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Nielsen KT, Andersen U, Wæhrens EE, von Bülow C. Quality of ADL task performance in persons with schizophrenia: Looking beyond independence. Scand J Occup Ther 2023:1-10. [PMID: 36635973 DOI: 10.1080/11038128.2023.2165541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Persons with schizophrenia may experience decreased ability to perform activities of daily living (ADL) indicated by need for assistance in everyday life. Others are independent, but their quality of ADL task performance in terms of effort and efficiency may still be impacted. AIMS/OBJECTIVES The overall purpose of this study was to explore the quality of ADL task performance in subgroups with schizophrenia (independent/needing assistance). MATERIALS AND METHODS Participants were in- and outpatients at a Psychiatric Hospital diagnosed with schizophrenia (n = 83). Their quality of ADL task performance was evaluated using the Assessment of Motor and Process Skills (AMPS). Evaluations were conducted at the hospital. Two subgroups (A: independent and B: needing assistance) were created based on AMPS ADL ability measures. RESULTS The majority in both subgroups had AMPS ADL ability measures within the risk zones. Further, the majority in subgroup A had ADL ability measures within age expectations but below mean for well persons of the same age. Both ineffective motor and process skills were identified in both subgroups. CONCLUSIONS/SIGNIFICANCE Occupational therapy is indicated for persons with schizophrenia, both for independent persons and for persons needing assistance. This is to prevent decline in or to enhance ADL ability.
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Affiliation(s)
- Kristina Tomra Nielsen
- The Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark.,Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Andersen
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,The Department of Occupational Therapy, Copenhagen University College, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, Occupational Science, User Perspectives and Community-Based Research, University of Southern Denmark, Odense, Denmark
| | - Cecilie von Bülow
- Occupation-Centered Occupational Therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Fabricius J, Huynh MNM, Pedersen AR, Sampedro Pilegaard M. Predicting length of stay with assessment of motor and process skills in subjects with acquired brain injury. Brain Inj 2023; 37:1-6. [PMID: 36597272 DOI: 10.1080/02699052.2022.2163291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/30/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The Functional Independence Measure (FIM) is a well-established predictor of length of stay (LOS) for rehabilitation. The Assessment of Motor and Process Skills (AMPS) is a more in-depth construct for measuring activities of daily living (ADL) and may therefore be a valuable adjunct when predicting LOS. This paper aimed to investigate AMPS as a candidate predictor of LOS in a statistical model including FIM. METHODS A cohort study of 647 patients with acquired brain injuries admitted for rehabilitation. LOS was analyzed in a multiple regression model with the motor and process/cognitive domains of AMPS and FIM. RESULTS Independence in ADL process ability and FIM cognition were associated with 31% (p < 0.001) and 38% (p < 0.001) shorter LOS, respectively, relative to patients needing total assistance. Independence in ADL motor ability was associated with a 26% (p = 0.002) shorter LOS, whereas FIM motor was not a predictor. CONCLUSIONS The AMPS predicts LOS for rehabilitation at a level that is at least as good as that of FIM. Conducting the AMPS early in the course of inpatient rehabilitation provides clinicians and managers with valuable information for planning LOS.
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Affiliation(s)
- Jesper Fabricius
- Department of Research, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Martin Nhut Minh Huynh
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Asger Roer Pedersen
- Department of Research, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - Marc Sampedro Pilegaard
- Department of Social Medicine and Rehabilitation, Gødstrup Hospital, Denmark
- DEFACTUM, Central Region Denmark, Aarhus, Denmark
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3
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Mallinson T, Kozlowski AJ, Johnston MV, Weaver J, Terhorst L, Grampurohit N, Juengst S, Ehrlich-Jones L, Heinemann AW, Melvin J, Sood P, de Winckel AV. Rasch Reporting Guideline for Rehabilitation Research (RULER): The RULER Statement. Arch Phys Med Rehabil 2022; 103:1477-1486. [PMID: 35421395 DOI: 10.1016/j.apmr.2022.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
The application of Rasch Measurement (RM) Theory to rehabilitation assessments has proliferated in recent years. RM Theory helps design and refine assessments so that items reflect a unidimensional construct, in an equal interval metric that distinguishes among persons of different abilities in a manner that is consistent with the underlying trait. Rapid growth of RM in rehabilitation assessment studies has led to inconsistent results reporting. Clear, consistent, transparent reporting of RM Theory results is important for advancing rehabilitation science and practice based on precise measures. Precise measures, in turn, provide researchers, practitioners, patients, and other stakeholders with tools for effective decision-making. The goal of this Rasch Reporting Guideline for Rehabilitation Research (RULER) is to provide peer-reviewed, evidence-based, transparent, and consistent recommendations for reporting studies that apply RM Theory in a rehabilitation context. The purpose of the guideline is to ensure that authors, reviewers, and editors have uniform expectations about how to write and evaluate research on rehabilitation outcome assessments. A task force of rehabilitation researchers, clinicians, and editors met regularly between November 2018 and August 2020 to identify the need for the guideline, develop an organizing framework, identify content areas, and develop the recommendations. This RULER statement includes the organizing framework and a checklist of 59 recommendations. The guideline is supported by an Explanation & Elaboration manuscript that provides more detail about the framework and recommendations in the checklist. A glossary of key terms and a recommended iterations table are provided in supplemental, online only materials.
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Affiliation(s)
- Trudy Mallinson
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University
| | - Allan J Kozlowski
- Department of Epidemiology and Biostatistics, Michigan State University - College of Human Medicine and Mary Free Bed Rehabilitation Hospital
| | - Mark V Johnston
- Professor Emeritus, Department of Occupational Science & Technology, College of Health Sciences, University of Wisconsin-Milwaukee
| | - Jennifer Weaver
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University; Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
| | - Namrata Grampurohit
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University
| | - Shannon Juengst
- Department of Physical Medicine and Rehabilitation, School of Health Professions, University of Texas Southwestern Medical Center
| | - Linda Ehrlich-Jones
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University and Shirley Ryan AbilityLab, Chicago, Illinois
| | - Allen W Heinemann
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University and Shirley Ryan AbilityLab, Chicago, Illinois
| | - John Melvin
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University
| | - Pallavi Sood
- Department of Aging & Geriatric Research, Institute of Aging, University of Florida
| | - Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota.
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4
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Jansa J, Ferdinand S, Milo M, Løyning IG, Huilla T, Kallmayer L, Ilsbroukx S, Filló N, Raats J, Jakobson J, Kos D. Performance of Activities of daily living in people with multiple sclerosis. Mult Scler Relat Disord 2022; 57:103342. [PMID: 35158429 DOI: 10.1016/j.msard.2021.103342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) may result in activity and participation limitations, including the performance of activities of daily living (ADL). This study aims at systematically investigate ADL performance by using Assessment of Motor and Process Skills (AMPS) in people with MS (PwMS) of all disease types and within the Kurtzke Expanded Disability Status Scale (EDSS) range from 1.0 - 8.0. METHODS Eight multiple sclerosis (MS) centres participated in data collection of a consecutive sample of PwMS. Participants were referred for assessment to occupational therapy (OT) by treating physician or recruited from neurology department in each hospital and assessed by EDSS and AMPS. The AMPS is an observational, criterion referenced ADL assessment, providing values for a person's ADL performance in terms of motor and process skills. Criterion referenced cut-off scores were established at 2.0 for motor skills and at 1.0 for process skills and both values above the cut-off score indicate competent (independent, safe, efficient and effortless) ADL performance. Process skills refer to the act of carrying out a series of actions and is summarized in terms of efficiency, like initiating without pauses, continuing actions through to completion, performing actions in logical order (sequences), choosing, and completing the task as planned (heeds). RESULTS Two hundred and ten PwMS were recruited (48 +/- 13 years of age, 145 women/65 men, average disease duration was 11.8 +/- 9.6 years, average EDSS was 4.8+/-1.8). Average motor skills score was 1.01+/- 1.12 (indicating need for assistance with evidence of increased clumsiness/physical effort) and average process skills score was 1.02 +/- 0.66 (risk zone, questionable efficiency and more likely to need assistance). Overall, motor skills and process skills decreased with increasing EDSS score. No need for assistance in motor skills was indicated in subjects with lower EDSS scores (1.0 - 2.5). In higher EDSS group (≥4.5), 57% of subjects needed assistance in motor skills and 27% in process skills. The competency in process skills was either questionable or reduced within all EDSS scores. However, 33-38% of subjects with higher EDSS scores (6.0-8.5) showed competent performance in process skills. Overall correlation between motor and process scores was moderate (r = 0.56, p<0.0001), but no significant relationships between motor and process skills were found in the lower EDSS (1-2.5) and high EDSS scores (8-8.5). Further, EDSS and disease type were significant predictors, explaining 52.7% of motor skills and 22.3% of process skills performance. CONCLUSION Problems in ADL performance were found in EDSS categories 1.0 to 8.0 and in all disease types, therefore it is advisable to screen all PwMS for ADL deficits and provide relevant rehabilitation interventions.
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Affiliation(s)
- Jelka Jansa
- University Medical Centre Ljubljana, Slovenia; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Sofie Ferdinand
- National MS Center Melsbroek, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Meta Milo
- National MS Center Melsbroek, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Inger G Løyning
- MS-Senteret Hakadal, Norway; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Tarja Huilla
- MS Center Masku, Finland; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Lene Kallmayer
- The Multiple Sclerosis Hospital Ry, Denmark; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | | | - Núria Filló
- MS Center of Catalonia, Cemcat, Universitat Autònoma de Barcelona, Spain; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Joke Raats
- AZ Klina, RC De Mick, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Jytte Jakobson
- The Multiple Sclerosis Hospital Haslev, Denmark; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
| | - Daphne Kos
- National MS Center Melsbroek, Belgium; KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; Rehabilitation in MS (RIMS) - SIG Occupation group, Tervuursevest 101, 3001 Leuven, Belgium.
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5
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Amris K, Bandak E, Kristensen LE, Wæhrens EE. Agreement between self-reported and observed functioning in patients with rheumatoid arthritis, osteoarthritis, and fibromyalgia, and the influence of pain and fatigue: a cross-sectional study. Scand J Rheumatol 2021; 51:452-460. [PMID: 34596488 DOI: 10.1080/03009742.2021.1952755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: To evaluate the relationship between self-reported and performance-based measures of functioning in rheumatoid arthritis (RA), knee osteoarthritis (OA), and fibromyalgia (FM), and the influence of pain and fatigue.Method: Self-reported functioning was assessed by the Stanford Health Assessment Questionnaire, Fibromyalgia Impact Questionnaire, and Knee injury and Osteoarthritis Outcome Score. Performance-based measures of task-related physical activity included grip strength and Six-Minute Walk Test (6MWT). Assessment of Motor and Process Skills (AMPS) was used to obtain performance-based measures of activities of daily living (ADL) ability. Pain and fatigue were assessed by 100 mm visual analogue scales. Spearman's rho correlation and regression modelling were applied.Results: Correlations between self-reported functioning and performance-based measures of ADL ability were weak to moderate, and strongest in OA (r = 0.57, p = 0.002), and AMPS ADL ability measures did not enter regression models as explanatory factors for self-reported functioning. Correlations between AMPS ADL ability measures and measures of task-related physical activity were weak, except for a strong correlation between AMPS ADL motor ability and 6MWT in OA (r = 0.63, p = 0.000). The 6MWT was the only performance-based test explaining variance in AMPS motor ability (OA = 42%; FM = 11%). Pain explained variance in self-reported ability and contributed to variance in AMPS ADL motor ability measures in OA.Conclusion: Self-reported and observed measures of functioning assess partly different aspects of functioning, and both approaches may therefore be relevant in a structured assessment of patients with musculoskeletal disorders.
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Affiliation(s)
- K Amris
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - E Bandak
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - L E Kristensen
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - E E Wæhrens
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Occupational Science & Occupational Therapy, User Perspectives and Community-Based Interventions, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Christensen J, Eskildsen SJ, Winkel BG, Dichman CK, Wagner MK. Motor and process skills in activities of daily living in survivors of out-of-hospital cardiac arrest: a cross-sectional study at hospital discharge. Eur J Cardiovasc Nurs 2021; 20:775-781. [PMID: 33755128 DOI: 10.1093/eurjcn/zvab020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/16/2020] [Accepted: 03/01/2021] [Indexed: 01/10/2023]
Abstract
AIMS An individuals' ability to perform basic activities of daily living (ADL) is said to be one of the strongest predictors of performance ability and independent living within the community. The Assessment of Motor and Process Skills (AMPS) tool was designed to assess global functional level during ADL by investigating motor and process skills. The purpose of this study was to assess ADL performance ability by investigating motor and process skills in a consecutive cohort of adult survivors of out-of-hospital cardiac arrest at the time of discharge from hospital. METHODS AND RESULTS This cross-sectional study uses data from a prospective cohort of cardiac arrest survivors admitted to the Copenhagen University Hospital, Rigshospitalet. The specific data used in this study were obtained at the time of the days or the day before hospital discharge. Adult survivors of out-of-hospital cardiac arrest due to cardiac causes were eligible for inclusion. Assessment of Motor and Process Skills was used to assess ADL performance ability by investigating motor and process skills. The ADL ability of 61 individuals was assessed. The mean ADL ability measures recorded were AMPS process 1.40 logits (0.48) and AMPS motor 1.82 logits (0.40). Based on the dichotomized AMPS results, 23% were most likely to need assistance to live independently in the community. CONCLUSION Performance ability during ADL revealed difficulty in the performance of process skill and an increased need for rehabilitation among survivors of out-of-hospital cardiac arrest at the time of hospital discharge.
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Affiliation(s)
- Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Signe Janum Eskildsen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Bo Gregers Winkel
- Department of Cardiology, Centre For Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Camilla Kofoed Dichman
- Department of Cardiology, Centre For Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Mette Kirstine Wagner
- Department of Cardiology, Centre For Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
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Gartz R, Dickerson A, Radloff JC. Comparing Component-Based and Occupation-Based Interventions of a Person with Visual Deficits' Performance. Occup Ther Health Care 2020; 35:40-56. [PMID: 33347359 DOI: 10.1080/07380577.2020.1862443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to compare the effectiveness of component-based, occupation-based, and a combined intervention for visual-scanning to improve occupational performance. This exploratory case study used a 55-year-old female, seven years post-stroke with visual field deficits, who completed a component-based intervention (Vision Coach), an occupation-based intervention (IADL activities that incorporated scanning tasks), and a combined intervention. The Assessment of Motor and Process Skills (AMPS) was completed prior to and after each intervention. Participant's data was compared between interventions and AMPS standardization sample, with observable improvements in motor skills and process skills. Visual-scanning training as a compensatory method appears to be effective for chronic visual field deficits post-stroke, particularly using component-based and occupation-based interventions in combination.
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Affiliation(s)
- Rachel Gartz
- Rehabilitation - SCI/GR, Vidant Medical Center, Greenville, NC, USA
| | - Anne Dickerson
- Occupational Therapy, East Carolina University, Greenville, NC, USA
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Wæhrens EE, Brandt Å, Peoples H, Cour K. Everyday activities when living at home with advanced cancer: A cross‐sectional study. Eur J Cancer Care (Engl) 2020; 29:e13258. [DOI: 10.1111/ecc.13258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 01/13/2020] [Accepted: 04/16/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Eva Ejlersen Wæhrens
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- Department of Rheumatology The ADL Unit The Parker Institute Copenhagen University Hospitals Bispebjerg – Frederiksberg Frederiksberg Denmark
| | - Åse Brandt
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- The National Board of Social Services Center for Disability and Mental Vulnerability Odense Denmark
| | - Hanne Peoples
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
| | - Karen Cour
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
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Walsh RJ, Lee J, Drasga RM, Leggett CS, Shapnick HM, Kottorp AB. Everyday Technology Use and Overall Needed Assistance to Function in the Home and Community Among Urban Older Adults. J Appl Gerontol 2019; 39:1115-1123. [PMID: 31578898 DOI: 10.1177/0733464819878620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Older adults manage increasing numbers of everyday technologies to participate in home and community activities. Purpose: We investigated how assessing use of everyday technologies enhanced predictions of overall needed assistance among urban older adults. Method: We used a cross-sectional design to analyze responses from 114 participants completing the Everyday Technology Use Questionnaire, the Montreal Cognitive Assessment, and a sociodemographic questionnaire. We estimated overall needed assistance based on definitions in the Assessment of Motor and Process Skills. We created logistic regression models and receiver operator characteristic curves to analyze variables predicting overall needed assistance. Findings: With high specificity and sensitivity, the Everyday Technology Use Questionnaire and the Montreal Cognitive Assessment were the strongest predictors of overall needed assistance. Implications: Assessing everyday technology use enhanced predictions of overall needed assistance among urban older adults.
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Affiliation(s)
- Ryan J Walsh
- School of Medicine, Washington University, St. Louis, MO, USA
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10
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Brekke MF, la Cour K, Brandt Å, Peoples H, Wæhrens EE. The Association between ADL Ability and Quality of Life among People with Advanced Cancer. Occup Ther Int 2019; 2019:2629673. [PMID: 31531007 PMCID: PMC6745094 DOI: 10.1155/2019/2629673] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/09/2019] [Accepted: 08/06/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Occupational therapy and occupational science are founded on the theoretical core assumption that occupation and quality of life (QoL) are closely related. However, such theoretical core assumptions must be supported through empirically based research. OBJECTIVE To investigate the association between QoL and occupation, here self-reported and observed ADL abilities as a part of occupation, among people with advanced cancer, including determining whether self-reported or observed ADL ability had the stronger association with QoL. METHODS The study was nested in a cross-sectional study. The association between ADL ability and QoL among 108 people with advanced cancer was investigated using the ADL Interview (ADL-I), the Assessment of Motor and Process Skills (AMPS), and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30). RESULTS AND CONCLUSIONS Results showed that high observed ADL motor ability was associated with high QoL. In contrast, observed ADL process ability and self-reported ADL ability were not significantly associated with QoL. Oppositely expected, observed ADL ability had a stronger association with QoL than self-reported ADL ability. Thereby, the study to some extent contributes knowledge confirming the theoretical core assumptions about the relation between occupation, here performance of ADL, and QoL.
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Affiliation(s)
- Mette Falk Brekke
- Department of Occupational Therapy, University College Absalon, Næstved, Denmark
| | - Karen la Cour
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
- The Danish Knowledge Center for Rehabilitation and Palliative Care, REHPA, Vestergade 17, 5800 Nyborg, Denmark
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
| | - Åse Brandt
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense, Denmark
| | - Hanne Peoples
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- Faculty of Health Sciences, Health Sciences Research Center, University College Lillebaelt, Odense, Denmark
| | - Eva Ejlersen Wæhrens
- Department of Public Health, Research Unit for General Practice, The Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense, Denmark
- The Parker Institute, Copenhagen University Hospital Bispebjerg & Frederiksberg, Copenhagen, Denmark
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11
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The benefit of adding a physiotherapy or occupational therapy intervention programme to a standardized group-based interdisciplinary rehabilitation programme for patients with chronic widespread pain: a randomized active-controlled non-blinded trial. Clin Rehabil 2019; 33:1367-1381. [DOI: 10.1177/0269215519843986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective:To evaluate the benefit of adding occupational therapy or physiotherapy interventions to a standard rehabilitation programme targeted for chronic widespread pain.Design:Randomized active-controlled non-blinded trial.Subjects:Women with chronic widespread pain recruited in a tertiary outpatient clinic.Methods:Participants were randomized to a two-week, group-based standard rehabilitation programme followed by 16 weeks of group-based occupational therapy (Group BOT, n = 43) or 16 weeks of group-based physiotherapy (Group BPT, n = 42). Group A only received the two-week rehabilitation programme acting as comparator ( n = 96).Outcomes:Primary outcomes were the Assessment of Motor and Process Skills and Short Form-36 (SF36) Mental Component Summary score.Results:Mean changes in motor and process ability measures were clinically and statistically insignificant and without differences across the three groups assessed 88 weeks from baseline. Motor ability measures: −0.006 (95% confidence interval (CI): −0.244 to 0.233) in Group BOT; −0.045 (95% CI: −0.291 to 0.202) in Group BPT; and −0.017 (95% CI: −0.248 to 0.213) in Group A, P = 0.903. Process ability measures: 0.087 (95% CI: −0.056 to 0.231) in Group BOT; 0.075 (95% CI: −0.075 to 0.226) in Group BPT; and 0.072 (95% CI: −0.067 to 0.211) in Group A, P = 0.924. Mean changes in patient-reported outcomes were likewise small; clinically and statistically insignificant; and independent of group allocation, except for the SF36 mental component summary score in the BPTgroup: 8.58 (95% CI: 1.75 to 15.41).Conclusion:Participants were on average stable in observation-based measures of functional ability and patient-reported outcomes, except in overall mental well-being, favouring the enhanced intervention. Efficacy of additional interventions on functional ability remains uncertain.
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Ryd C, Nygård L, Malinowsky C, Öhman A, Kottorp A. Can the everyday technology use questionnaire predict overall functional level among older adults with mild cognitive impairment or mild-stage alzheimer's disease? - a pilot study. Scand J Caring Sci 2016; 31:201-209. [DOI: 10.1111/scs.12330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 12/21/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Charlotta Ryd
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Louise Nygård
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Camilla Malinowsky
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Annika Öhman
- Division of Health Activity and Care; National Institute for the Study of Ageing and Later Life (NISAL); Department of Social and Welfare studies; Linköping University; Norrköping Sweden
| | - Anders Kottorp
- Division of Occupational Therapy; Department of Neurobiology, Care sciences and Society; Karolinska Institutet; Stockholm Sweden
- Department of Occupational Therapy; Zurich University of Applied Sciences; Winterthur Switzerland
- Department of Occupational Therapy; University of Illinois at Chicago; Chicago IL USA
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Von Bülow C, Amris K, La Cour K, Danneskiold-Samsøe B, Wæhrens EE. Ineffective ADL skills in women with fibromyalgia: a cross-sectional study. Scand J Occup Ther 2015; 23:391-7. [PMID: 26468666 DOI: 10.3109/11038128.2015.1095237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Subgroups of women with fibromyalgia likely show different activity of daily living (ADL) skill deficits. Identifying ineffective ADL skills of significance in the 'typical' woman with fibromyalgia will promote the planning of targeted occupational therapy interventions aiming at improving ADL ability. OBJECTIVE To identify frequently reported ADL skill deficits of significance in subgroups of women with fibromyalgia who have decreased ADL motor ability in combination with decreased or competent ADL process ability. METHOD Women with fibromyalgia were evaluated with the Assessment of Motor and Process Skills (AMPS). If they demonstrated decreased ADL motor ability, the calibrated AMPS raters identified and reported ineffective ADL skills of significance. Descriptive comparisons were made between subgroups displaying either decreased or competent ADL process ability. RESULTS Moves, calibrates, bends, reaches, and paces were identified as the most frequently reported ineffective ADL skills of significance within the total sample (n = 188). The ADL process skills items organise and accommodate were identified as ineffective only in the subgroup with decreased ADL process ability (n = 105). CONCLUSION It is suggested that clinicians modify the individual's tasks and environments to compensate for identified ineffective ADL skills and to use the AMPS to differentiate interventions in women with fibromyalgia.
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Affiliation(s)
- Cecilie Von Bülow
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark .,b The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark , and.,c Metropolitan University College , Copenhagen , Denmark
| | - Kirstine Amris
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark
| | - Karen La Cour
- b The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark , and
| | - Bente Danneskiold-Samsøe
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark
| | - Eva Ejlersen Wæhrens
- a The Parker Institute, Department of Rheumatology , Copenhagen University Hospital , Bispebjerg and Frederiksberg , Denmark .,b The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health , University of Southern Denmark , Odense , Denmark , and
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Ayres H, Panickacheril John A. The Assessment of Motor and Process Skills as a measure of ADL ability in schizophrenia. Scand J Occup Ther 2015; 22:470-7. [DOI: 10.3109/11038128.2015.1061050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Taule T, Strand LI, Assmus J, Skouen JS. Ability in daily activities after early supported discharge models of stroke rehabilitation. Scand J Occup Ther 2015; 22:355-65. [PMID: 26005768 PMCID: PMC4673522 DOI: 10.3109/11038128.2015.1042403] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
UNLABELLED More knowledge is needed about how different rehabilitation models in the municipality influence stroke survivors' ability in activities of daily living (ADL). OBJECTIVES To compare three models of outpatient rehabilitation; early supported discharge (ESD) in a day unit, ESD at home and traditional treatment in the municipality (control group), regarding change in ADL ability during the first three months after stroke. METHODS A group comparison study was designed within a randomized controlled trial. Included participants were tested with the Assessment of Motor and Process Skills (AMPS) at baseline and discharged directly home. Primary and secondary outcomes were the AMPS and the modified Rankin Scale (mRS). RESULTS AND CONCLUSIONS Included were 154 participants (57% men, median age 73 years), and 103 participants completed the study. There were no significant group differences in pre-post changed ADL ability measured by the AMPS. To find the best rehabilitation model to improve the quality of stroke survivors' motor and process skills needs further research. Patients participating in the ESD rehabilitation models were, compared with traditional treatment, significantly associated with improved ADL ability measured by the mRS when controlling for confounding factors, indicating that patients with social needs and physical impairment after stroke may benefit from ESD rehabilitation models.
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Affiliation(s)
- Tina Taule
- Department of Occupational Therapy, Haukeland University Hospital (HUH) , Bergen , Norway
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Nielsen KT, Wæhrens EE. Occupational therapy evaluation: use of self-report and/or observation? Scand J Occup Ther 2014; 22:13-23. [PMID: 25327781 DOI: 10.3109/11038128.2014.961547] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Occupational Therapy Intervention Process Model (OTIPM) serves to guide occupational therapists in their professional reasoning. The OTIPM prescribes evaluation of task performance based on both self-report and observation. Although this approach seems ideal, many clinicians raise the issue that time to perform evaluations is limited. It is, therefore, relevant to examine whether similar information concerning task performance can be obtained using self-report or observation. OBJECTIVE The aims were to investigate what information can be obtained regarding the quality of ADL task performance based on self-report and observation, respectively, and to examine the relationship between measures of self-reported and observed quality of ADL task performance. METHODS The quality of ADL task performance among 20 adults with depression was evaluated using the ADL Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS). RESULTS AND CONCLUSIONS Results indicated that participants both reported and demonstrated increased effort and/or fatigue, increased use of time, need for assistance, and safety problems. However, little relationship was found between measures of self-reported and observed quality of ADL task performance, supporting the use of both self-report and observation as part of the evaluation phase outlined in the OTIPM.
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Affiliation(s)
- Kristina Tomra Nielsen
- Occupational Therapy Department, University College of Northern Denmark , Aalborg , Denmark
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Amris K, Wæhrens EE, Christensen R, Bliddal H, Danneskiold-Samsøe B. Interdisciplinary rehabilitation of patients with chronic widespread pain: Primary endpoint of the randomized, nonblinded, parallel-group IMPROvE trial. Pain 2014; 155:1356-1364. [DOI: 10.1016/j.pain.2014.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 04/07/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
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Albert SM, Bear-Lehman J, Anderson SJ. Declines in mobility and changes in performance in the instrumental activities of daily living among mildly disabled community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2014; 70:71-7. [PMID: 24952575 DOI: 10.1093/gerona/glu088] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gait speed is as an important predictor of mortality, volume of medical care, hospitalization, onset of activities of daily living (ADL) disability, and nursing home placement. We examined associations between change in gait speed and change in observed performance in the instrumental ADL (IADL) in a sample of mild-to-moderately disabled older adults. METHODS Participants in the Sources of Independence in the Elderly project (n = 375) were approached to complete a 4-m gait assessment and a performance test of IADL competency at three points over 2 years. IADL competency was assessed by occupational therapists, who rated participants using the Assessment of Motor and Process Skills (AMPS) and who also made a global rating of need for help or supervision. Linear mixed models were developed to assess change in motor AMPS score relative to baseline status and change in gait speed and AMPS process scores. RESULTS Baseline gait and change in gait were significant correlates of change in the AMPS motor ability measures in models that adjusted for cognitive status and AMPS process ability. Even respondents with gait speeds of 1 m/s at baseline were at risk of declining AMPS motor ability and an occupational therapist rating of IADL disability if gait speed declined. CONCLUSIONS Slowing in gait speed is an important risk factor for IADL disability in mild to moderately disabled older adults.
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Affiliation(s)
- Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pennsylvania.
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Mesa S, Heron P, Chard G, Rowe J. Using the Assessment of Motor and Process Skills as Part of the Diagnostic Process in An Inner-City Learning Disability Service. Br J Occup Ther 2014. [DOI: 10.4276/030802214x13968769798674] [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
Learning disability is characterized by significant impairment of both intellectual function and social and adaptive function, with onset before adulthood, and yet social and adaptive function is often omitted from assessment processes. This practice analysis explores the feasibility of administering the Assessment of Motor and Process Skills to assess adaptive function (alongside the assessment of intellectual function) as part of the diagnostic process for people with a learning disability. After a 2-year period, scores for the two assessments were correlated and a low level of correlation was found. Findings suggested that the Assessment of Motor and Process Skills should continue to be used as part of the diagnostic process alongside assessments of intellectual function, because assessment of intellectual function alone does not predict adaptive function and cannot be relied on for diagnosis of learning disability; doing so would ensure that practice was evidence based.
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Affiliation(s)
- Sue Mesa
- Senior Lecturer in Occupational Therapy, St John University, Health and Life Sciences, York
| | - Penny Heron
- Senior Occupational Therapist, Hackney Learning Disabilities Team, London
| | - Gill Chard
- Country Coordinator, AMPS UK and Ireland, Lancaster
| | - John Rowe
- Consultant Clinical Psychologist, Hackney Learning Disabilities Team, London
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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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HIV and disability: a pilot study exploring the use of the Assessment of Motor and Process Skills to measure daily life performance. J Int AIDS Soc 2013; 16:17339. [PMID: 23336724 PMCID: PMC3551982 DOI: 10.7448/ias.16.1.17339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 12/05/2012] [Accepted: 12/10/2012] [Indexed: 01/19/2023] Open
Abstract
Introduction Limitations in performing activities of daily living (ADL) are important indicators of health and overall wellness, yet relatively few studies specifically identify the ADL abilities of people living with HIV/AIDS (PHAs). Given the wide range of abilities and ages of PHAs, there is an urgent need to utilize an assessment of ADL ability that can validly evaluate those who are very able, as well as those who are very disabled, without the presence of ceiling or floor effects, to provide sensitive measures to detect change. Purpose The purpose of this study was to gather preliminary evidence of the validity of using the Assessment of Motor and Process Skills (AMPS) with PHAs. Methods By utilizing existing data records of PHAs from the international AMPS database, we explored (a) demographic factors; (b) person response validity by examining person and individual item goodness-of-fit to the AMPS measurement model; and (c) trends in ADL abilities of PHAs. Findings There were 137 data records in the international AMPS database (0.08% of the database). Goodness-of-fit analyses revealed that >90% of the individuals in the sample fit AMPS measurement model and >99% of the individual item ratings fit the model. More than 80% of the data record had ADL motor abilities that were significantly lower than age expectations, and 67% had ADL process ability measures that were significantly lower than age expectations. Conclusions The findings indicate that the AMPS is a valid measure of ADL ability for PHAs. Coupled with the lower than expected number of AMPS data records for PHAs and the significant ADL ability challenges that were encountered by this sample, this pilot study may indicate that PHAs encounter barriers to accessing rehabilitation services and/or may not receive referrals until significant ADL challenges are encountered.
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Kottorp A, Heuchemer B, Lie IP, Gumpert CH. Evaluation of Activities of Daily Living Ability and Awareness among Clients in a Forensic Psychiatry Evaluation Unit in Sweden. Br J Occup Ther 2013. [DOI: 10.4276/030802213x13576469254658] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: The aim of this exploratory study was to investigate activities of daily living (ADL) functioning for clients in a forensic psychiatry evaluation unit and also to investigate the relationship between ADL functioning and awareness of their ability to perform ADL. Method: The sample consisted of 35 participants at a forensic psychiatry evaluation unit in Sweden. ADL was investigated using the Assessment of Motor and Process Skills (AMPS) and awareness of ability was investigated using the Assessment of Awareness of Ability (A3). Results: The ADL mean motor ability for the participants was 1.68 logits and the process ability showed an ADL mean value of 0.83 logit. The mean value of awareness was 0.60 logit. A majority of the participants demonstrated ability measures below the cut-off criteria in the AMPS, which indicates that they might need support to function in the community. There was also a significant relationship between awareness of ability and ADL motor ability (rho = 0.49, p<0.01) and ADL process ability (rho = 0.77, p<0.01). Conclusion: Clients in forensic psychiatry demonstrate limited ability in ADL, associated with a limited awareness. Clients in forensic psychiatry may also need assistance to live in the community, which suggests that occupational therapy may be offered to these clients in order to prepare them to manage in the community.
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Affiliation(s)
- Anders Kottorp
- Associate Professor, Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Birgit Heuchemer
- Occupational Therapist, The Stockholm Centre for Dependency Disorders, County Council of Stockholm, Stockholm, Sweden
| | - Ingela Petersson Lie
- Formerly Assistant Professor, Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Clara Hellner Gumpert
- Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Provencher V, Demers L, Gélinas I, Giroux F. Cooking task assessment in frail older adults: who performed better at home and in the clinic? Scand J Occup Ther 2012. [PMID: 23181355 DOI: 10.3109/11038128.2012.743586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The purpose of this study was to determine: (i) the proportion of frail older adults who demonstrate (a) statistically significant and (b) clinically meaningful differences between home and clinic cooking task performance; and (ii) factors associated with a better performance in each environment. METHODS Thirty-seven participants were evaluated with the Assessment of Motor and Process Skills (AMPS) in home and clinic environments using a counterbalanced design. Demographic, physical, cognitive, psychological, and environmental characteristics were also collected. RESULTS Thirty-three participants were retained for analysis. A statistically significant difference (> ±2 standard errors of measurement) between environments was found in 33% of the participants on the motor scale and the same proportion on the process scale. A clinically meaningful difference (based on cut-off scores predicting need for assistance) was noted in 30% of the participants. Better performance at home on the process scale was associated with a decrease in some executive functions, while better performance in the clinic on the motor scale was mostly related to a decline in grip strength. CONCLUSIONS Our findings may help occupational therapists identify frail patients for whom home assessments would be advisable prior to discharge so that assistance provided meets their needs at home.
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Affiliation(s)
- Véronique Provencher
- Research Center, Institut universitaire de gériatrie de Montreal, Montreal, Canada.
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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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Ammeraal MA, Coppers J. Understanding living skills: first steps to evidence-based practice. Lessons learned from a practice-based journey in the Netherlands. Occup Ther Int 2012; 19:45-53. [PMID: 22314611 DOI: 10.1002/oti.1323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 01/05/2012] [Accepted: 01/05/2012] [Indexed: 11/08/2022] Open
Abstract
Living skills training is a commonly used but sparsely described and researched - occupational therapy - intervention for people with severe mental health problems. A service improvement project was established in a mental health organization in the Netherlands starting in 2006 to design more effective living skills training courses for individuals and groups. The steps of the evidence-based practice process underpinned the project. Theoretical and empirical evidence was derived from an extensive literature review. This was supplemented by the preferences of clients and their families as an equally valued source of evidence as is the experience and knowledge of a range of mental health professionals. Information from these three sources provided building blocks for the development of living skills training, resulting in an individual process guideline and two group courses. Implications for practice is that living skills training needs to be part of multidisciplinary treatment and can be best provided in the client's natural context. Limitations of this study are the lack of an evaluation of both the group courses and of the individual process guideline, also due to the continuous implementation in an ever-changing context. There is further need for research into the clinical and cost effectiveness of living skills training, both for individuals and groups, to support evidence-based decision making and service planning.
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Affiliation(s)
- Marion A Ammeraal
- Actenz, GGZ inGeest, Valeriusplein 9, 1075 BG, Amsterdam, The Netherlands.
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Wæhrens EE, Bliddal H, Danneskiold-Samsøe B, Lund H, Fisher AG. Differences between questionnaire- and interview-based measures of activities of daily living (ADL) ability and their association with observed ADL ability in women with rheumatoid arthritis, knee osteoarthritis, and fibromyalgia. Scand J Rheumatol 2012; 41:95-102. [DOI: 10.3109/03009742.2011.632380] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Merritt BK. Validity of using the Assessment of Motor and Process Skills to determine the need for assistance. Am J Occup Ther 2012; 65:643-50. [PMID: 22214108 DOI: 10.5014/ajot.2011.000547] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study evaluated the validity of using Assessment of Motor and Process Skills (AMPS) measures as evidence of the need for assistance in the community. METHOD In a retrospective analysis of existing data (N = 64,466), receiver operating characteristic (ROC) curves were generated, and a split-sample method was used to validate the predictions. RESULTS When identifying people who need assistance versus those who do not need assistance in the community, activity of daily living (ADL) motor and ADL process measures have fair and good discriminating value, respectively (areas under the ROC curves were .78 and .84). Evidence supports placing ADL motor and ADL process independence cutoff measures at 1.50 logits (sensitivity = .67, specificity = .72) and 1.00 logit (sensitivity = .81, specificity = .70), respectively. Accuracy was highest when matched motor and process decisions occurred (sensitivity = .85, specificity = .83). CONCLUSION Evidence supports using ADL ability measures from the AMPS to provide evidence of a client's need for assistance in the community.
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Affiliation(s)
- Brenda K Merritt
- School of Occupational Therapy at Dalhousie University, Halifax, Nova Scotia, Canada.
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