Development of a new occupational balance-questionnaire: incorporating the perspectives of patients and healthy people in the design of a self-reported occupational balance outcome instrument

Abstract

BackgroundSelf-reported outcome instruments in health research have become increasingly important over the last decades. Occupational therapy interventions often focus on occupational balance. However, instruments to measure occupational balance are scarce. The aim of the study was therefore to develop a generic self-reported outcome instrument to assess occupational balance based on the experiences of patients and healthy people including an examination of its psychometric properties.MethodsWe conducted a qualitative analysis of the life stories of 90 people with and without chronic autoimmune diseases to identify components of occupational balance. Based on these components, the Occupational Balance-Questionnaire (OB-Quest) was developed. Construct validity and internal consistency of the OB-Quest were examined in quantitative data. We used Rasch analyses to determine overall fit of the items to the Rasch model, person separation index and potential differential item functioning. Dimensionality testing was conducted by the use of t-tests and Cronbach’s alpha.ResultsThe following components emerged from the qualitative analyses: challenging and relaxing activities, activities with acknowledgement by the individual and by the sociocultural context, impact of health condition on activities, involvement in stressful activities and fewer stressing activities, rest and sleep, variety of activities, adaptation of activities according to changed living conditions and activities intended to care for oneself and for others. Based on these, the seven items of the questionnaire (OB-Quest) were developed. 251 people (132 with rheumatoid arthritis, 43 with systematic lupus erythematous and 76 healthy) filled in the OB-Quest. Dimensionality testing indicated multidimensionality of the questionnaire (t = 0.58, and 1.66 after item reduction, non-significant). The item on the component rest and sleep showed differential item functioning (health condition and age). Person separation index was 0.51. Cronbach’s alpha changed from 0.38 to 0.57 after deleting two items.ConclusionsThis questionnaire includes new items addressing components of occupational balance meaningful to patients and healthy people which have not been measured so far. The reduction of two items of the OB-Quest showed improved internal consistency. The multidimensionality of the questionnaire indicates the need for a summary of several components into subscales.

Occupational balance and its association with life satisfaction in men and women with rheumatoid arthritis

“…The OBQ has not previously been used in a sample with RA, and although it is intended to be generic, more knowledge is needed about its psychometric properties regarding this population. It should also be recognized that another measure of occupational balance exists and has been used in this population, the OB‐Quest (Dür et al, ). However, as the instrument had not been published at the time of data collection, it was not possible to use it.…”

Do patient-reported outcome measures cover personal factors important to people with rheumatoid arthritis? A mixed methods design using the International Classification of Functioning, Disability and Health as frame of reference

“…We used a mixed methods design consisting of a qualitative analysis, a systematic literature search and a linking process. The current project was part of a larger study [ 27 , 28 ].…”

Occupational Therapy Practice in Sleep Management: A Review of Conceptual Models and Research Evidence

“…FIM focuses on one's functioning while COPM focuses on occupational performance and satisfaction, without fully exploring lifestyle. Dür et al [ 33 ] developed an occupational balance questionnaire (OB-Quest) to further explore occupational balance, and it can be applied to assess the occupational balance of both patients and healthy individuals. More comprehensive occupation-based assessment will definitely advance the development of sleep management in occupational therapy.…”