Assessment of productivity performance in men with HIV Associated Neurocognitive Disorder (HAND).

OBJECTIVES: The purpose of this paper is to review what is known about return to productivity roles for people who have HIV/AIDS and HIV Associated Neurocognitive Disorder (HAND), to highlight gaps in knowledge and practice for assisting people with HAND to engage in productivity roles, to describe an occupational therapy assessment system that overcomes some of the limitations of current research and practice, and to demonstrate the clinical utility of this instrument for use with clients who have HAND. PARTICIPANTS: The participant in this study is a man with HIV Associated Dementia (HAD), one sub-type of HAND. METHODS: The real-world impact of HAD on productivity role participation was assessed using the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological assessment method. Productivity tasks assessed were those associated with this man's desire to become a volunteer grocery shopper. The assessment took place under naturalistic conditions in a grocery store. RESULTS: The participant demonstrated 28.6% mastery of the grocery shopping task. Performance was impacted on primarily by errors of accuracy and timing. Reasons for these errors centered on the participant's difficulties in applying cognitive strategies to perceive, recall, plan and perform the task. CONCLUSIONS: The PRPP System of Task Analysis shows promise in being able to identify errors in task mastery and the underlying cognitive strategy application errors that impact on mastery in people with HAND.