The predictive power of narrative data in occupational therapy evaluation.
OBJECTIVE
This study examined whether adding the Canadian Occupational Performance Measure (COPM) to existing occupational therapy evaluation measures used in a subacute skilled nursing facility unit enhanced the accuracy of therapists' predictions of the functional status of clients at discharge.


METHODS
This study utilized a prospective comparison design. Two independent predictive variables were developed using the standard Functional Independent Measure (FIM), and an enhanced FIM that included narrative information from the Canadian Occupational Performance Measure (FIM/COPM). These variables were subsequently compared with the actual FIM discharge (DFIM) scores for 31 clients. The primary author (D.S.) gathered data from chart review and conducted the statistical analysis. The data were analyzed using descriptive correlations (Pearson r) and comparison statistics (Wilcoxon signed rank test).


RESULTS
Comparison statistics (Wilcoxon signed rank test) revealed a statistically significant difference between the standard FIM predictive score and the discharge FIM score. No statistically significant difference was found between the FIM/COPM predictive score and the discharge FIM score. These findings suggest that predictive scores based solely on information attained from the standard FIM resulted in less accuracy in outcome predictions. Correlational analyses further supported these conclusions.


CONCLUSIONS
The findings support the study hypothesis that use of the COPM in combination with the FIM enhances accuracy in prediction of outcomes for rehabilitative services for persons in adult physical disabilities settings.
Simmons
D C
DC
Occupational Therapy Department, University of New Hampshire, Durham 03824-3563, USA. dsimmons@cisunix.unh.edu
Crepeau
E B
EB
White
B P
BP
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000145:classification*; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D012866:Skilled Nursing Facilities; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires / Q000592:standards*