Routine use proportion and determining factors of the Canadian Occupational Performance Measure in the real-world setting: A retrospective cross-sectional study in Japan

Abstract

Introduction The aim of this retrospective cross-sectional study is to examine the routine use proportion and factors determining the use of the Canadian Occupational Performance Measure in the real-world subacute rehabilitation setting. Methods This study retrospectively collected data from all inpatients and occupational therapists at a single Japanese subacute rehabilitation ward during 2017, including Functional Independence Measure motor/cognitive scores, years of experience, and rate of Canadian Occupational Performance Measure administration (that is, Canadian Occupational Performance Measure proportion). Multiple logistic regression analyses were used to identify the determining factors of daily routine Canadian Occupational Performance Measure use/non-use, after which cut-off values were calculated. Results Of the 619 included clients, the Canadian Occupational Performance Measure was applied in 232 cases (37%). A multiple logistic regression analysis revealed two significant determining factors of its use: Canadian Occupational Performance Measure proportion (odds ratio, 1.06) and Functional Independence Measure cognitive item (odds ratio, 1.22). The cut-off value, sensitivity, and specificity, respectively, were 35.4%, 0.73, and 0.36 ( p < 0.0001) for the Canadian Occupational Performance Measure proportion and 25.5, 0.84, and 0.45 ( p < 0.0001) for the Functional Independence Measure cognitive score. Conclusion The client’s high-level cognitive skill and occupational therapist’s attitude may determine the use of the Canadian Occupational Performance Measure.

Information bias in the Canadian occupational performance measure: A qualitative study

“…In addition to the problems described above, this study also identified sources of information bias that related more to problems with scoring change in occupational performance over time. A ceiling effect in the initial scoring of COPM is a problem we have noted in an earlier study: In a study of 232 COPM assessments in an inpatient rehabilitation hospital in Japan, we found that 5% of all initial COPM assessment involved scores of 9 or 10 (Sawada et al, 2020). Baseline scores of 9 or 10 are problematic because they cannot be used to detect the clinically meaningful difference of >2 points on the COPM scale at reassessment (Law et al, 2014).…”

“…Selection bias occurs when data collection is influenced by the methods used to recruit participants or by factors affecting their participation (Tripepi et al, 2010). For example, in one hospital in Japan, we found that the COPM was used with 37% of clients, with OTs being statistically more likely to use the measure when clients had a higher cognitive score (Sawada et al, 2020). Information bias occurs when there are systematic distortions in the collection of data (Tripepi et al, 2010).…”

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

“…Our sample was predominantly experienced therapists. We do not know how or if results might have been different with a more varied or less experienced sample although a recently published analysis investigating factors that determined the use of the COPM indicated that years of experience was not among the relevant factors [24]. That said, the sample being relatively experienced is noteworthy.…”

“…A recent retrospective chart review conducted in Japan found a 37% rate of actual COPM use in a subacute rehabilitation context [24]. This impressive rate of "real-world" COPM use should lead us to feel optimistic about increasing COPM use rates.…”