Umeå University's logo

Background: There are no validated assessment tools for evaluating quality of schoolwork task performance of children living in German-speaking Europe (GSE).

Objective: To determine whether the international age-normative means of the School Version of the Assessment of Motor and Process Skills (School AMPS) are valid for use in GSE.

Methods: The participants were 159 typically-developing children, 3-12 years, from GSE. We examined the proportions of School AMPS measures falling within +/- 2 standard deviation (SD) of the international age-normative means, and evaluated for significant group differences (p<0.05) in mean School AMPS measures between the GSE sample and the international age-normative sample using one-sample Z tests. When significant mean differences were found, we evaluated if the differences were clinically meaningful.

Results: At least 95% of the GSE School AMPS measures fell within +/- 2 SD of the international age-normative means for the School AMPS. The only significant mean differences were for 6(p < 0.01) and 8-year-olds (p = 0.02), and only the 6-year-old school process mean difference was clinically meaningful.

Conclusions: Because the only identified clinically meaningful difference was associated with likely scoring error of one rater, the international age-normative means of the School AMPS appear to be valid for use with children in GSE.

Objective: To examine the relationship among (a) quality of activities of daily living (ADL) task performance, (b) quality of social interaction, and (c) the extent of discrepancy between the person's and the occupational therapist's perspectives; and explore patterns of strengths and challenges among people with developmental disabilities (DD). Methods: Fifty-eight adults with different types of DD, living in northern Sweden, were evaluated using the Assessment of Motor and Process Skills (AMPS), the Evaluation of Social Interaction (ESI) and the Assessment of Compared Qualities -Occupational Performance (ACQ-OP) and Assessment of Compared Qualities -Social Interaction (ACQ-SI). The relationships among assessments were analysed using Pearson correlation analyses. Cluster analysis was used to group participants based on their evaluation results. Results The quality of ADL task performance and the quality of social interaction demonstrated weak to moderate positive relationships while the ACQ-OP and ACQ-SI demonstrated a strong positive relationship. The cluster analysis resulted in identifying three distinct groups that differed significantly from one another. Conclusion: The findings support the clinical use of multiple assessment tools, including observation and self-report, to evaluate different aspects of occupational performance. Comprehensive and relevant evaluation supports collaborative goal setting and intervention planning.

The aim of this study was to examine leisure engagement among people in later life and the potential relationship between leisure engagement and self-rated health. A population-representative sample of 5,435 persons between 65 and 80 years of age, living in northern Sweden and Finland were included. Data were collected by a posted questionnaire survey. Results revealed that levels of leisure engagement decreased progressively between the youngest and the oldest age groups. A significant relationship was found between leisure engagement and self-rated health. The relationship between leisure engagement and health as well as implications for developing health promotion programs are discussed.

Background: Several factors facilitate or hinder efficacy research in occupational therapy. Strategies are needed, therefore, to support the successful implementation of trials.

Aim: To assess the feasibility of conducting a randomised controlled trial (RCT). The main feasibility objectives of this study were to assess the process, resources, management, and scientific basis of a trial RCT.

Material and methods: A total of 10 occupational therapists, between the ages of 30 and 55 (M 43.4; SD 8.3) with seven to 26 years' (M 14.3; SD 6.1) experience, participated in this study. Qualitative data collected included minutes of meetings, reports, and field notes. The data were analysed based on the principles of content analysis, using feasibility objectives as the main categories.

Results: Data analysis revealed strengths in relation to retention and inclusion criteria of participants, the study protocol, study organisation, and the competence of researchers. Weaknesses were found related to recruitment, randomisation, data collection, time for training and communication, commitment, and design.

Conclusion: The findings indicated that there are several factors which had a considerable impact on the implementation of an RCT in practice. However, it was useful to assess methods and procedures of the trial RCT as a basis to refine research plans.

Introduction: The aim of this study was to evaluate three occupational therapy interventions, focused on supporting continued engagement in occupation among older people, to determine which intervention was most cost effective, evaluated as the incremental cost/quality adjusted life year gained.

Method: The study was based on an exploratory randomized controlled trial. Participants were 77–82 years, single living and without home help. One hundred and seventy seven persons were randomized to an individual intervention, an activity group, a discussion group or a no intervention control group. All interventions focused on supporting the participants to maintain or improve occupational engagement. Outcomes were evaluated at baseline, three and 12 months and included general health and costs (intervention, municipality and health care). Based on linear regression models, we evaluated how outcomes had changed at each follow-up for each intervention group in relation to the control group.

Results: Both group interventions resulted in quality adjusted life years gained at three months. A sustained effect on quality adjusted life years gained and lower total costs indicated that the discussion group was the most cost-effective intervention.

Conclusion: Short-term, occupation-focused occupational therapy intervention delivered in group formats for well older people resulted in quality-adjusted life years gained. A one-session discussion group was most cost effective.

Background: One important goal of paediatric occupational therapy services is to improve activities of daily living (ADL) abilities of children. In order to plan and evaluate the effectiveness of targeted interventions, valid assessments are critically needed. The Assessment of Motor and Process Skills (AMPS) is an internationally standardized assessment of ADL performance that has not been validated for use with children in Middle Europe.

Aim: To evaluate for (i) significant differences in mean ADL motor and mean ADL process ability measures among children from Middle Europe compared with children from North America, UK/Republic of Ireland, Nordic countries, Western Europe, Australia/New Zealand and Asia; and (ii) meaningful differences between the international age-normative means of the AMPS and those for children from Middle Europe.

Method: We analysed data of children across world regions extracted from the international AMPS database using many-facet Rasch and two-wayanova analyses and by estimating contrasts to evaluate for significant group differences.

Results: anova analyses of data for 11 189 children ages 2–15 revealed significant effects for mean ADL motor and ADL process ability by region [F ≥ 15.32, d.f. = (6, 11 091), MSE ≥ 0.20, P < 0.001, ή² ≥ 0.008], and age [F ≥ 253.47, d.f. = (13, 11 091), MSE ≥ 0.20, P < 0.001, ή² ≥ 0.229], and a significant interaction effect for mean ADL process ability [F = 1.48, d.f. = (78, 11 091), P = 0.004, ή² = 0.010]. Out of 168 estimated contrasts between Middle Europe and the other world regions for mean ADL motor and ADL process ability, seven were statistically significant (4.17%), but none exceeded ±1SE from the international means.

Conclusion: The AMPS remains free of relevant differences in mean ADL ability measures between Middle Europe and other world regions, indicating that the international age-normative mean values are likely to be applicable to children from Middle Europe. The AMPS can be used internationally to evaluate ADL performance in children and to determine if the child is eligible for occupational therapy services.

Background: Since the beginning of the occupational therapy profession, engagement in occupation has been valued as the primary therapeutic agent as well as the goal of intervention. While there are few today who would not support this idea, occupational therapists continue to struggle with implementing their beliefs through "what we do" and "how we do it". Contributing to this problem is their failure to use terminology in a manner that clearly defines what and how occupational therapists do what they do in occupational therapy research, education, and practice. Methods: The author will, therefore, first discuss some key occupational therapy terms and propose that they represent an occupation-related taxonomy that can be used to more clearly define and describe for occupational therapists and others what they do and how they do what they do as occupational therapists. Then, with a goal of fostering critical self-reflection among occupational scientists and occupational therapy researchers, educators, and practitioners, the author will go through the stages of the occupational therapy process outlined in the Occupational Therapy Intervention Process Model (OTIPM) and demonstrate how a more precise use of this occupation-related taxonomy can facilitate maximizing the power of occupation in practice.

Objective: The aim of this exploratory randomised controlled trial (RCT) was to evaluate three different occupation-focused interventions for well older people by estimating effect sizes for leisure engagement and ability in activities of daily living (ADL) and thereby identifying the most effective interventions.

Methods: One hundred and seventy seven persons, 77-82 years old, living alone and without home help, were randomized to a control group (CG), an individual intervention (IG), an activity group (AG), and a one-meeting discussion group (DG). All interventions focused on occupational engagement and how persons can cope with age-related activity restrictions in order to enhance occupational engagement. Data were collected by blinded research assistants at baseline, three, and 12 months. Ordinal outcome data were converted, using Rasch measurement methods, to linear measures of leisure engagement and ADL ability. Standardized between-group effect sizes, Cohen's d, were calculated.

Results: While all groups showed a decline in leisure engagement and ADL over time, the IG and the DG were somewhat effective in minimizing the decline at both three and 12 months. However, the effect sizes were small.

Conclusions: The findings indicate that occupation-focused interventions intended to minimize a decline in leisure engagement and ADL were sufficiently promising to warrant their further research.

The objective of this study was to compare the activities of daily living (ADL) ability of older adults who were chronically homebound to older adults who were nonhomebound. The participants were 40 older adults 60 years of age or older, 20 homebound and 20 nonhomebound. The two groups did not differ in mean age, gender distribution, ethnicity, marital status, living situation, or type of housing. The older adults who were homebound had significantly more conditions than those who were nonhomebound. T tests revealed statically significant differences in the mean Assessment of Motor and Process Skills ADL motor and ADL process ability measures of older adults in the homebound and nonhomebound groups, with the latter group demonstrating higher ADL ability measures. Based on a power analysis indicating a need for 10 persons in each group, the nonhomebound group was subsequently divided into two subgroups, those who needed assistance to perform ADL from paid staff and/or family members and those who performed ADL independently. The results of two analyses of variance revealed that participants who were chronically homebound and those who were nonhomebound and had assistance had significantly lower ADL motor ability and ADL process ability than those who were nonhomebound and independent. The homebound group and the nonhomebound group with assistance did not differ significantly in ADL motor or ADL ability.

The findings support the need for occupational therapists to provide services for older adults who have ADL limitations regardless of their homebound status. © 2013 Informa Healthcare USA, Inc.