The relationship between Motivation for Occupation and Pattern of Occupation scores of the MOHOST and types of discharge placement from a mental health rehabilitation unit

Introduction

Model of Human and Occupational Screening Tool (MOHOST) is a scale used to assess occupational functioning in mental health inpatients which can inform suitable post-discharge placements. However, there is little research on the relationship between scores on Motivation for Occupation (MO) and Pattern of Occupation (PO) subscales of the MOHOST and types of discharge placement.

Method

The records of all patients discharged over a 2-year period from a male psychiatric rehabilitation unit were examined. All patients had undergone MOHOST assessments; however, these scores were not a factor in their discharge placement selection. Analyses were done on types of discharge placements (transfer to another psychiatric unit or community discharge) versus predischarge scores in MO and PO of MOHOST.

Results

N = 20 and average length of stay was 23 months. There was positive correlation between MO and PO scores and discharge placements (rs = 0.66, p = 0.002; rs = 0.67 and p = 0.001, respectively). Using ordinal logistic regression, for each unit increase of negative score in PO, there was 0.68 increase in the log odds of more restrictive discharge placements, p = 0.008.

Conclusion

The study suggests that MOHOST is a useful tool in determining suitable placements for patients being discharged or transferred from psychiatric rehabilitation units.

Psychometric evaluation of the Relative Mastery Scale: An Occupational Adaptation instrument

This study evaluated the psychometric properties of the Relative Mastery Scale (RMS). Valid and reliable client-centered instruments support practice in value-based health care and community-based settings. Participants were 368 community-dwelling adults aged 18 to 95 years. Researchers conducted validity and reliability examinations of the RMS using classical test theory and Rasch measurement model. A partial credit model allowed exploration of individual scale properties. Spearman's correlation coefficients between items were statistically significant at the .01 level. Cronbach's alpha coefficient was .94 showing strong internal consistency. In exploratory factor analysis, Factor 1 accounted for 71% of variance with an eigenvalue of 4.26. In Rasch analysis, the 5-point rating scale demonstrated adequate functioning, confirmed unidimensionality, and person/item separation. The RMS instrument demonstrates sound psychometric characteristics. A valid and reliable measure of internal occupational adaptation supports application to monitor progress of internal occupational adaptation across a variety of individuals.

The Development of Care Pathways and Packages in Mental Health Based on the Model of Human Occupation Screening Tool

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.

A Rasch analysis of the model of human occupation screening tool single observation form (MOHOST-SOF) in mental health

Introduction

This study examined the psychometric properties of the model of human occupation screening tool single observation form.

Method

Clinical records were extracted pre- and post-treatment for 152 mental health service users. Data were model of human occupation screening tool single observation form scores and demographics. We investigated the form using Rasch analysis; we also present an analysis of change over time.

Results

We identified four misfitting items and evidence of instability with respect to change over time. After anchoring to adjust for unstable estimates, it was possible to measure client change, and there were significant differences in form scores pre–post treatment indicating client improvement in ability.

Conclusion

The study provides initial psychometric assessment of this version of the model of human occupation screening tool.

Examining the validity and reliability of the Taita symptom checklist using Rasch analysis

BACKGROUND/PURPOSE

The Taita symptom checklist (TSCL) is a standardized self-rating psychiatric symptom scale for outpatients with mental illness in Taiwan. This study aimed to examine the validity and reliability of the TSCL using Rasch analysis.

METHODS

The TSCL was given to 583 healthy people and 479 people with mental illness. Rasch analysis was used to examine the appropriateness of the rating scale, the unidimensionality of the scale, the differential item functioning across sex and diagnosis, and the Rasch cut-off score of the scale.

RESULTS

Rasch analysis confirmed that the revised 37 items with a three-point rating scale of the TSCL demonstrated good internal consistency and met criteria for unidimensionality. The person and item reliability indices were high. The TSCL could reliably measure healthy participants and patients with mental illness. Differential item functioning due to sex or psychiatric diagnosis was evident for three items. A Rasch cut-off score for TSCL was produced for detecting participants' psychiatric symptoms based on an eight-level classification.

CONCLUSION

The TSCL is a reliable and valid assessment to evaluate the participants' perceived disturbance of psychiatric symptoms based on Rasch analysis.

Examining the Psychometric Properties of the Model of Human Occupation Screening Tool—Japanese Version

Objective/Background

The Model of Human Occupation Screening Tool-Japanese version (J-MOHOST) was developed, and it was identified that the J-MOHOST did not have any problems in linguistic validation. The purpose of this study is to examine the psychometric properties of the J-MOHOST for the physical disabilities.

Methods

Forty-four participants were recruited from the rehabilitative wards and data, including demographic variables and the J-MOHOST scores, were obtained. The fit statistics, rating scale characteristics, and reliability index were examined using the Rasch analysis.

Results

There were no misfitting participants, and the J-MOHOST measures reliably separated the participants into 3.95 statistically distinct strata with a person reliability of .88. The result of item fit showed that it did not have noticeable problem in the items of the J-MOHOST. Moreover, the item reliability was .88. The content of the item difficulty could represent the characteristics of occupational participation of the participants in conformity with the rating system of the J-MOHOST.

Conclusion

The J-MOHOST rating scale could discriminate the level of occupational participation in physical disabilities. The results indicate that the J-MOHOST is an effective tool for measurement. Further studies are needed to increase the number of participants with a variety of disabilities and settings.

Meeting the Occupational Needs of Mental Health Service Users: Indicative Care Packages and Actual Practice

Payment mechanisms in English mental health services require professionals to describe treatments and demonstrate cost-effectiveness. A national occupational therapy study has prepared the way by profiling the occupational needs of service users and describing indicative care packages.

This practice analysis reports on a local survey, which was conducted in parallel with the national study. Treatment aims were found to correspond with key elements of the occupational profiles. This supports the accuracy of the profiles. It also provides evidence towards the effectiveness of the service being provided by demonstrating the ability of occupational therapists to target the proven needs of service users.

Mental Health Payment-by-Results Clusters and the Model of Human Occupation Screening Tool

In the United Kingdom, payment for mental health services follows a system of payment-by-results. A mental health clustering tool, classifying individuals into clusters based on service needs, was developed as a broad-based means of planning care packages. It is yet unknown whether payment-by-results clusters will be reflective of the occupational needs of service users. To evaluate the relationship between service users' membership in service need clusters and occupational groupings based on outcomes from an independent measure on participation and engagement in self-care, productivity, and leisure (Model of Human Occupation Screening Tool [MOHOST]), retrospective medical record data were gathered from 675 service users with a range of psychiatric disorders from two organizations in England. Using six subscales of the MOHOST, the two-step cluster analysis identified occupational groupings. Then the multivariate analysis of variance was used to examine whether the mean scores of the six MOHOST subscales were significantly different across the occupational groupings. Finally, participants' membership in the payment-by-results clusters was compared to their membership in the occupational groupings. Participants fell into one of three levels: high-, middle-, or low-functioning occupational groups. These groups did not bear direct relationships with the individual payment-by-results clusters. This suggests that the mental health clustering tool and the MOHOST are likely targeting different characteristics in the service users.