interviews (91%), observations (91%) and standardized assessments (73%). The most frequently used standardized assessments were the Clock Drawing test (60%) and the Mini Mental State Examination (MMSE 59%). The most common reasons for using standardized assessments were to get a better foundation for initiating interventions (74%), to get more reliable results (64%) and to measure the effect of interventions (47%). The most common reasons for not using standardized assessments were that they did not have competence (49%) or that they did not have access to the materials (40%). CONCLUSION The results indicate that there are challenges when it comes to the methods and standardized assessments used. These findings invite further research on enabling municipal OTs to move further towards evidence-based practice.
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Affiliation(s)
- Linda Stigen
- a Department of Health Science , NTNU, Norwegian University of Science and Technology , Gjøvik , Norway
| | - Evastina Bjørk
- a Department of Health Science , NTNU, Norwegian University of Science and Technology , Gjøvik , Norway
| | - Anne Lund
- b Department of Occupational Therapy, Prosthetics and Orthotics , Oslo and Akershus University College , Oslo , Norway
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van der Wijst E, Wright J, Steultjens E. The Suitability of the Montreal Cognitive Assessment as a Screening Tool to Identify People with Dysfunction in Occupational Performance after Mild Stroke. Br J Occup Ther 2014. [DOI: 10.4276/030802214x14122630932511] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Cognitive deficits are an important determinant for experiencing limitations in occupational performance after stroke. It is important to recognize these deficits, and their impact on daily activities, at an early stage so people can get the support they need. The non-challenging environment of a hospital hampers this recognition, making it difficult for occupational therapists to select which patients should be assessed extensively, and which not. This study aims to explore the Montreal Cognitive Assessment as a screening tool by investigating its relationship with occupational performance in patients with mild stroke. Method: Twenty-nine people with mild stroke were recruited for this cross-sectional study. Scores on the Montreal Cognitive Assessment and Assessment of Motor and Process Skills were compared and correlations were calculated. Findings: The Montreal Cognitive Assessment cut-off did not identify those who might experience problems in daily functioning after mild stroke. A moderate correlation was found between scores on the Montreal Cognitive Assessment and the Assessment of Motor and Process Skills process scores. Conclusion: The Montreal Cognitive Assessment cannot be used as a screening tool to identify problems in occupational performance after mild stroke.
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Affiliation(s)
- Elien van der Wijst
- Occupational Therapist, Jeroen Bosch Hospital, Tolbrug Allied Health Care, Hertogenbosch, Netherlands
| | - Jonathan Wright
- Principal Lecturer, School of Health Sciences, University of Brighton, Eastbourne, East Sussex
| | - Esther Steultjens
- Associate Professor in Neurorehabilitation, Research Department of Neurorehabilitation, HAN University of Applied Sciences, Nijmegen, Netherlands
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White A, Hocking C, Reid H. How Occupational Therapists Engage Adults with Cognitive Impairments in Assessments. Br J Occup Ther 2014. [DOI: 10.4276/030802214x13887685335427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: There is little discussion in the multidisciplinary literature about how to engage adults with cognitive impairments in health-related assessments. This qualitative descriptive study used semi-structured interviews to explore how nine occupational therapists working across a range of practice settings addressed this issue. Method: Interviews were digitally recorded and transcribed verbatim. Inductive analysis revealed themes, which were refined through an iterative process. Findings: The findings showed that the participants used individually developed strategies to engage clients in assessments. The first theme, ‘Managing a complex process’, described the steps used with clients and families to obtain informed consent, prepare for the assessment, and consider the impact of having a third party present. The second theme, ‘Recruiting cooperation’, addressed how the participants used their relationship with clients to recruit them to engage in the assessment. Conclusion: The findings provided a snapshot of processes employed in practice to determine the needs and capabilities of clients with cognitive impairments, and the compromises therapists make in relation to eliciting informed consent and the integrity of formal assessment tools. The findings have implications for the profession and further research.
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Affiliation(s)
- Amanda White
- Occupational Therapist, Waitemata District Health Board, Occupational Therapy, Auckland, New Zealand
| | - Clare Hocking
- Professor, Occupational Therapy, Aukland University of Technology, Auckland, New Zealand
| | - Heleen Reid
- Senior Lecturer, Auckland University of Technology, Occupational Science and Therapy, Auckland, New Zealand
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Sansonetti D, Hoffmann T. Cognitive assessment across the continuum of care: the importance of occupational performance-based assessment for individuals post-stroke and traumatic brain injury. Aust Occup Ther J 2013; 60:334-42. [PMID: 24089985 DOI: 10.1111/1440-1630.12069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM When working with individuals following stroke or traumatic brain injury, an important role of the occupational therapist is to assess the impact of cognitive impairment on their ability to engage in occupations and resume important life roles. The aim of this study was to survey therapists' reasons for selection of and challenges with using various cognitive assessment approaches, across the continuum of care, when working with individuals following stroke and traumatic brain injury. METHODS A cross-sectional survey, completed via post or online, with responses from 209 Australian occupational therapists was conducted. Participants included clinicians working in acute, inpatient rehabilitation and community settings. RESULTS Occupational performance-based assessments were ranked as the most important assessment method, with 69% of participants reporting using these assessments for more than 75% of their clients with cognitive impairment. Participants identified the lack of quantitative data provided by these assessments as a frequent challenge. The identification of cognitive deficits was the highest ranked reason for using cognitive screens and batteries. Challenges identified with using cognitive screens and batteries included difficulty linking assessment results to occupational performance, and difficulty using results to generate intervention strategies. The majority of participants reported using a combined approach to assessment, and used screens and batteries to support findings of occupational performance-based assessments. CONCLUSIONS Targeted efforts to further incorporate standardised occupational performance-based methods into clinical practice, research, and ongoing professional development is required to enhance occupational therapy services when working with individuals with cognitive impairment.
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Affiliation(s)
- Danielle Sansonetti
- Occupational Therapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia; Eastern Health, Melbourne, Victoria, Australia
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Hatfield JP, Hirsch JK, Lyness JM. Functional impairment, illness burden, and depressive symptoms in older adults: does type of social relationship matter? Int J Geriatr Psychiatry 2013; 28:190-8. [PMID: 22495689 PMCID: PMC3417080 DOI: 10.1002/gps.3808] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/09/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The nature of interpersonal relationships, whether supportive or critical, may affect the association between health status and mental health outcomes. We examined the potential moderating effects of social support, as a buffer, and family criticism, as an exacerbating factor, on the association between illness burden, functional impairment and depressive symptoms. METHODS Our sample of 735 older adults, 65 years and older, was recruited from internal and family medicine primary care offices. Trained interviewers administered the Hamilton Rating Scale for Depression, Duke Social Support Inventory, and Family Emotional Involvement and Criticism Scale. Physician-rated assessments of health, including the Karnofsky Performance Status Scale and Cumulative Illness Rating Scale, were also completed. RESULTS Linear multivariable hierarchical regression results indicate that social interaction was a significant buffer, weakening the association between illness burden and depressive symptoms, whereas perceived social support buffered the relationship between functional impairment and depressive symptoms. Family criticism and instrumental social support were not significant moderators. CONCLUSIONS Type of medical dysfunction, whether illness or impairment, may require different therapeutic and supportive approaches. Enhancement of perceived social support, for those who are impaired, and encouragement of social interactions, for those who are ill, may be important intervention targets for treatment of depressive symptoms in older adult primary care patients.
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Douglas AM, Letts LJ, Richardson JA, Eva KW. Validity of predischarge measures for predicting time to harm in older adults. The Canadian Journal of Occupational Therapy 2013; 80:19-27. [DOI: 10.1177/0008417412473577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Concern is often expressed about the ability of persons with cognitive impairment to manage safely after discharge home from hospital. Measures validated for predicting safety are required. Purpose. The purpose of this study was to determine whether two predischarge functional measures were valid for predicting time to incident of harm after discharge. Method. Participants ( n = 47) were recruited from an inpatient rehabilitation unit. The Assessment of Motor and Process Skills (AMPS) and Cognitive Performance Test (CPT) were administered in hospital. Incident-of-harm outcome was measured by caregiver telephone questionnaire monthly for 6 months. Findings. Compared with all independent variables, AMPS Process scale was the best single predictor of time to incident of harm ( p = .01). CPT had a high specificity (91%) for identifying persons who did not have harm. Implications. Both AMPS and CPT demonstrated predictive validity for harm outcome over less predictive variables, such as comorbidities and activities-of-daily-living burden of care.
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Use of the cognitive performance test for identifying deficits in hospitalized older adults. Rehabil Res Pract 2012; 2012:638480. [PMID: 22720163 PMCID: PMC3361339 DOI: 10.1155/2012/638480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 02/26/2012] [Accepted: 02/28/2012] [Indexed: 11/18/2022] Open
Abstract
Objectives. The Cognitive Performance Test (CPT) is a functional assessment for persons with dementia. The study purpose was to evaluate the reliability, discriminant, and concurrent validity of the CPT.
Method. The CPT was tested against other measures of cognition (Standardized Mini Mental Status Exam (SMMSE) and Assessment of Motor and Process Skills-Process scale (AMPS-Process)). Participants were persons 65 years and older admitted to a geriatric rehabilitation unit (n = 47).
Results. The CPT correlated moderately with measures of cognition (SMMSE r = 0.47, AMPS-Process r = 0.53, P < 0.01), and ADL burden of care (FIM r = 0.32, P < 0.05). Scores were not affected by age, sex, years of education, motor skills, or comorbidities. The CPT differentiated between impaired and unimpaired individuals differently from other measures. Conclusion. While CPT appears related to other measures of cognition, test interpretation requires noting the variability between CPT scores and those measures.
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Asimakopulos J, Boychuck Z, Sondergaard D, Poulin V, Ménard I, Korner-Bitensky N. Assessing executive function in relation to fitness to drive: a review of tools and their ability to predict safe driving. Aust Occup Ther J 2011; 59:402-27. [PMID: 23174109 DOI: 10.1111/j.1440-1630.2011.00963.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIM The assessment of executive functions is an integral component in determining fitness to drive. A structured review was conducted to identify assessment tools used to measure executive function in relation to driving and to describe these tools according to: (i) specific executive function components assessed; (ii) the tool's validity in predicting safe driving; and (iii) clinical utility. METHODS Sixty-nine articles were reviewed, identifying 53 executive function tools/assessments used in driving research. Each tool was critically appraised and the findings were compiled in a Driving Executive Function Tool Guide. RESULTS Among the 53 tools, there were 27 general assessments of cognition, 19 driving-specific and seven activities of daily living/instrumental activities of daily living assessments. No single tool measured all executive function components: working memory was the most common (n = 20/53). Several tools demonstrated strong predictive validity and clinical utility. For example, tools, such as the Trail Making Test and the Maze Task, have the shortest administration time (i.e. often less than 10 minutes) and the most easily accessible method of administration (i.e. pen and paper or verbal). Driving-specific tools range from short questionnaires, such as the 10-minute Manchester Driving Behaviour Questionnaire, to more complex tools requiring about 45 minutes to administer. CONCLUSIONS AND SIGNIFICANCE OF THE STUDY: The appropriateness of a tool depends on the individual being assessed and on practical constraints of the clinical context. The Driving Executive Function Tool Guide provides useful information that should facilitate decision-making and selection of appropriate executive function tools in relation to driving.
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Affiliation(s)
- Julia Asimakopulos
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
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Vrkljan BH, McGrath CE, Letts LJ. Assessment Tools for Evaluating Fitness to Drive: A Critical Appraisal of Evidence. The Canadian Journal of Occupational Therapy 2011; 78:80-96. [DOI: 10.2182/cjot.2011.78.2.3] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background. Many office-based assessment tools are used by occupational therapists to predict fitness to drive. Purpose. To appraise psychometric properties of such tools, specifically predictive validity for on-road performance. Methods. A literature search was conducted to identify assessment tools and studies involving on-road outcomes (behind-the-wheel evaluation, crashes, traffic violations). Using a standardized appraisal process, reviewers rated each tool's psychometrric properties, including its predictive validity with on-road performance. Findings. Seventeen measures met the inclusion criteria. Evidence suggests many tools do not have cut-off scores linked with on-road outcomes, although some had stronger evidence than others. Implications. When making a determination regarding driver fitness, clinicians should consider the psychometric properties of the tool as well as existing evidence concerning its utility in predicting on-road performance. Caution is warranted in using any one office-based tool to predict driving fitness; rather, a multifactorial-based assessment approach that includes physical, cognitive, and visual-perceptual components, is recommended.
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Affiliation(s)
| | - Colleen E. McGrath
- Colleen E. McGrath, MSc, O.T. Reg. (Ont.), Occupational Therapist, is doing her PhD in Health and Rehabilitation Sciences at The University of Western Ontario, London, ON, Canada
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Hansen T, Kjaersgaard A, Faber J. Measuring elderly dysphagic patients' performance in eating--a review. Disabil Rehabil 2011; 33:1931-40. [PMID: 21291339 DOI: 10.3109/09638288.2011.553706] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This review aims to identify psychometrically robust assessment tools suitable for measuring elderly dysphagic patients' performance in eating for use in clinical practice and research. METHOD Electronic databases, related citations and references were searched to identify assessment tools integrating the complexity of the eating process. Papers were selected according to criteria defined a priori. Data were extracted regarding characteristics of the assessment tools and the evidence of reliability, validity and responsiveness. Quality appraisal was undertaken using developed criteria concerning the study design, the statistics used for the psychometric evaluation and the reported values. RESULTS Eight of fourteen identified assessment tools met the inclusion criteria. Three assessment tools were specific to dementia, two were specific to stroke and three targeted a range of neurological and geriatric conditions. The rigor of the assessment tools' psychometric properties varied from no evidence available to excellent evidence. Only two assessment tools were rated adequate to excellent. CONCLUSION 'The Minimal Eating Observation Form-Version II' to be used for screening and 'The McGill Ingestive Skills Assessment' to be used for treatment planning and monitoring appeared to be psychometrically robust for clinical practice and research. However, further research on their psychometric properties is needed.
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Affiliation(s)
- Tina Hansen
- Department of Occupational Therapy 53P1, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark.
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