Strategies in the development of outcome measures

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Introduction of the problem

Occupational therapists are facing many challenges when measuring outcomes after intervention. This chapter gives the reader an overview of the background and setting of the problem, and how this research has been planned to investigate the problem.
Occupational therapists in mental health care settings find it difficult to produce convincing evidence of their contribution to health care. What they do looks simple (Mattingly & Flemming 1994). Making cards with patients, facilitating groups, planning and preparing meals with patients, teaching stress management, playing volleyball etc. seem to be simple tasks or activities. What happens behind the scenes, such as applying theoretical frameworks and models to guide clinical reasoning and activity analysis, building the therapeutic relationship, and adapting activities and the environment before deciding on these « simple » activities, are not always evident to patients, care givers, multidisciplinary team members, management, or to employers.
Occupational therapists rely on theoretical frameworks to guide practice, and several theories and models are available (Law, Baum & Dunn 2001a). These theories and models provide assessment and intervention methods, techniques or principles, but should also assist in providing evidence of the service delivered. Consistent and routine measurement of outcomes of the service could provide the much needed evidence of the effect of the service (Baum & Christiansen 2005a; Bowman 2006; Lakeman 2004; Laver Fawcett 2007; Law, King & Russel 2001a; Unsworth 2000). All measuring instruments, including outcome measures, should be supported by a theoretical framework or model of practice. When a specific theory is used in an outcome measure, it should support the clinician in the types of services that are delivered. For example if a clinician addresses balanced lifestyle and role performance in intervention, the guiding theory should include engagement and participation in occupation.

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Chapter 1
1.1 Introduction of the problem
1.2 Background and setting of the problem
1.3 Quantifying mental health outcomes in occupational therapy
1.4 Definition of the problem
1.5 Purpose of the study
1.6 Research aims and objectives
1.7 Value of the study
1.8 Concluding remarks
Chapter 2
2.1 Introduction
2.2 Key issues in outcome measurement
2.3 Strategies in the development of outcome measures
2.4 The outcomes research process .
2.6 Outcome measurement in occupational therapy .
2.7 Occupational therapy models .
2.8 Concluding remarks
Chapter 3
3.1 Introduction
3.2 Challenges in measurement of human behaviour
3.3 Tools and techniques in measurement of human behaviour.
3.4 Psychometrics
3.5 Concluding remarks
Chapter 4
4.1 Introduction .
4.2 Research approach for the three phases
4.3 Research design for the three phases
4.4 Phase 1
4.5 Phase 2
4.6 Phase 3 .
4.7 Ethical issues considered
Chapter 5
5.1 Introduction
5.2 Phase 1: Focus groups with occupational therapy clinicians and mental health care users
5.2.1 The sample
5.2.2 Analysis of the data from the focus groups with clinicians
5.2.3 Results of the nominal group technique .
5.2.4 Results from individual and focus group interviews with mental health users/clients .
5.3 Phase 2: Design and development of the outcome measure
5.3.1 Scale development .
5.3.2 Operationalisation of the domains
5.3.4 Guidelines for use of the instrument
5.3.5 Training of the clinicians in the use of the outcome measure
5.4 Phase 3: Pilot the outcome measure and investigate selected psychometric
5.4.1 Psychometric propertie
5.4.2 Clinical Utility .
5.5 Concluding remarks .
Chapter 6
Chapter 7
References .


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