عملکرد کارکردی در بیماران شدید روانپزشکی و معرفی ابزارهای پرکاربرد کاردرمانی جهت ارزیابی آن: مطالعه مروری

نوع مقاله: مقاله مروری

نویسندگان

گروه کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

10.22037/jrm.2019.111964.2133

چکیده

مقدمه و اهداف
امروزه اختلالات شدید روانپزشکی مانند اختلالات خلقی و اسکیزوفرنیا به­علت اختلال در عملکردهای فیزیولوژیکی، روانی-اجتماعی و ژنتیکی ایجاد می­گردد. این اختلالات بر عملکرد کارکردی این افراد تاثیر می­گذارد. عملکرد کارکردی به توانایی افراد برای انجام فعالیت­های روزمره و وجود کارایی در حوزه­های شغل، تفریح و مراقبت از خود و همچنین داشتن رضایت از انجام این فعالیت­ها گفته می­شود. وجود عملکرد کارکردی باعث مشارکت، بهزیستی و استقلال این افراد می­شود؛ بنابراین ارزیابی عملکرد کارکردی و آشنایی با ابزارهای پرکاربرد و دارای مشخصات روانسنجی مناسب در این زمینه برای ارائه خدمات حائز اهمیت است.
مواد و روش ­ها
در مطالعه حاضر ابتدا عملکرد کارکردی در بیماران شدید روانپزشکی تعریف و شرح داده شد. سپس پس از بررسی کتاب­های موجود در حوزه کاردرمانی روان و پایگاه­های اطلاعاتی Google Scholar، PubMed، ProQuest و OT Seeker در مرحله اول آزمون­های پرکاربرد را شناسایی کرد، سپس در مرحله دوم به بررسی مشخصات روانسنجی آزمون­ها در پایگاه­های اینترنتی و کتابچه راهنمای تست­ها پرداخته شد.
یافته ­ها
با توجه به جستجوی صورت­گرفته، 316 تست مورد شناسایی قرار گرفت که با توجه به معیارهای ورود و خروج که شامل سنجش عملکرد کارکردی، استفاده از روش­ها و آموزش­های استاندارد مختص بیماران روان بزرگسال دارای کاربرد کلینیکی، نشان دادن کارایی درمان، سنجش مشخصات فرد و مشخصات روانسنجی مناسب، شش آزمون OPHI، COPM، ACLS، KELS، BaFPE و AMPS بود، برای این مطالعه مورد بررسی قرار گرفت.
نتیجه­ گیری
به نظر می‌رسد با اهمیتی که عملکرد کارکردی در توانایی این افراد برای مشارکت، بهزیستی و استقلال دارد، آشنایی با ابزارهای ارزیابی عملکرد کارکردی که در مطالعه حاضر مورد شناسایی قرار گرفت، می­تواند گامی مهم در راستای غربالگری، ارائه خدمات درمانی و نشان دادن کارایی درمان برای این افراد باشد. همچنین به­منظور استفاده این آزمون­ها در داخل کشور پیشنهاد می­شود آزمون­هایی که هنجاریابی نشده­اند، مورد بررسی قرار گیرند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Functional Performance in Severe Psychiatric Patients and Introducing Most Practical Occupational Therapy Tools to Assess It: A Review Study

نویسندگان [English]

  • Ali Rashidian
  • Ashraf Karbalaee Nouri
Dep. of Occupational Therapy, University Of Social Welfare and Rehabilitation Science, Tehran, Iran
چکیده [English]

Background and Aims: Severe psychiatric disorders, such as mood disorders and schizophrenia, are caused due to impairment of physiological, psychosocial, and genetic functions. These disorders affect the functional performance of these people. Functional performance is called the ability of individuals to carry out daily activities and to have efficiency in their fields of work, leisure, and self-care, as well as having the satisfaction of doing these activities. The existence of functional performance contributes to the participation, well-being, and independence of these individuals. Therefore, evaluating functional performance and familiarity with the most widely used tools and appropriate psychometric properties in this field is essential for the provision of services.
Materials and Methods: In the current study, functional performance was first defined and described in severe psychiatric patients. After examining existing books in the field of occupational therapy of mental health, and google scholar, OT seeker, PubMed, and ProQuest databases, in the first step, identifying the most commonly used tests, in the second step, we examined the psychometric properties of the tests on the database and the test manual.
Results: Our investigation resulted in identifying 316 tests. According to entry and exit criteria, including functional performance measurement, the use of standardized methods and training, adult psychiatric disorder, clinical application, showing treatment efficacy, measurements individual profile, and appropriate psychometric properties, six tests, namely OPHI, COPM, ACLS, KELS, BaFPE, and AMPS were studied.
Conclusion: According to the results, considering the importance of functional performance in their ability to participate, well-being, and independence, familiarity with the functional performance evaluation tools identified in this study can be an important step in screening, providing health care, and demonstrating the effectiveness of treatment for these individuals. Also, in order to use these tests in our country, it is recommended that the tests which have not been standardized be investigated.

کلیدواژه‌ها [English]

  • occupational therapy
  • Evaluation
  • Psychiatric disorder
  • Assessment Tools Properties
  1. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.##
  2. Schell BA, Gillen G, Scaffa M, Cohn ES. Willard and Spackman's occupational therapy: Lippincott Williams & Wilkins; 2013. ##
  3. Atchison B, Dirette DK. Conditions in occupational therapy: effect on occupational performance: Lippincott Williams & Wilkins; 2007. ##
  4. Sørensen HJ, Nielsen PR, Pedersen CB, Benros ME, Nordentoft M, Mortensen PB. Population impact of familial and environmental risk factors for schizophrenia: A nationwide study. Schizophrenia Research  2014; 153: 214-9. ##
  5. Houston D, Williams SL, Bloomer J, Mann WC. The bay area functional performance evaluation: Development and standardization. American Journal of Occupational Therapy  1989; 43: 170-83. ##
  6. Roley SS, Barrows CJ, Susan Brownrigg OTR L, Sava DI, Vibeke Talley OTR L, Kristi Voelkerding B, COTA L, MOT ES, Pamela Toto M, Deborah Lieberman M. Occupational therapy practice framework: Domain & process 3rd edition. The American journal of occupational therapy  2014: 9-11. ##
  7. Vandad Sharifi M, Hajebi A, Radgoodarzi R. Twelve-month prevalence and correlates of psychiatric disorders in Iran: The Iranian Mental Health Survey, 2011. Archives of Iranian medicine  2015; 18: 76. ##
  8. Cara E, MacRae A. Psychosocial occupational therapy: An evolving practice: Nelson Education; 2012. ##
  9. Nielsen KT, Petersen RS, Wæhrens EE. Self-reported Quality of ADL Task Performance in Adults with Schizophrenia. Ergo 15  2015. ##
10. Lipskaya L, Jarus T, Kotler M. Influence of cognition and symptoms of schizophrenia on IADL performance. Scandinavian journal of occupational therapy  2011; 18: 180-7. ##

11. Hirsch RK. The perceived and observed occupational performance of individuals with schizophrenia 1998. ##

12. Nelson DL. Why the profession of occupational therapy will flourish in the 21st century. American Journal of Occupational Therapy  1997; 51: 11-24. ##

13. Cole MB, Tufano R. Applied theories in occupational therapy: A practical approach: Slack Thorofare, NJ; 2008. ##

14. Ikiugu MN, Ciaravino EA. Psychosocial conceptual practice models in occupational therapy: Building adaptive capability: Elsevier Health Sciences; 2007. ##

15. Castilla LM, Klyczek JP. Comparison of the kinetic person drawing task of the bay area functional performance evaluation with measures of functional performance. Occupational therapy in mental health  1993; 12: 27-38. ##

16. Ivarsson A. Occupational Performance in Individuals with Severe Mental Disorders. Assessment and Family Burden  2002. ##

17. Christiansen C, Baum CM, Bass-Haugen J. Occupational therapy: Performance, participation, and well-being: Slack Thorofare, NJ; 2005. ##

18. Flemming K. Asking answerable questions. Evidence-based nursing  1998; 1: 36-7. ##

19. Kielhofner G. Research in Occupational Therapy: Methods of Inquiry for Enhancing Practice2007. ##

20. Rice M, Cutler SK. Clinical research in occupational therapy: Cengage Learning; 2012. ##

21. Hendrick RE, Russ PD, Simon JH. Mental health concepts and techniques for the occupational therapy assistant: Raven Press (ID); 1993. ##

22. Hemphill-Pearson BJ. Assessments in occupational therapy mental health: an integrative approach: Slack; 1999. ##

23. Kielhofner G. Model of human occupation: Theory and application: Lippincott Williams & Wilkins; 2008. ##

24. Managh MF, Cook JV. The use of standardized assessment in occupational therapy: The BaFPE-R as an example. American Journal of Occupational Therapy  1993; 47: 877-84. ##

25. Leary C. The effects of age, diagnosis, gender, ethnicity, marital status, and years of education in BaFPE-TOA component and total TOA scores (Order No. 1390542) (1998). ##

26. Amaya. Using the bay area functional performance evaluation to assess individuals with dual diagnosis (Order No. EP14501). (2003). ##

27. Early mb. Mental Health Concept and Techniques for the Occupational Therapy Assistant. ##

28. Velligan DI, Bow-Thomas CC, Mahurin R, Miller A, Dassori A, Erdely F. Concurrent and predictive validity of the Allen Cognitive Levels Assessment. Psychiatry research  1998; 80: 287-98. ##

29. Marom B, Jarus T, Josman N. The relationship between the Assessment of Motor and Process Skills (AMPS) and the Large Allen Cognitive Level (LACL) test in clients with stroke. Physical & Occupational Therapy in Geriatrics  2006; 24: 33-50. ##

30. Raweh DV, Katz N. Treatment effectiveness of Allen's cognitive disabilities model with adult schizophrenic outpatients: A pilot study. Occupational Therapy in Mental Health  1999; 14: 65-77. ##

31. Helfrich CA, Chan DV, Sabol P. Cognitive predictors of life skill intervention outcomes for adults with mental illness at risk for homelessness. American Journal of Occupational Therapy  2011; 65: 277-86. ##

32. Mallinson T, Mahaffey L, Kielhofner G. The Occupational Performance History Interview: Evidence for three underlying constructs of occupational adaptation. Canadian Journal of Occupational Therapy  1998; 65: 219-28. ##

33. Lynch KB, Bridle MJ. Construct validity of the occupational performance history interview. The Occupational Therapy Journal of Research  1993; 13: 231-40. ##

34. Kielhofner G, Mallinson T, Forsyth K, Lai J-S. Psychometric properties of the second version of the Occupational Performance History Interview (OPHI-II). American Journal of Occupational Therapy  2001; 55: 260-7. ##

35. Park S, Fisher AG, Velozo CA. Using the assessment of motor and process skills to compare occupational performance between clinic and home settings. American Journal of Occupational Therapy  1994; 48: 697-709. ##

36. Goldman SL, Fisher AG. Cross-cultural validation of the Assessment of Motor and Process Skills (AMPS). British Journal of Occupational Therapy  1997; 60: 77-85. ##

37. Fisher AG. The assessment of IADL motor skills: an application of many-faceted Rasch analysis. American journal of occupational therapy  1993; 47: 319-29. ##

38. Stauffer LM, Fisher AG, Duran L. ADL performance of black Americans and white Americans on the assessment of motor and process skills. American Journal of Occupational Therapy  2000; 54: 607-13. ##

39. Fisher AG, Liu Y, Velozo CA, Pan AW. Cross-cultural assessment of process skills. American Journal of Occupational Therapy  1992; 46: 876-85. ##

40. Merritt BK. Validity of using the Assessment of Motor and Process Skills to determine the need for assistance. American Journal of Occupational Therapy  2011; 65: 643-50. ##

41. McNulty MC, Fisher AG. Validity of using the Assessment of Motor and Process Skills to estimate overall home safety in persons with psychiatric conditions. The American journal of occupational therapy : official publication of the American Occupational Therapy Association  2001; 55: 649-55. ##

42. Zimnavoda T, Weinblatt N, Katz N. Validity of the Kohlman Evaluation of Living Skills (KELS) with Israeli elderly individuals living in the community. Occupational Therapy International  2002; 9: 312-25. ##

43. Ilika Y, Haffman N. Concurrent validity study on Kohlman evaluation of living skills and global assessment scale. Unpublished manuscript  1981. ##

44. Burnett J, Dyer CB, Naik AD. Convergent validation of the Kohlman Evaluation of Living Skills as a screening tool of older adults' ability to live safely and independently in the community. Archives of physical medicine and rehabilitation  2009; 90: 1948-52. ##

45. Davis J, Kutter CJ. Independent living skills and posttraumatic stress disorder in women who are homeless: Implications for future practice. American Journal of Occupational Therapy  1998; 52: 39-44. ##

46. McGourty LK. Kohlman evaluation of living skills. Seattle, WA, KELS Resarch  1979. ##

47. Houston D, Williams SL, Bloomer J, Mann WC. The Bay Area Functional Performance Evaluation: development and standardization. The American journal of occupational therapy : official publication of the American Occupational Therapy Association  1989; 43: 170-83. ##

48. Ali rashidian akn, sammaneh hossen zade, hojatollha haghgo. A psychometric study of Bay area Functional Performance Evaluation-Task Oriented Assessment (BaFPE-TOA) in severe psychiatric patient archive of rehabilitation  2018. ##

49. Law MC, Baptiste S, Carswell A, McColl MA, Polatajko HJ, Pollock N. Canadian occupational performance measure: Canadian Association of Occupational Therapists Toronto; 1998. ##

50. Dedding C, Cardol M, Eyssen IC, Beelen A. Validity of the Canadian Occupational Performance Measure: a client-centred outcome measurement. Clinical rehabilitation  2004; 18: 660-7. ##

51. McColl MA, Paterson M, Davies D, Doubt L, Law M. Validity and community utility of the Canadian Occupational Performance Measure. Canadian Journal of Occupational Therapy  2000; 67: 22-30. ##

52. Warren A. An evaluation of the Canadian Model of Occupational Performance and the Canadian Occupational Performance Measure in mental health practice. British Journal of Occupational Therapy  2002; 65: 515-21. ##

53. Kazazi L, Karbalaei Noori AM, Mahmoodi. Evaluation of cognitive levels in schizophrenic patients using Allen cognitive level screening (ACLS) Journal of Research in Rehabilitation Sciences  2011; 7 ##

54. Kielhofner G, Henry AD. Development and investigation of the occupational performance history interview. American Journal of Occupational Therapy  1988; 42: 489-98. ##

55. Kazazi L, karbalaei Noori A, Rafei H. The reliability and validity of kohlman evaluation of living skills in schizophrenic patients. Journal of Research in Rehabilitation Sciences  2010; 6. ##

56. Thomson LK. The Kohlman evaluation of living skills: Amer Occupational Therapy Assn; 1992. ##

57. Bloomer JS, Williams SK. Bay Area Functional Performance Evaluation: Behavioral Guidelines: Consulting Psychologists Press; 1978. ##

58. Dehghan L, Dalvand H, Pourshahbaz A. Translation of Canadian Occupational Performance Measure and testing Persian version validity and reliability among Iranian mothers of children with cerebral palsy. Journal of Modern Rehabilitation  2015; 9: 25-31. ##

59. Pan A-W, Fisher AG. The Assessment of Motor and Process Skills of persons with psychiatric disorders. American Journal of Occupational Therapy  1994; 48: 775-80. ##

60. Allen CK, Blue T, Earhart CA, editors. Understanding cognitive performance modes1998: Allen Conferences Incorporated. ##

61. Allen CK, Earhart CA, Blue T. Occupational therapy treatment goals for the physically and cognitively disabled.   1992. ##