Occupational Therapy

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    Chinese Manual of the Model of Human Occupation Screening Tool (MOHOST)
    (School of Occupational Therapy, College of Medicine, National Taiwan University, 2009) Fan, Chia-Wei; Pan, Ay-Woan
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    Motivational Change Over the Course of Hippotherapy: An Exploratory Study of Three Children with Autism
    (2010) Fan, Chia‐Wei; Smith, Caitlin; Kielhofner, Gary; Taylor, Renee
    This article describes the findings from a research study looking at the motivational pathways of children with autism while participating in a 16‐week hippotherapy intervention. The Pediatric Volitional Questionnaire (PVQ) was used to document quantitative data for the changes in motivation that each child experienced, and videotaping was used for qualitative information. The study found that the motivation of children with autism will take highly individual pathways over time, and will be dependent on environmental factors.
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    A Psychometric Study of the Model of Human Occupation Screening Tool (MOHOST)
    (2010) Kielhofner, Gary
    Objective: This study examined the psychometric properties of the Model of Human Occupation Screening Tool (MOHOST) using item response theory and classical test theory approaches for clients with psychiatric disorders. Methods: Data, including demographic variables and scores on the MOHOST and a version of the Health of the Nation Outcomes Scale, were retrieved from case records of 1039 adult psychiatric service users. Results: Participants ranged in age from 18 to 102 and 57% were female and 43% were male. Most (94%) were unemployed, retired, or receiving other education or training. The items that make up each of the MOHOST subscales demonstrated good discriminant validity and excellent goodness of fit showing that the items measured the MOHO constructs unidimensionally. All subscales were able to distinguish clients into at least three statistically distinct strata and showed convergence with an independent measure of functioning. Conclusion: Findings from this study must take into account implicit limitations associated with the use of Rasch analysis and classical test theory. At the same time, results did support use of the MOHOST for research and clinical purposes. The MOHOST demonstrated good construct validity, item separation reliability, and concurrent validity. As a measure of occupational participation, the MOHOST offers practitioners and researchers a valid and reliable measure of volition, habituation, communication/interaction skills, process skills, motor skills, and environmental influences on participation.
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    Examining the Validity of the Model of Human Occupation Screening Tool: Using Classical Test Theory and Item Response Theory
    (2011) Pan, Ay-Woan; Fan, Chia-Wei; Chung, LyInn; Chen, Tsyr-Jang; Kielhofner, Gary; Wu, Ming-Yi; Chen, Yun-Ling
    Introduction: This study examined the psychometric properties of the Model of Human Occupation Screening Tool, using both item response theory and classical test theory. Method: One hundred and one people with mental health problems, aged 18–65 years, were recruited. The Chinese version of the Model of Human Occupation Screening Tool, the National Taiwan University Hospital Symptom Checklist, the Volitional Questionnaire, the Assessment of Communication and Interaction Skills, and the Mini Mental State Examination were administered. Rasch analysis and correlational analysis were used to examine the construct, convergent, divergent validity and known group validity. Results: Rasch analysis confirmed that there were six subscales within the Chinese version of Model of Human Occupation Screening Tool. The Volitional Questionnaire strongly correlated with the volition subscale (r = 0.583). The Assessment of Communication and Interaction Skills strongly correlated with the communication and interaction subscale (r = 0.815). The Mini Mental State Examination was moderately correlated with the process subscale (ρ = 0.334) and the symptomatology was not associated with any of the subscales as expected. There were significant differences on selected subscale scores across four known groups of participants. Conclusion: The Chinese version of the Model of Human Occupation Screening Tool was valid when applied to people with mental health problems.
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    The Test–Retest Reliability and the Minimal Detectable Change of the Purdue Pegboard Test in Schizophrenia
    (2013) Lee, Posen; Liu, Chin-Hsuan; Fan, Chia-Wei; Lu, Chi-Pang; Lu, Wen-Shian; Hsieh, Ching-Lin
    Background/Purpose: The Purdue pegboard test is widely used in measuring the hand dexterity of patients with schizophrenia. In patients with schizophrenia, the test–retest reliability and minimal detectable change (MDC) of this test remain largely unknown, limiting the interpretability of this popular measure. The purpose of this study was to estimate the test–retest reliability and the MDC of the Purdue pegboard test for patients with schizophrenia. Methods: A total of 147 patients with schizophrenia participated in this study. The participants were administrated the five subtests of the Purdue pegboard test, three trials in a row at both of the two sessions 1 week apart. The intraclass correlation coefficient (ICC) was used to examine the test–retest reliability and the MDC was calculated on the basis of standard error of measurement. Results: The test–retest reliabilities of the five subtests were moderate to good (ICC = 0.73–0.88). The MDC (MDC%) was 3.0 (22.9%) for the dominant hand subtest, 3.1 (26.1%) for the nondominant hand subtest, 3.0 (31.7%) for the both hands subtest, 6.1 (17.7%) for the dominant + nondominant + both hands subtest, and 8.5 (35.3%) for the assembly subtest. Conclusion: Our results reveal that the Purdue pegboard test has moderate-to-good test–retest reliability but substantial random measurement error. These findings should enable clinicians and researchers to monitor and interpret the changes in the hand dexterity of patients with schizophrenia more accurately and confidently.
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    Clinical Assessment of Modes - Client Outcomes Version (CAM-C2): Communicating with Your Therapist
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Taylor, Renee R.; Wong, S.; Fan, Chia-Wei; Kjellber, A.; Alfredsson-Agren, K.; Andersson, E.; Zubel, B.
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    Evaluating the Psychometric Properties of a Clinical Vocational Rehabilitation Outcome Measurement: The Assessment of Work Performance
    (2013) Fan, Chia-Wei; Taylor, Renée R.; Ekbladh, Elin; Hemmingsson, Helena; Sandqvist, Jan
    This study examined the validity and reliability of the Assessment of Work Performance (AWP) using Rasch analysis. The AWP was administered to 365 clients with a variety of work-related problems. Rasch analysis and principal component analysis were used to examine the appropriateness of the rating scales and unidimensionality of AWP items. The person-response validity, internal consistency, targeting appropriateness, and differential item function were also analyzed. The Rasch analysis confirmed the 4-point rating scale, and the item set met the criteria of unidimensionality. The AWP exhibited satisfactory person-response validity and internal consistency. Among the three subdomains, the targeting of item-difficulty was sufficient in the motor skills and process skills subdomains. Differential item functioning was found across gender and diagnoses. This study presented evidence to support that the AWP functioned as a reliable and valid assessment in assessing work performance.
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    Clinical Assessment of Modes - Client Outcomes Version (CAM-C2): Communicating with Your Therapist (Spanish Version)
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Fan, Chia-Wei; Taylor, Renee R.; Wong, S.; Zubel, B.
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    Clinical Assessment of Modes - Client Preferences Version (CAM-C1): Communicating with Your Therapist (Spanish Version)
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Fan, Chia-Wei; Taylor, Renee R.; Wong, S.; Zubel, B.
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    Clinical Assessment of Modes - Client Preferences Version (CAM-C1): Communicating with Your Therapist (Mandarin Version)
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Fan, Chia-Wei
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    Clinical Assessment of Modes - Therapist Outcomes Version (CAM-T): Communicating with Your Client
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Taylor, Renee R.
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    Clinical Assessment of Modes—Observational Version (CAM-O): Communicating with Your Therapist—Observational Version
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Fan, Chia-Wei; Taylor, Renee R.; Wong, S.; Kjellber, A.; Alfredsson-Agren, K.; Andersson, E.; Zubel, B.
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    Clinical Assessment of Modes - Client Preferences Version (CAM-C1): Communicating with Your Therapist
    (University of Illinois at Chicago, Department of Occupational Therapy, 2013) Taylor, Renee R.; Wong, S.; Fan, Chia-Wei; Kjellber, A.; Alfredsson-Agren, K.; Andersson, E.; Zubel, B.
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    Work Environment Impact Scale: Testing the Psychometric Properties of the Swedish Version
    (2014) Ekbladh, Elin; Fan, Chia-Wei; Sandqvist, Jan; Hemmingsson, Helena; Taylor, Renée
    BACKGROUND: The Work Environment Impact Scale (WEIS) is an assessment that focuses on the fit between a person and his or her work environment. It is based on Kielhofner's Model of Human Occupation and designed to gather information on how clients experience their work environment. OBJECTIVE: The aim of this study was to examine the psychometric properties of the Swedish version of the WEIS assessment instrument. METHOD: In total, 95 ratings on the 17-item WEIS were obtained from a sample of clients with experience of sick leave due to different medical conditions. Rasch analysis was used to analyze the data. RESULTS: Overall, the WEIS items together cohered to form a single construct of increasingly challenging work environmental factors. The hierarchical ordering of the items along the continuum followed a logical and expected pattern, and the participants were validly measured by the scale. The three occupational therapists serving as raters validly used the scale, but demonstrated a relatively high rater separation index, indicating differences in rater severity. CONCLUSION: The findings provide evidence that the Swedish version of the WEIS is a psychometrically sound assessment across diagnoses and occupations, which can provide valuable information about experiences of work environment challenges.
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    Clinical Assessment of Modes—Patient Preferences Version (CAM–P), version 2.0
    (University of Illinois at Chicago, Department of Occupational Therapy, 2015) Taylor, Renee R.; Fan, Chia-Wei
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    Clinical Assessment of Modes—Patient Experience Version (CAM–E), Version 2.0
    (University of Illinois at Chicago, Department of Occupational Therapy, 2015) Taylor, Renee R.
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    Assessing therapeutic communication during rehabilitation: The Clinical Assessment of Modes
    (2016) Fan, Chia-Wei; Taylor, Renee R.
    OBJECTIVE. This study applied Rasch analysis to test four versions of the Clinical Assessment of Modes (CAM), an assessment based on Taylor’s Intentional Relationship Model: CAM–P, which assesses clients’ pretreatment preferences; CAM–E, clients’ treatment experience; CAM–T, therapists’ self-reported perspective; and CAM–O, an observer rating scale. METHOD. The CAM–P was administered to 63 inpatients. The CAM–E was administered to 110 inpatients and outpatients. Trained raters rated therapists’ modes with 59 inpatients and outpatients on the CAM–O. The CAM–T was administered to 38 therapists. Analyses of reliability and validity were conducted. RESULTS. The CAM demonstrated adequate construct validity. All versions showed acceptable internal consistency and unidimensionality within each of the subscales. Disorder between the 5 points on the ordinal rating scale was found for the client measures (CAM–P, CAM–E) and was resolved by modifying the ratings to encompass a 4-point scale. CONCLUSION. The four CAM versions are reliable and valid measures of therapeutic communication in rehabilitation.