Date Presented 4/20/2018
A discord between the Canadian Occupational Performance Measure and the Assessment of Motor and Process Skills suggests that a discrepancy exists between older adults’ subjective perception and occupational therapists’ objective evaluation of occupational performance early in the disablement process.
Primary Author and Speaker: Chiung-ju Liu
Additional Authors and Speakers: Hilary Harris, Alyssa Davis, Louella Schoenfeld, Taylor Romero
PURPOSE: Unlike disability caused by catastrophic events, late-life disability occurs in a progressive and dynamic manner. Early detection of older adults with functional decline allows occupational therapy practitioners to provide preventive intervention to attenuate the disablement process and promote productive aging. Examining the consistency or discrepancy between self-reported occupational performance assessments and performance-based occupational performance assessments is informative for practitioners to interpret assessment results and plan interventions. There were two research questions for this study: (1) What is the relationship between self-reported occupational performance assessments and performance-based occupational performance assessments in community-dwelling older adults experiencing functional decline? and (2) What are the factors associated with the assessments’ results?
METHOD: A secondary data analysis was conducted on baseline data collected for a clinical trial. Fifty-six sedentary older adults (M age = 72.64) who experienced muscle weakness and difficulty in performing activities of daily living were recruited from senior living communities. The Canadian Occupational Performance Measure (COPM) was used to measure self-reported occupational performance outcomes. The Assessment of Motor and Process Skills (AMPS) was used to measure performance-based occupational performance outcomes. We conducted Pearson correlations to examine the association between results on the two occupational performance tests and multiple regression analysis to examine factors (age, gender, depression, years of education, and lower extremity functioning) associated with each occupational performance assessment.
RESULTS: There was no significant correlation between the COPM Performance score (M = 4.85 ± 1.75) and the AMPS composite score (M = 2.25 ± 0.84; r = .06, p = .68). Older adults with better lower extremity functioning measured by the Timed Up and Go test showed better performance on the AMPS (B = –.42, p < .01). Older adults with higher education tended to report better performance on the COPM (B = .11, p = .09).
CONCLUSION: In general, both occupational performance measures were able to capture functional decline in the study population; however, the two measures were not always in agreement. Some participants had low scores on self-reported occupational performance and high scores on performance-based occupational performance assessed by therapists. Low educational attainment might relate to underestimation of occupational performance. When working with older adults with low educational attainment, using a performance-based occupational performance assessment is suggested as our findings show that this group may underestimate their performance. Occupational therapists may choose a self-reported occupational performance assessment over a performance-based assessment because of time constraints in the practice setting.
References
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