Perception of occupational performance between clients and occupational therapists

Abstract

This study examined differences among clients suffered from stroke and their case occupational therapists in their perception of clients' occupational performance. The differences were examined in terms of the clients' considerations of their own illnesses and the different clinical reasoning styles of the therapists. A total of 60 clients and their case occupational therapists were recruited in five rehabilitation hospitals in Hong Kong by convenience sampling. Both groups of subjects were asked to identify clients' problems in occupational performance by following the procedure stipulated in the Canadian Occupational Performance Measure (COPM). All subjects were then interviewed to explore on the mechanisms of their perception process by protocol analysis. According to content analyses of the protocols, the clients were classified into three different groups with respect to the resources that they considered when identifying their problems. The therapists were also classified into three groups according to their styles of clinical reasoning. Results of the study revealed high percentages of agreement (95%) on the problems identified by clients who formed positive strategies when coping with their illnesses and considered all their resources and the group of therapists who employed a conditional style of reasoning. In such cases, both the clients and therapists demonstrated the consideration of internal (personal) and external (environmental) resources of the clients when problems were identified. The overall client-therapist agreement indices on the ten most common problems identified were found to be significantly higher for therapists employing the conditional and interactive styles of reasoning than procedural reasoning (F(2,51) = 10.46, p = .000). Findings of this study supported the notion that therapists adopting the conditional style of reasoning shared the most similar perception of clients' problems, which is the pre-requisite of client-centered practice. Therapists should also consider clients' responses to their disability based on which assessment and treatment can be implemented.