Date Presented 4/19/2018
To support instrument utility in hospital settings, the Occupational Self-Assessment–Short Form (OSA–SF) was developed and validated. Findings indicate that the OSA–SF is a valid and reliable patient-centered self-report measure of perceived occupational competence and value in inpatient rehabilitation.
Primary Author and Speaker: Rikki Ostrowski
Additional Authors and Speakers: Jennifer Wescott
Contributing Authors: Renee R. Taylor
PURPOSE: Client-centered care is essential to the delivery of quality health care services and optimal client outcomes. Despite this, implementation of client-centered measures remains a challenge in hospital-based settings. The Occupational Self-Assessment (OSA) Version 2.2 (Baron et al., 2006) is a self-report measure of clients’ occupational competence and value that is based on the Model of Human Occupation (Taylor, 2017). The OSA 2.2 has been shown to have good structural validity and internal consistency (Kielhofner et al., 2009; Taylor et al., 2011). The client-centered and collaborative nature of the OSA makes it appropriate for adults with various ability levels. However, administration length can be perceived as a barrier for its use in fast-paced rehabilitation settings. To support instrument utility in acute care and acute inpatient rehabilitation, this study aimed to develop and validate the OSA–Short Form (OSA–SF).
METHOD: The primary data were collected using a cross-sectional study design. Eighty-six adults aged 27–80 receiving acute care and acute inpatient rehabilitation services completed the OSA 2.2. The inclusion criteria specified that the participants had to be aged 18–90, able to communicate in English, and referred for occupational or physical therapy in acute care or acute inpatient rehabilitation.
Participants completed the OSA 2.2, a self-report measure of clients’ perception of their ability to perform occupations and the importance placed on those occupations (Baron et al., 2006). The OSA 2.2 consists of 21 items that are rated on two subscales, Competence and Value. The original 21-item OSA was reduced to the 12-item OSA–SF through iterative removal of items in a manner that did not compromise the instrument’s validity and reliability. The psychometric properties of the OSA–SF were examined using a partial credit Rasch model.
RESULTS: The four-point OSA–SF Competence rating scale functioned as expected and was retained. Based on the analysis, the rating scale for the Value scale was reduced to three points. The OSA–SF Competence and Value scales demonstrated adequate dimensionality and item targeting, excellent item goodness of fit, and good person goodness of fit, thus supporting instrument validity. Item hierarchies for both scales were found to be similar to those reported in previous validation studies.
The OSA–SF Competence and Value scales separated the items into three distinct groups with good reliability. The Competence scale separated the participants into three distinct groups with good reliability, and the Value scale separated the participants into two distinct groups with adequate reliability. The OSA–SF was found to have excellent concurrent validity with the OSA 2.2.
CONCLUSION: Provided the ever-increasing focus on client-centered care in rehabilitation, it is essential that occupational therapists are equipped with valid and reliable assessment tools that can guide client-centered goal setting and treatment planning. These research findings support reliability and validity of the 12-item OSA–SF in acute care and acute inpatient rehabilitation. Although the present study offers preliminary support for utility of the OSA–SF in clinical practice, additional research with a more heterogeneous population of occupational therapy clients is warranted.
IMPACT STATEMENT: The findings from this study suggest that the OSA–SF is a valid and reliable self-report measure of the client’s perceived occupational competence and value that can be used to guide client-centered practice in acute care and acute inpatient rehabilitation.
References
Baron, K., Kielhofner, G., Iyenger, A., Goldhammer, V., & Wolenski, J. (2006). The Occupational Self-Assessment (OSA) Version 2.2. Chicago: Model of Human Occupation Clearinghouse, University of Illinois at Chicago.
Kielhofner, G., Forsyth, K., Kramer, J. M., & Iyenger, A. (2009). Developing the Occupational Self Assessment: The use of Rasch analysis to assure internal validity, sensitivity, and reliability. British Journal of Occupational Therapy, 72, 94–104. https://doi.org/10.1177/030802260907200302
Taylor, R. R. (2017). Kielhofner’s Model of Human Occupation: Theory and application (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
Taylor, R., Lee, S. W., Kramer, J., Shirashi, Y., & Kielhofner, G. (2011). Psychometric study of the Occupational Self Assessment with adolescents after infectious mononucleosis. American Journal of Occupational Therapy, 65, e20–e28. https://doi.org/10.5014/ajot.2011.000778
