The Occupational Performance History Interview: Evidence for Three Underlying Constructs of Occupational Adaptation

Abstract

The Occupational Performance History Interview (OPHI) was developed to gather data on a person's past and current occupational functioning. The OPHI includes both a life history narrative component designed to render the life history from the client's perspective and a rating scale designed to measure the client's past and present occupational adaptation. Previous research documented the reliability of the OPHI, but there has been limited study of its construct validity. This study used Rasch analysis to determine the construct validity of a modified version of OPHI scale (OPHI-R). Data previously gathered on 20 clients in a psychiatric setting were analyzed. The results indicate that the items of the OPHI-R do not effectively measure a single construct of occupational adaptation as originally thought. Rather, the OPHI-R items appear to measure three underlying constructs reflecting occupational competence, identity and environment. These findings suggest that revision of the OPHI scale should seek to capture these three underlying constructs for the measurement of occupational adaptation. RÉSUMÉ La Occupational Performance History Interview (OPHI) a été mise au point pour recueillir de l'information sur le fonctionnement occupationnel passé et actuel d'une personne. La OPHI comprend une composante sur l'histoire du client, dont le but est de consigner l'histoire du client du point de vue du client ainsi qu'une échelle d'évaluation qui mesure la capacité d'adaptation occupationnelle passée et actuelle du client. Des recherches antérieures ont permis de mettre en évidence la validité de la OPHI, mais peu d'études se sont penchées sur sa validité de construit. La présente étude s'est appuyée sur l'analyse de Rasch pour déterminer la validité de construit d'une version modifiée de l'échelle de la OPHI (OPHI-R). On a procédé à l'analyse de données recueillies précédemment auprès de 20 clients d'un établisse-ment psychiatrique. Les résultats indiquent que les items de la OPHI-R ne mesurent pas un construit de l'adaptation occupationnelle de façon efficace, comme on le croyait à l'origine. Les items de la OPHI-R semblent plutôt mesurer trois construits sous-jacents qui sont le reflet de la compétence occupationnelle, l'identité et l'environnement. Ces résultats suggèrent que lors de la révision de l'échelle de la OPHI, il faudrait tenter de saisir ces trois construits afin de pouvoir mesurer la capacité d'adaptation occupationnelle.

Occupational Adaptation as a Construct: A Scoping Review of Literature

“…In developing the Relative Mastery Measurement Scale, George, Schkade, and Ishee (2004) emphasized the use of self-selected activities to increase engagement and increase awareness of new or modified responses to environmental demands as key features of the occupational adaptation process. In developing the Occupational Performance History Interview, Mallinson, Mahaffey, and Kielhofner (1998) also found the influence of the environment to be strong enough to warrant its assessment as a unique construct of the occupational adaptation process.…”

“…Occupational adaptation was defined in the literature as an ongoing, non-linear process to achieve a desired sense of self (Lexell, Iwarsson, & Lund, 2011); a manner of developing a sense of competence, self-efficacy, and identity in occupational participation (Johansson & Isaksson, 2011;Yazdani, 2011;Crist et al, 2005;Firfirey & Hess-April, 2014); and a manner of reframing identity, competence, the environment, and the fit between all three (Klinger, 2005;Mallinson, Mahaffey, & Kielhofner, 1998). In addition, Luck and Beagan (2015) asserted the reciprocal process between occupational adaptation and identity.…”

“…For example, in the Relative Mastery Measurement Scale based on the OA model (George, Schkade, & Ishee, 2004), occupational adaptation was viewed as a normative process that develops and changes as individuals seek relative mastery. Occupational adaptation was viewed as a process that leads to occupational identity and competence in MOHO and was a guiding construct in the development of the Occupational Circumstances Assessment Interview and Rating Scale (Lai, Hgalund, & Kielhofner, 1999) and the revision of the Occupational Performance History Interview (Mallinson et al, 1998). The goal of the aforementioned tools, directly and indirectly, is to measure the temporal progression of the individual's occupational adaptation during participation in occupations.…”

Using the OPHI-II to Support People With Mental Illness in Their Recovery

“…First, three rating scales are used to generate quantitative data from the interview that are helpful in tracking change over time for individuals. These scales are based on research that identified three underlying constructs (occupational identity, occupational competence, and environmental impact) (Mallinson, Mahaffey, & Kielhofner, 1998). Second, narrative information may be recorded descriptively and visually presented in a narrative slope diagram representing the trajectory of the person's life story.…”

Occupational Case Analysis Interview and Rating Scale: An Examination of Construct Validity

“…However, the present study also found that each OCAIRS item has its own unique scale (an unexpected but understandable finding given the unique criteria for rating each item). In contrast, studies of the WRI and OPHI scales, which use a generic format to rate all items, have found that all the items share a common scale (20,21). However, raters using these two scales show greater differences in rater severity (20,21).…”