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Occupational Performance History Interview (OPHI-II)

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Lorenzo Hernandez

on 31 October 2015

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Transcript of Occupational Performance History Interview (OPHI-II)

Applicable Population
Over the age of 12,
Cognitively aware and can respond to a life history interview
Sufficient maturity and self understanding to benefit from the interview.
Emotionally stable
If the emotional capacity of the client is questionable, keep the interview shorter or split it into multiple days

Occupational Performance History Interview (OPHI-II)
Content/ Area of Focus
The OPHI-II focuses on the life story of a person.
Using a semi-structured interview,
The therapist gains information gathered to rate
Client’s occupational identity, competence, and environment.
It also focuses on specific life events to target impact of illness and trauma in a person’s life. (Kielhofner et al., 2004)

Psychometrics
Test-retest reliability are not available for the OPHI-II. (Asher, 2014)
The original OPHI confirmed acceptable inter-rater and test-retest reliability, and construct validity.
Rasch analysis to identify the three underlying constructs (OPHI-II)
Identity, Competence, and Environment (Hemphill-Pearson, 2008)
Along with detecting differences in occupational performance (Asher, 2014)

Objective Measures
Include the 3 rating scales
Scores from 4-point ratings across all items
Key forms.
These measures provide objective data to identify the strength of the three constructs
Occupational identity,
Competence,
Environment.
The ordinal data is derived from calculated raw scores using the key form.


Reliability
History
The Occupational Performance History Interview (OPHI) is a client-centered assessment, customizable, suited for individuals with a wide range of disabilities, that was first developed in 1988 through a jointly funded research initiative by the American Occupational Therapy Association (AOTA) and American Occupational Therapy Foundation (AOTF)

There are two rationales for these differences in scoring
Because of differences in theological perspectives results of the OPHI-II may have varying levels of interrater reliability. After subsequent discussion between the Occupational Therapy Student authors of this paper it was found that one student readily tends to use a theoretical approach similar to the Model of Human Occupation, whereas the other student was found to innately use a Person Environment, and Occupation Model (PEO)
The second , single client was that there were variation in question interpretation. When discussing their reasons for particular scores, one of the Occupational Therapy Students tended to use a broader interpretation of the questions and all aspects of the historical interview and the other Occupational Therapy Student based the scores on the client’s current functioning and situation.

Validity
In Kielhofner’s study of the OPHI-II, he uses several strategies to provide evidence that the data gathered captures an underlying construct (competence, identity, and environmental support). First a scale was created to assess how effectively the items measured its intended construct. Second, the items must be able to target the population for which it was designed and discriminate between clients of different levels of adaptation.


Sr. Francis
94 years old
Grew up in New York
Has nephews and nieces upstate
Cannot drive as of this year
lives in the Convent within Dominican College school grounds
just retired 2 weeks ago
enjoys reading,, practicing her faith, helping others, keeping busy, and socializing.
Dx: fall leading to hip surgery about 1 year ago
Roles include sister, helper, teacher, and new retiree
Occupied with activities throughout the day
Walks with a cane
Ease of Administration and Scoring
Administration can be referenced in the OPHI-II Manual which provides the user with a guide to follow to conduct the interview portion.
The interview should take a place in a private area void of distractions and loud noise to allow the client to speak freely.
Formal training is not required to administer the OPHI-II.
Scoring is based on the clinical judgement of the therapist and the manual provides guidelines for scoring effectively. (Kielhofner, 2004)
Timeliness of administration and scoring
40-75 Minutes
60 minutes for student therapists

Usefulness for goal setting/intervention planning

One aspect that was a key focus within the study by Apte, Kielhofner, Paul-Ward, and Braveman (2005) was the usefulness of the Life History Narrative or Narrative Slope for setting goals.

The OPHI-II guides the therapeutic process by allowing the therapist access to the important events in a client's history. This data is important because it can be useful to identify a foundation for which to start the therapeutic process, but also support decisions for providing services, placement, necessary supports, and discharge planning. (Kielhofner et al, 2004)

Applicability to diverse setting
Mental Health
Physical Disability
Adults with Neuropsychiatric Disorders
Sleep Apnea
Spinal Cord Inury
Substance Abuse Recovery
Chronic Pain
MS
Transition Programs
Compatibility to OT FOR
MOHO is both a Model of Occupation as well as a Frame of Reference designed to explain how a person’s occupations are influenced by the interaction of Volition, Habituation, Performance Capacity, and Environmental Context (Kielhofner, 2002).
The OPHI-II directly assesses three theoretical constructs described within the scope of MOHO:
Occupational identity
Occupational competence
Environment.
(Sandell, Kjellberg, & Taylor, 2013).

Resources for utilization and interpretation of assessment
The Model of Human Occupation website (http://www.cade.uic.edu/moho/default.aspx) is a helpfull resouce in understanding the full properties of the OPHI-II.
One extradinary feature of the website is availible information through the listserve and archive (http://www.cade.uic.edu/moho/resources/listserv.aspx). T
Another rich resources for administering and interpreting the OPHI-II are The Occupational Performance History Interview (Version 2.0) OPHI-II and Model of Human Occupation: Theory and Application (4th ed) (Kielhofner, 2008) and .


Both qualitative and qualitative data are gathered

Supplies needed to complete the OPHI-II are the manual, guide for semi-structured interview, rating scales with key forms, paper and pencil for notes.

40 to 75 minutes is necessary to complete the

Time it required for student therapists to score was 1 hour.

Applicable to many different settings

Currently, psychometric properties such as test-retest reliability are not available. (Asher, 2014) Research for the OPHI-II is ongoing
OPHI-II vs. OCAIRS
Conclusion
The OPHI-II guides the therapeutic process by allowing the therapist access to the important events in a client's history. This data is important because it can be useful to identify a foundation for which to start the therapeutic process, but also support decisions for providing services, placement, necessary supports, and discharge planning.

Interview
Client-centered
Semistructured
Therapist can follow one of three pre scripted question

covering five thematic areas (Activity/Occupational Choices, Critical Life Events, Daily Routine, Occupational Roles, and Occupational Settings (Environment) the three scales, and the life history narrative.

The scales use information gathered through the interview and convert them into a total score to receive a client measure and standard error.
Standardization
Critical Analysis
Between the two Occupational Therapy Students working together to administer the assessment on a single subject,


Differences in scoring occurred on 14 out of 29 items within the three scales. Areas of difference were discussed between the two Occupational Therapy Students who then agreed upon a singular score.





There are two rationales for these differences in scoring.
Because of differences in theological perspectives results of the OPHI-II may have varying levels of Interrater reliability. \

The second rationale for the differences that emerged in scoring a single client was that there were variation in question interpretation.

No Formal Training Required
take 40-75 minutes to administer
Use of life history narrative for setting goals (motivations, interests

*not appropriate for acute settings due to the time required administering the assessment and the depth of information collected.
Conclusion
Goals

LTG: Client will increase her scheduled leisure activities to 30 minutes, 5 days a week within 8 weeks

STG1: Client will create a weekly schedule to walk for 30 minutes, atleast 3 days a week, within 2 weeks

STG2: Client will walk for 30 minutes, 3 days a week and maintain leisure activity calendar within 4 weeks
Sample Form
Full transcript