Behaviour Change Domains Likely to Influence Occupational Therapist Use of the Canadian Occupational Performance Measure

Abstract

Introduction. Occupational therapists have shown low adoption rates for many evidence-based practices. One such practice is the limited uptake of standardized outcome measures such as the Canadian Occupational Performance Measure. Use of this measure has not consistently translated into practice despite decades of encouragement. Theory-based approaches to understanding healthcare provider behaviour change are needed if we are to realize the goal of attaining practice that is in keeping with evidence. This study utilized the Theoretical Domains Framework, a theory-based approach for understanding barriers to evidence-based practice, in order to increase our understanding of the limited uptake of the Canadian Occupational Performance Measure in occupational therapy practice. Methods. Theoretical Domains Framework methods were followed. First, primary data was collected from occupational therapists through semistructured interviews that focused on key behaviour change domains as they related to the use of the Canadian Occupational Performance Measure. Two independent researchers coded interview data into domains, derived belief statements from the data, and used belief strength, conflict, and frequency to determine the more and less influential domains for using the Canadian Occupational Performance Measure. Results. Interviews with 15 practicing occupational therapists across a range of practice areas yielded six key behaviour change domains for increasing the use of the Canadian Occupational Performance Measure. The more relevant domains were Social influences, Social professional role and identity, Beliefs about consequences, Beliefs about capabilities, Skills, and Behavioural regulation). The other eight domains were found to be less relevant. Conclusion. We identified important domains and beliefs that influence the use of the Canadian Occupational Performance Measure by occupational therapists. Results inform our understanding of the use of this measure in practice and identify potential targets for behaviour change interventions.

Clinical Utility of the Canadian Occupational Performance Measure in Older Adult Rehabilitation and Nursing Homes: Perceptions among Occupational Therapists and Physiotherapists in Spain

“…Similar to the findings of Colquhoun et al, they assumed they knew what would be the best for the clients or what they would be able to do. Parker and Sykes considered this dynamic [ 10 , 36 ]. Previous studies showed that it had to do with the adoption of the new paradigm, the difficulty, and the dedication time needed to accept this new perspective, even if the professionals had previous training [ 1 , 2 ].…”

“…This shows the necessity for each therapist to find personal strategies when conducting the interview [ 1 , 2 , 5 , 14 ]. Moreover, like any evaluation instrument, it requires learning and practice [ 36 ].…”

“…It will be a challenge to explore the multidimensional clinical utility, integrating the voices of other key actors implied in the change [ 28 , 36 ]. It would be preferable to contrast and triangulate the opinions of the family members and caregivers or receive a contribution from the institutional perspective.…”

Utilisation of outcome measures by therapy teams in an NHS Trust

“…1 It is recommended that AHPs use outcome measures in practice, however it is recognised that there is a gap between guidance and implementation. [1][2][3][4] Outcome measures are assessments which measure a change in a patient's health status over time. 5 They play an important role in directing the treatment for an individual patient, monitoring the quality and effectiveness of healthcare services, and measuring population health.…”

“…6,9,[10][11][12] Despite over 40 years of recommendations to use outcome measures, 13 AHPs are still not implementing them into routine practice. 1,2,5,11,14 Previous studies investigating outcome measure use among therapists have found anywhere from 1-65% of therapists reporting routine outcome measure use. 2,15,16 This is concerning, as without outcome measures it can prove challenging for AHPs, their patients, managers, commissioners, or the public, to know whether their work has meaningful impact on health and quality of life.…”