Dataset Information

Canadian Occupational Performance Measure Supported by Talking Mats: An Evaluation of the Clinical Utility.

ABSTRACT:

Background

Some clients with cognitive and communicative impairments after a brain injury are unable to participate in the Canadian Occupational Performance Measure (COPM) without support. The study originates from an assumption that some of these clients are able to participate independently in the COPM interview by using a visual material.

Aim

The aim was to investigate the clinical utility of COPM supported by Talking Mats (TM) for community-based clients with cognitive and communicative impairments.

Methods

Six clients (51-60 years) were included. After matching the visual material of TM to COPM, the COPM interview was administered twice with an interval of 10 days, once using TM and once without. Interviews were videotaped and studied by six evaluators.

Results

The most obvious benefits of using TM as a supportive tool in the COPM interview were related to the first two steps of the COPM interview.

Conclusion

Using TM in the COPM interview with clients with cognitive and communicative impairments after a brain injury is recommended as the basis for goal setting. The present study demonstrates a possibility to include a COPM interview to clients who had not been able to complete a COPM interview and thus start a rehabilitation process in a client-centered manner.

SUBMITTER: Hagelskjær V

PROVIDER: S-EPMC6362486 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Canadian Occupational Performance Measure Supported by Talking Mats: An Evaluation of the Clinical Utility.

Hagelskjær Vita V Krohn Mette M Christensen Pia Susanne PS Christensen Jeanette Reffstrup JR

Occupational therapy international 20190122

<h4>Background</h4>Some clients with cognitive and communicative impairments after a brain injury are unable to participate in the Canadian Occupational Performance Measure (COPM) without support. The study originates from an assumption that some of these clients are able to participate independently in the COPM interview by using a visual material.<h4>Aim</h4>The aim was to investigate the clinical utility of COPM supported by Talking Mats (TM) for community-based clients with cognitive and com ...[more]

PMID: 30804725

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Project description:BACKGROUND:In the past years, a mobile health (mHealth) app called the Dutch Talking Touch Screen Questionnaire (DTTSQ) was developed in The Netherlands. The aim of development was to enable Dutch physical therapy patients to autonomously complete a health-related questionnaire regardless of their level of literacy and digital skills. OBJECTIVE:The aim of this study was to evaluate the usability (defined as the effectiveness, efficiency, and satisfaction) of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of experience in using mobile technology. METHODS:The qualitative Three-Step Test-Interview method, including both think-aloud and retrospective probing techniques, was used to gain insight into the usability of the DTTSQ. A total of 24 physical therapy patients were included. The interview data were analyzed using a thematic content analysis approach aimed at analyzing the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took the participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating that was used to provide a rough estimate of the need for additional usability efforts. RESULTS:All participants within this study were very satisfied with the ease of use of the DTTSQ. Overall, 9 participants stated that the usability of the app exceeded their expectations. The group of 4 average-/high-experienced participants encountered only 1 problem in total, whereas the 11 little-experienced participants encountered an average of 2 problems per person and the 9 inexperienced participants an average of 3 problems per person. A total of 13 different kind of problems were found during this study. Of these problems, 4 need to be addressed before the DTTSQ will be released because they have the potential to negatively influence future usage of the tool. The other 9 problems were less likely to influence future usage of the tool substantially. CONCLUSIONS:The usability of the DTTSQ needs to be improved before it can be released. No problems were found with satisfaction or efficiency during the usability test. The effectiveness needs to be improved by (1) making it easier to navigate through screens without the possibility of accidentally skipping one, (2) enabling the possibility to insert an answer by tapping on the text underneath a photograph instead of just touching the photograph itself, and (3) making it easier to correct wrong answers. This study shows the importance of including less skilled participants in a usability study when striving for inclusive design and the importance of measuring not just satisfaction but also efficiency and effectiveness during such studies.

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Project description:Clinical performance measurement has been a key element of efforts to transform the Veterans Health Administration (VHA). However, there are a number of signs that current performance measurement systems used within and outside the VHA may be reaching the point of maximum benefit to care and in some settings, may be resulting in negative consequences to care, including overtreatment and diminished attention to patient needs and preferences. Our research group has been involved in a long-standing partnership with the office responsible for clinical performance measurement in the VHA to understand and develop potential strategies to mitigate the unintended consequences of measurement.Our aim was to understand how the implementation of diabetes performance measures (PMs) influences management actions and day-to-day clinical practice.This is a mixed methods study design based on quantitative administrative data to select study facilities and quantitative data from semi-structured interviews.Sixty-two network-level and facility-level executives, managers, front-line providers and staff participated in the study.Qualitative content analyses were guided by a team-based consensus approach using verbatim interview transcripts. A published interpretive motivation theory framework is used to describe potential contributions of local implementation strategies to unintended consequences of PMs.Implementation strategies used by management affect providers' response to PMs, which in turn potentially undermines provision of high-quality patient-centered care. These include: 1) feedback reports to providers that are dissociated from a realistic capability to address performance gaps; 2) evaluative criteria set by managers that are at odds with patient-centered care; and 3) pressure created by managers' narrow focus on gaps in PMs that is viewed as more punitive than motivating.Next steps include working with VHA leaders to develop and test implementation approaches to help ensure that the next generation of PMs motivate truly patient-centered care and are clinically meaningful.

Dataset Information

Canadian Occupational Performance Measure Supported by Talking Mats: An Evaluation of the Clinical Utility.

Background

Aim

Methods

Results

Conclusion

Publications

Canadian Occupational Performance Measure Supported by Talking Mats: An Evaluation of the Clinical Utility.

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