"It has changed my picture of myself": how did females living with chronic pain perceive the impact of the standard pain rehabilitation, including the occupational therapy lifestyle intervention REVEAL(OT)?

PURPOSE: This study investigated patient perceptions of multidisciplinary chronic pain rehabilitation, including the occupational therapy lifestyle management program REVEAL(OT), on everyday life with chronic pain. METHODS: Individual interviews were conducted using video conferencing after completing multidisciplinary chronic pain rehabilitation. The interviews followed a semi-structured interview guide and investigated patient experiences with occupational therapy-supported health behavior transformation. The interviews were transcribed verbatim and analyzed iteratively using an inductive semantic data-driven approach inspired by Braun & Clarke's methodology. RESULTS: Five females, 34 to 58 years old, revealed three common themes: To discover oneself anew; Increased energy and calmness; and Look into the future. The themes reflected transformations towards a healthier lifestyle through enhanced self-control, developing meaningful and secure everyday activities, and gaining reaffirmed dignity. The study also identified the participants' need for professional assistance to cope with the pain after discharge. CONCLUSIONS: Chronic pain rehabilitation that included an occupational therapy intervention supported health behavior transformation and chronic pain self-management in females, where meaningful daily occupations and physical activity played an important role. Individually tailored support, also available after chronic pain rehabilitation, would benefit the transformation process towards improved pain coping in females.Implications for rehabilitationPersonal gains for health and well-being may develop over a shorter or longer time after chronic pain rehabilitation.Targeting daily occupations and physical activity during chronic pain rehabilitation appears meaningful for females living with chronic pain.Progression from an individual to group approach can be relevant in planning chronic pain rehabilitation, but the individual capacities shall be considered.Male perspectives on chronic pain rehabilitation that includes focus on daily occupations and lifestyle need further investigation.

Reliability and validity of the Danish version of the Self-Assessment of Modes Questionnaire.

BACKGROUND: The Self-Assessment of Modes Questionnaire (SAMQ) is developed to help therapists identify their preferred use of modes when interacting with clients in clinical practice. A Danish translation of the SAMQ has been developed (D-SAMQ). To provide a robust instrument for occupational therapy practice and research, evaluation of the psychometric properties of the D-SAMQ is needed. OBJECTIVES: The study aims to evaluate test-retest reliability, measurement error and content validity in terms of cultural relevance of the D-SAMQ. MATERIAL AND METHODS: Danish occupational therapists were recruited to represent diverse clinical settings and to work with various age groups. The D-SAMQ consists of 20 clinical cases. A repeated measures design was employed with evaluation of content validity at the second timepoint. The Content Validity Index and Kappa statistics were employed. RESULTS: In most cases (n = 12, 60%) agreement (test-retest reliability and measurement error) was moderate or strong. Also, there was a moderate (n = 6 cases, 30%), strong (n = 4 cases, 20%) or almost perfect agreement (n = 10 cases, 50%) on the cultural relevance of the cases. CONCLUSIONS: Acceptable test-retest reliability, measurement error and content validity were found. The SAMQ may support occupational therapists to adapt their therapeutic style to meet the needs of the clients.

Danish translation, adaptation and initial validation of the clinical assessment of modes questionnaires.

BACKGROUND: The Clinical Assessment of Modes questionnaires (CAMQs) determine clients' preferential modes for therapy (CAM-C1), clients' perception of modes used by the occupational therapist (OTs) during therapy (CAM-C2), or modes the OTs believed to have used (CAM-T). Access to valid CAMQs for Danish OTs and clients required a rigorous translation and cultural adaptation process. OBJECTIVES: To translate and culturally adapt the CAMQs into Danish, examining face validity in a Danish context. MATERIAL AND METHODS: A 10-step guideline for the process of translating and culturally adapting questionnaires was followed. Steps 1-6 included translation into Danish, steps 7-8 involved cognitive debriefing interviews and validation based on the Content Validity Index (CVI) analyzed using Kappa statistics. Steps 9-10 finalized the process. RESULTS: CAMQs were translated into Danish. Based on cognitive debriefing interviews and CVIs involving 15 clients and 7 OTs, modifications regarding titles, layouts, instructions, wording and response categories were performed in all Danish CAMQs. The Item CVI and the modified kappa revealed that most participants had a high level of agreement on the cultural relevance. CONCLUSIONS AND SIGNIFICANCE: Translated versions of the CAMQs have been culturally adapted into Danish. The current Danish versions seem culturally relevant and useable in Danish occupational therapy.

Feasibility assessment of an occupational therapy lifestyle intervention added to multidisciplinary chronic pain treatment at a Danish pain centre: a qualitative evaluation from the perspectives of patients and clinicians.

Purpose: As part of intervention feasibility evaluation before conducting a clinical trial, this study aimed to investigate perspectives of patients and clinicians involved in the occupational therapy lifestyle-oriented programme REVEAL(OT) [Redesign your EVEveryday Activities and Lifestyle with Occupational Therapy] which was added to multidisciplinary chronic pain treatment.Methods: We conducted three focus group interviews, two with eight voluntarily selected patients and one with four clinicians. Data were analysed using Braun & Clarke's semantic data-driven analysis.Results: Patients reported satisfaction with the intervention and a greater acceptance of living with chronic pain through increased understanding of pain mechanisms, more effective daily planning and improved social interaction. Patients felt empowered to change lifestyle habits by restarting habitual interests, prioritizing joyful occupations for improved occupational balance, and lifestyle modifications. Contact to occupational therapists and peer support were important empowering factors for working with lifestyle goals. Patients and clinicians expressed their views on further improvement of the REVEAL(OT).Conclusions: Patients and clinicians found the lifestyle-oriented occupational therapy programme relevant as an add-on to the multidisciplinary chronic pain treatment. A need was expressed for a reduced information and treatment load and a higher degree of communication and cooperation among the clinicians involved in the intervention.

Clinical utility of the Danish version of the Canadian Occupational Performance Measure.

BACKGROUND: The Canadian Occupational Performance Measure (COPM) is intended to help clients identify and evaluate their occupational performance issues. As it enhances client-centred practice (CCP), more frequent use of the COPM might fulfill the political agenda of patient involvement in Denmark. However, in a study translating the COPM into Danish, challenges were found highlighting the need to study its clinical utility. AIM: To examine the clinical utility of the Danish version of the COPM (COPM-DK) and help determine whether to recommend a more routinely use. METHODS: Data gathered during qualitative interviews with 16 occupational therapists (OTs) from various settings were subjected to a qualitative content analysis. RESULTS: The COPM-DK appeared to have clinical utility, especially regarding the meaning and relevance of the information obtained, and seemed to facilitate an occupational lens and CCP. The OTs' difficulties and concerns when using the COPM and their personal and environmental commitment to the COPM seemed associated with how they performed the COPM. Thus, training was recommended to facilitate a valid and reliable use. CONCLUSION: Given the benefits and the perceived utility of the COPM-DK, a more routinely use, to place OTs and CCP in the center of Danish healthcare system, is recommended.Key MessagesThe utility of the Danish version of the Canadian Occupational Performance Measure is supported, according to Danish occupational therapists in various rehabilitation settings and hospitals.Using the Canadian Occupational Performance Measure seems to enhance a client-centred practice with collaborative goals and helps to establish partnership, being of value to the interdisciplinary team, too.The utility and acceptability of the Canadian Occupational Performance Measure seemed to be linked to the occupational therapists' experience and understanding of the Canadian Occupational Performance Measure's content and form, thus an introduction course is recommended to avoid a use that affects the assessment's validity and reliability.

Looking into the Content of the Canadian Occupational Performance Measure (COPM): A Danish Cross-Sectional Study.

PURPOSE: To examine the content validity of the Danish version of the Canadian Occupational Performance Measure (COPM-DK). MATERIALS AND METHODS: This cross-sectional study was performed in a hospital and a community rehabilitation centre. The content validity of the COPM was assessed by relating the clients' prioritized occupational performance issues (OPIs) to the conceptual model of the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the levels of the Taxonomic Code of Occupational Performance (TCOP). Six occupational therapy lecturers participated in classifying the OPIs using the TCOP. RESULTS: A total of 112 clients from a regional and community-based rehabilitation participated. The 56% regional participants came from a hospital's hand and knee surgery department. The remaining 44% participants came from a community-based rehabilitation centre with in- and outpatient departments. There were 44% males, with a mean age of 65.2 years. They prioritized 495 OPIs, of which 40% concerned self-care, 32% productivity, and 28% leisure. The prioritized OPIs were divided into a total of 224 different OPIs. There were significant differences in which areas were prioritized in the various population groups. Of the OPIs, 64.3% could be classified into the TCOP levels of occupation and activity, i.e., 1/3 of the OPIs were related to tasks and actions, and thus beyond the scope of the COPM. The interrater agreement of the OPI classification was only fair (kappa 0.3). CONCLUSION: The content validity of the COPM seems to depend on how and with which clients it is administered. Caution must be taken to secure OPIs on the higher levels of the TCOP, while maintaining the clients' right to nominate OPI preferences. Therefore, an introductory course and on-going support are recommendable. Bearing this in mind, the COPM seems useful to identify individual clients' prioritized OPIs in a Danish context.

The Validity of the Danish Version of the Canadian Occupational Performance Measure.

PURPOSE: To establish the construct validity of the Danish version of the Canadian Occupational Performance Measure (COPM). METHODS: A cross-sectional study was performed in two settings, a regional hospital and a rehabilitation centre in a community. Including adult clients with a variety of diagnoses, we assessed construct validity by correlating the COPM to the Occupational Self-Assessment (OSA), the five-item World Health Organization Well-Being Index (WHO-5), and the EuroQol-five domain-five level questionnaire (EQ-5D-5L). Further examination of the comparability of the OSA and the COPM was performed in two ways. First, an interrater agreement of the theoretical correlation of the 21 OSA items and the three areas of the COPM was conducted. Secondly, we examined the compliance between the prioritized occupational performance issues (OPIs) and items of the OSA prioritized for change. RESULTS: The study included a total sample of 112 participants with more than half of the participants (56%) recruited from the hospital. 109 participants had measurements for both COPM and OSA (44% males) with a mean age of 64.7 years (range 16-96 years). All correlations, between the COPM and the OSA, the WHO-5, and the EQ-5D-5L, were low or negligible (r < 0.50). Manual examination confirmed a difference in the constructs of the OSA and the COPM. This was demonstrated by a negligible interrater agreement between the items of the OSA and the areas of the COPM, and differences in the prioritized OPIs and OSA items, even if there were some resemblances, were found. CONCLUSIONS: This study suggests that the construct of the COPM provides data different to those obtained with the standardized measurements included for comparison. The present study supports the assumption that the COPM can detect unique OPIs that clients want to do, need to do, must do, or are not satisfied with the way they do.

Perceptions of the Canadian occupational performance measure in enhancing the client-centered approach in the rehabilitation process: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this qualitative systematic review is to identify whether the use of the Canadian occupational performance measure (COPM) enhances the perceived experience of a client-centered approach throughout the rehabilitation process. Specifically the review questions are:How do healthcare professionals and their clients perceive the use of the COPM as an instrument to enhance the client-centered approach in the rehabilitation process?Does the use of the COPM provide a more client-centered approach and more involvement in the rehabilitation process, as experienced by the client and professionals?How do the clients and/or the professionals perceive the usability of the COPM in regard to facilitating the client-centered approach in specific settings or phases of the rehabilitation process?

Utility of the Canadian Occupational Performance Measure as an admission and outcome measure in interdisciplinary community-based geriatric rehabilitation.

In a community-based geriatric rehabilitation project, the Canadian Occupational Performance Measure (COPM) was used to develop a coordinated, interdisciplinary, and client-centred approach focusing on occupational performance. The purpose of this study was to evaluate the utility of the COPM as an admission and outcome measure in an interdisciplinary geriatric rehabilitation context in Denmark. Eighteen occupational and physiotherapists administered the COPM among elderly citizens. Of 185 citizens referred to the study, 152 were admitted to rehabilitation based on health indices, and 124 completed the COPM after their admission, identifying 404 occupational performance issues in all. Post-assessment data were obtained from 95 participants and revealed statistically significant positive change (p < 0.001) in both performance and satisfaction with performance. Furthermore the therapists answered a questionnaire evaluating their experiences, showing that they found development in knowledge and community between the professions to benefit both therapists and citizens, and gained a better insight into their clients' everyday lives through the COPM. In conclusion, the COPM may be useful as an admission and outcome measurement for the rehabilitation of elderly citizens; however, aspects of education and administration must be considered before the instrument can be successfully administered in an interdisciplinary geriatric rehabilitation context.