A Systematic Review of the Canadian Occupational Performance Measure: A Clinical Practice Perspective

Abstract

Occupational therapists working to a philosophy of client-centred practice will benefit from a reliable and well reviewed outcome measure to provide an evidence base. A systematic review of the literature was undertaken to evaluate worldwide publications on the use of the Canadian Occupational Performance Measure (COPM) to determine its impact on clinical practice in occupational therapy. A literature search strategy was deployed which resulted in a review of 64 articles. A themed analysis approach was used to integrate the results into linked and recurring themes. The focus of the systematic review was to concentrate on issues affecting clinical practice and the following were selected as key factors for consideration: negative and positive issues arising from the use of the COPM; impact on practice for the therapist, client, process and clinical work; and change initiatives for the therapist, client, process and clinical practice. A profile of all articles, which identifies where these factors are indicated, is presented as a summary guide to assist the clinician. The findings of the review indicated that the greatest impact of using the COPM was within clinical practice. Change initiatives indicated the need for further research in different clinical areas, as well as the continual development and need for more training of occupational therapists in the use of COPM as an outcome measure.

The Experience of Transition to College for Students Diagnosed with Asperger’s Disorder

“…The COPM is a client-centered standardized outcome measure that uses a semi-structured interview to identify and rate performance and satisfaction in self-identified problem areas on a 1-10 Likert scale (Law et al, 2005). A systematic review by Parker and Sykes (2006) reported that the COPM is responsive to change over time, shows positive effects with client-related factors, allows clients to name their own problems and generate client-centered goals, and allows therapists and clients to feel as if they are partners. Test-retest reliability of the COPM has been determined to be at .80 and above.…”

O uso da Medida Canadense de Desempenho Ocupacional (COPM) em saúde mental

“…O fato de o cliente apresentar déficits cognitivos é assinalado como uma limitação de uso da medida, já que sua habilidade de tomar decisões fica restrita (CLEwES, 2003;PAN et al, 2003;CARSwELL, 2004;PARkER;SYkES, 2006;CHATFIELD;BECkETT, 2007). Os terapeutas ocupacionais que aplicaram a COPM ressaltaram ainda a dificuldade de classificar alguns dos problemas identificados pelos clientes nas áreas de desempenho ocupacional que o instrumento aborda (PAN et al, 2003).…”

“…Outra vantagem detectada por meio da aplicação da COPM diz respeito ao esclarecimento dos membros da equipe multidisciplinar sobre o papel do terapeuta ocupacional, repercutindo em encaminhamentos mais apropriados para essa modalidade de intervenção (wARREN, 2002;CRESSwELL;RUGG, 2003;CLEwES, 2003;CARSwELL, 2004;PARkER;SYkES, 2006). Tal vantagem pode contribuir para a minimização da incongruência entre a razão para se procurar o serviço, o procedimento de admissão, o serviço em si e seu resultado.…”

“…Os autores pesquisados salientam a importância de o terapeuta ocupacional ter conhecimento sobre o modelo da prática centrada no cliente e também ser treinado para utilizar o instrumento na prática clínica (wARREN, 2002;wRESSLE et al, 2002;CLEwES, 2003;PAN et al, 2003;PARkER;SYkES, 2006;CHATFIELD;BECkETT, 2007;DEDDING et al, 2007). A literatura aponta ainda que a experiência do terapeuta no campo da saúde mental é muito importante para a utilização do instrumento com o propósito de auxiliar os clientes no estabelecimento de objetivos realistas e na construção de planos de tratamento que visem à superação das dificuldades identificadas no desempenho ocupacional (CHESwORTH et al, 2002).…”

“…A COPM é uma medida válida e confiável e tem sido utilizada de forma bem sucedida com diversos grupos de clientes, em diferentes locais (CARSwELL, 2004;EYSSEN et al, 2006;PARkER;SYkES, 2006;LEXELL et al, 2006;CHATFIELD;BECkETT, 2007). Os estudos atestam a versatilidade internacional e a aplicabilidade cultural da COPM, mesmo tendo ela sido desenvolvida em contexto cultural canadense (CARSwELL, 2004).…”