Principles of Assessment and Outcome Measurement for Occupational Therapists and Physiotherapists: Theory, Skills and Application

Principles of Assessment and Outcome Measurement for Occupational Therapists and Physiotherapists......Page 3
Contents......Page 9
Contributors......Page 15
Foreword Professor Jenny Butler......Page 17
Preface......Page 19
Acknowledgements......Page 21
Introduction......Page 25
Occupational Therapy and Physiotherapy......Page 26
The Importance of the Selection and Application of Terminology in Practice......Page 27
Definitions of Key Terms......Page 28
Summary of Definitions......Page 36
1 The Importance of Accurate Assessment and Outcome Measurement......Page 39
Assessment as a Core Part of the Therapy Process......Page 40
The Impact of Health and Social Care Policy on Assessment Practice......Page 41
The Demand for Evidence-based Practice......Page 42
So How Do You Track Down the Best Evidence?......Page 44
Levels of Evidence and Grades of Recommendations......Page 45
The Application of Standardised Assessments......Page 46
The Use of Standardised Versus Non-standardised Assessments......Page 47
Benefits of Applying Standardised Measures......Page 49
The Requirement to Demonstrate Effectiveness......Page 50
A Focus on Client-centred Practice......Page 52
The Use of Standards, Protocols, Guidelines and Care Pathways......Page 53
The Complexity of Assessment......Page 56
The Nature of Therapeutic Practice......Page 57
The Nature of Human Occupation and Occupational Performance......Page 58
The Complexity of Measuring Human Function......Page 60
The Influence of the Level of Task Demand......Page 62
The Influence of Environment on Performance......Page 63
Conclusion......Page 66
2 Methods of Assessment and Sources of Assessment Data......Page 69
Methods of Data Collection......Page 70
Self-report......Page 72
Interviewing as a Means of Collecting Self-report Data......Page 75
Communication, Insight and Capacity Issues......Page 78
Cultural Issues and Self-report Data Collection......Page 79
Examples of Self-report Assessments......Page 80
Proxy Report......Page 81
Examples of Assessments that Use Information from a Proxy......Page 83
Measures that Assess the Proxy......Page 84
Observational Assessment Methods......Page 86
Examples of Observational Assessment......Page 88
Examples of How Therapists Combine Different Assessment Methods......Page 89
Documentation......Page 90
Confidentiality......Page 93
Case Study: ‘Scott’......Page 94
Study Questions......Page 113
3 Purposes of Assessment and Measurement......Page 115
Timing of Assessment in the Therapy Process......Page 116
Descriptive Assessments......Page 120
Discriminative Assessments......Page 121
Predictive Assessments......Page 123
Evaluative Assessment......Page 124
Assessment for Particular Purposes......Page 126
Case Vignette: ‘Mr Smith’......Page 136
Service Evaluation......Page 140
Case Study: Service Evaluation – The Memory Activity and Self Help Group......Page 149
Reflecting on Purposes of Assessment in Your Own Practice......Page 156
Study Questions......Page 157
4 Levels of Measurement......Page 159
What is Measurement Theory?......Page 160
What are Levels of Measurement?......Page 162
Nominal Scales......Page 163
Ordinal Scales......Page 164
Interval Scales......Page 167
Ratio Scales......Page 169
Application of Different Levels of Measurement......Page 170
Rasch Analysis......Page 173
Study Questions......Page 174
5 Standardisation and Test Development......Page 175
Why Should Therapists Use Standardised Tests?......Page 176
What is a Standardised Test?......Page 177
Standardisation......Page 178
Test Construction Decisions......Page 183
Criterion-referenced Tests......Page 184
Norm-referenced Tests......Page 185
Criteria for Judging Norms......Page 186
Terminology Related to Norm-referenced Tests......Page 187
Training and Interpreting Standardised Test Scores......Page 191
Study Questions......Page 192
6 Validity and Clinical Utility......Page 193
Definition of Validity......Page 194
Content Validity......Page 195
Construct Validity......Page 197
Criterion-related Validity......Page 201
Other Types of Validity......Page 204
Establishing the Overall Validity of a Test......Page 205
Face Validity......Page 206
Clinical Utility......Page 208
Examining Validity and Clinical Utility Issues: Test Examples......Page 211
Study Questions......Page 215
7 Reliability......Page 217
Defining Reliability......Page 218
Reliability Coefficients and Standard Error of Measurement......Page 219
Standard Error of Measurement and Confidence Interval......Page 220
Test–retest Reliability......Page 221
Inter-rater Reliability......Page 222
Internal Consistency......Page 223
Methodological Issues......Page 224
Test Specificity......Page 225
Test Sensitivity......Page 226
Floor and Ceiling Effects......Page 228
Reliability Statistics......Page 229
The Statistic Can Affect the Result......Page 230
Examining Reliability Data: Test Examples......Page 232
Applying Concepts of Reliability to Your Own Practice......Page 235
Study Questions......Page 236
8 Test Administration, Reporting and Recording......Page 237
Step 1: Preparation for Testing......Page 238
Step 2: Test Administration......Page 243
Step 6: Decision-making in Light of the Interpretation of Test Scores......Page 248
Step 8: Recording and Reporting Results......Page 249
Case Study: James’s Assessment of Motor and Process Skills (AMPS) Report......Page 252
Study Questions......Page 256
9 Applying Models of Function to Therapy Assessment and Measurement......Page 257
Why Use Models?......Page 258
The Complexity of Human Function......Page 259
General Systems Theory and the Hierarchy of Living Systems......Page 260
International Classification of Impairments, Disabilities and Handicaps......Page 264
Wade’s Four-level Model for People with Stroke......Page 267
Five-level Model of Function and Dysfunction......Page 268
International Classification of Functioning, Disability and Health......Page 276
Applying the International Classification of Functioning, Disability and Health to Therapy Assessment......Page 280
Top-down Versus Bottom-up Assessment Approach......Page 285
Case Study: ‘Mary’......Page 287
Worksheets......Page 303
Study Questions......Page 304
10 The Importance of Clinical Reasoning and Reflective Practice in Effective Assessment......Page 305
Clinical Reasoning as an Essential Component of Practice......Page 306
Clinical Judgement and Clinical Reasoning......Page 308
Scientific Reasoning......Page 309
Diagnostic Reasoning and the Therapy Diagnosis......Page 312
Problem-orientated Clinical Reasoning Process......Page 315
Therapy Diagnosis......Page 319
Interactive Reasoning......Page 323
Narrative Reasoning......Page 324
Pragmatic Reasoning......Page 327
Reflective Practice......Page 329
Reflective Practice as a Component of Continuing Professional Development......Page 331
Cognitive Dissonance......Page 334
Novice to Expert Continuum......Page 338
Further Reading......Page 341
Case Study: Mrs Ellis’ Initial Assessment Process......Page 342
Worksheet......Page 358
Study Questions......Page 359
11 Implementing the Optimum Assessment and Measurement Approach......Page 361
Improving Assessment and Measurement Practice: Where to Begin?......Page 362
Improving Your Assessment Process......Page 366
Selecting Tests......Page 369
Test Critique......Page 374
Linking Improving Your Assessment Practice to Continuing Professional Development......Page 384
Assessment and Outcome Measurement Goals for Effective Practice......Page 385
Conclusion: Achieving an Effective and Efficient Assessment......Page 388
Study Questions and Tasks......Page 389
12 The Final Case Study ‘Carol’: Experience of a Chronic Pain Service......Page 391
Introduction to the Therapists and the Chronic Pain Service......Page 392
Standardised Measures Used in the Service......Page 393
Initial Assessment......Page 394
Multidisciplinary Team Half-day Clinic Assessment Process......Page 396
Physiotherapy Assessment......Page 397
Occupational Therapy Assessment......Page 399
Multidisciplinary Team Meeting with Carol......Page 403
Individual Treatment Sessions with the Physiotherapist......Page 404
Individual Treatment Sessions with the Occupational Therapist......Page 405
The Group Intervention Programme: Turnabout......Page 406
First Follow-up Evaluation......Page 409
Six-month Follow-up Evaluation......Page 410
Service Review......Page 411
Brief Answers to Study Questions......Page 413
Worksheets......Page 419
Glossary......Page 443
List of Abbreviations......Page 451
References......Page 455
Index......Page 479