Content Validity of the Occupational Therapy Taxonomy of Rehabilitation Interventions (OT–TRI)

SIGNIFICANCE: A review of the rehabilitation literature substantiates the need for an accurate description of interventions. Researchers have called for the continued development of taxonomies to characterize the active ingredients of interventions. The accurate and complete measurement of active ingredients provides a means to relate occupational therapy interventions with outcomes. However, none of the published taxonomies include a means to account for the impact of the actual interaction between the client and therapist.

INNOVATION: The Occupational Therapy Taxonomy of Rehabilitation Interventions (OT–TRI) is a new taxonomy that captures components of the therapeutic process (i.e., therapist actions, client response to intervention) that have not been collected by previously published taxonomies. The therapeutic process is espoused to be the missing piece in the relationship between occupational therapy interventions and treatment outcomes.

APPROACH: In this research study, we attempted to answer the following research question: How are the characteristics of the OT–TRI similar to and different from the occupational therapy taxonomy of the Post-Stroke Rehabilitation Outcomes Project (PSROP)?

We compared the OT–TRI with the most widely published taxonomy in the rehabilitation literature—that is, the PSROP occupational therapy taxonomy. The rationale was to examine the content validity of the new taxonomy in two ways: (1) the OT–TRI’s potential to capture the same information of a therapy session as the PSROP occupational therapy taxonomy, and (2) the OT–TRI’s potential to capture additional information of a therapy session that is beyond the scope of the PSROP occupational therapy taxonomy. Video recordings of actual therapy sessions provided the basis to collect data of therapy sessions using the two taxonomies.

METHOD: We used a descriptive study design, and the setting took place in an inpatient rehabilitation hospital in the southwest region of the United States. Video recordings of actual therapy sessions provided the basis to collect data of therapy sessions with the two taxonomies. Participants included 3 occupational therapists and 4 clients. Clients had a diagnosis of stroke and ranged from 57 to 85 yr of age.

The measures included the OT–TRI and the PSROP occupational therapy taxonomy. Two researchers separately and independently completed copies of the OT–TRI and the PSROP occupational therapy taxonomy to characterize the components of the therapy that were observed while viewing the videos of treatment sessions. This process yielded OT–TRI and PSROP profile data for each of the 12 videos. The two researchers used descriptive statistics to analyze similarities and differences between the OT–TRI and PSROP profile data.

RESULTS: The OT–TRI consistently identified more items in the therapy sessions that included several items with a greater degree of specificity comparison with similar PSROP items. Analysis of the OT–TRI profile data revealed that investigators marked approximately 13 therapist actions in a therapy session, whereas the PSROP occupational therapy taxonomy did not capture this information. Additionally, only the OT–TRI provided information on the client’s response during the therapy session.

CONCLUSION: The comparative analysis reveals that the domain of the published taxonomy is well represented within the OT–TRI. The comparative analysis also provides evidence that the OT–TRI expands on the characterization of the therapeutic process of the PSROP occupational therapy taxonomy.