A Reliability analysis of a clock test for patientes diagnosed with Alzheimer’s Disease: Implications for kinesiotherapy

This study focused on the reliabilty of the RCCT, specifically interrater and scale intercorrelational reliability. The administrators of the RCCT were kinesiotherapist and recreational therapists who were not trained in adminstration of the the RCCT. The interrater reliability was .95 and .86. This suggests that practitioners are reliable when using the manual to learn administration. In addition, there were strong positive correlations between the subscales and total RCCT scores.

“Clock tests are relatively cost effective quick screening tools, non-threatening in nature, portable with bedside capability, which are easily administered, and easily scored” pg 44

“While verbal tests are the common method of cognitive assessment, some geriatic patients may find this to be very thretening and may respong negatively to questioning because of decreased verbal skills” pg 44

Olsson, R., Greninger, L., Kucharewski, R., Bahmer, W., Gilbert, M., & Eichner, H. (2000). A reliability analysis of a clock test for patients diagnosed with Alzheimer’s Disease: Implications for kinesiotherapy. Clinical Kinesiology, 54(2), 44-47.

Jenny

Clocks tell more than time

This study found that those with high risk based on visual-spatial functioning were more likely to experience a fall over a 90 day period. (roughtly 3 times more likely to experience a fall). This suggests predictive validity of the RCCT.

Wambold, S., Brock, B., Waugh, D., Olsson, R., & Sprague, R. (2006). Clocks tell more than time. Provider, 31-34.

Jenny

Assessment of Cognition in the Elderly

This articles gives some good suggestions for administoring cognitve assessment (ex. give in short time periods, allow someone familiar to stay).

“Particularly in the early stages of dementia, defensive and agitated behaviors may occur when an older individual is confronted with cognitive losses as a result of poor test performance.” p 297. This article talks about how some individuals respond to cogntive tests poorly b/ they find them threatening or silly. For this reason, a drawing test might be less threatening.

Assessment domains: general appearance, speech patterns, care for oneself, level of awareness, orientation to external setting, memory, calculation, intellect, perceptual patterns, mood, thought processes

Dellasega, C. (1998). Assessment of cognition in the elderly: Pieces of a complex puzzle. Geriatric Nursing, 33(3), 395-405.

Jenny

Validity and reliability analysis of the RCCT for Individuals diagnosed with down syndrome

Purpose: determine reliability and validity with individuals with Down Syndrome

“the RCCT can be used to assess suble change in memory and overall cogntive functioning” pp 15

Research quetions

1. Is there a relationship between the RCCT and the Wechsler Adult Intelligence Scale for indiiduals diagnosed as DS? 2. Can the RCCT administred to individuals with DS discriminate between the American Association for Mental Disorders classifications? 3. Is there a relationship between the the first and second administration of the RCCT to individiuals diagnosed with DS? 4. Is there a relationship between the RCCT novice Certified Mental Retardation Specialist and one senior author of th RCCT when scoring the RCCT?

Results:

There was a correlation between the WAIS IQ score and the RCCT (pearson r =.80, p<.001). Ths supports tha the RCCT is testing cogntive/mental skills and performance.

The RCCT discriminated between MIld, Moderate, severe/Profound MR classifications. This supported previous findings that the RCCT could discriminate between grade levels (Brock, et al., 1999).

Strong relationship between (pearson r=.98, p<.001) between first and second administration. with strong internal consistancy (alpha of .99).

Relationship between expert and novice was .97 (pearson r).

Olsson, R. H., & Wambold, S. (2003). Validity and reliability analysis of the Reality Comprehension Clock Test (RCCT) for individuals diagnosed with down syndrome. The Journal of Multicultural Nursing and Health, 9(3), 29-33.

Jenny

Strangers in a Strange Land: Health Care Experiences for Recent Latino Immigrant in Midwest Communities

This qualitatitive focused on the barriors to health care hispanic immigrants. The main barriors were lack of health insurance, language barriors, and social isolation. 20% or respondants identified language barriors as their main obsticle. Many of these people looked for friends who were able to translate. They frequently delayed care or left not understanding their diagnosis or treatment needs. Additionally, participants identified translation services offered at the hospital to be inadequate.

Harari, N., Davis, M., & Heisler, M. (2008). Strangers in a strange land: Health care experiences for recent Latino immigrants in Midwest communities. Journal of Health Care for teh Poor and Underserved, 19, 1350-1367.

Jenny

A model of Person-Environment Compatibility

http://pao.chadwyck.com/articles/results.do;jsessionid=B2EA9D44E1DC7F3C28FE4DA157B9000B?QueryType=articles

Ecological Models in Occupational Therapy

(Brown, 2009)

Brown, A. (2009). Ecological Models in Occupational Therapy. In E. Crepeau, E. Cohn, & B. Schell, Willard and Spackman’s Occupational Therapy (pp. 435-461). Philidelphia: Lippincott Williams & Wilkins.

• The ecological models were built on social science theory, earlier OT models and the disability movement
• Czikszentmihalyi (1990) created another goodness of fit model based on the concept of flow. A flow experience occurs when a persons skills and abilities match the challenges of the activity. One is completely absorbed in the occupation that the passing of time goes unnoticed  (p. 436)
• The PEO model is based on the goodness of fit
• Studies that indicate a relationship between environment and occupational performance provide support for the ecological models (p. 443)
• DEFINITIONS
• Person a holistic view of the person is considered involving the mind, body and spirit. Values and interests help determine what is important, meaningful and enjoyable to the person. Skills and abilities include cognitive, social, emotional, and sensorimotor skills. As well as abilities such as reading and knowing how to balance a checkbook (p. 436)
• Environment where occupational performance takes place. Consists of physical, cultural, and social components.
• The physical environment is the most tangeable. It includes built and natural features.
• The cultural environment is based on shared experiences that determine values, beliefs and customs. The cultural environment includes ethnicity, religion and national identity.
• The social environment is made up of interpersonal relationships, social groups, large political and economic systems.
• Temporal environment is made up of time-oriented factors associated with the person (developmental and the life stage), and the task (when it takes place, how often and long).
• The environment can be helpful or create barriers to occupational performance
• Occupation/Task (p. 437)
  
• involves actions, which are observable behaviors, tasks which are combinations of actions with a common purpose and occupations which are goal directed meaningful pursuits that typically extend over time.
• Occupational Performance is the result of the combination of person, environmenta and occupation-

-Carla

Other lines of PEO research

Law (1996)

Baker and Intaglita (1982)

Berlin (1989)

Kahan (1982)

Kaplan (1982)

Csikszentmigayi and Csikszentmigayi  (1988)

CAOT (1991)

-Carla

Application of the Person-Environment-Occupation Model: A practice tool

(Strong, Rigby, Stewarts, Law, & Cooper, 1999)

Strong, S., Rigby, P., Stewarts, D., Law, M., & Cooper, B. (1999). Application of the Person-Environment-Occupation Model: A practical tool. Canadian Journal of Occupational Therapy, 66(3) 122-133.

• Since PEO Model was initially proposed as a tool to examine complex occupational performance issues, it has been used in hospitals, community, academic and research settings (p. 123)
• The PEO Model was developed using concepts mainly from environmental-behavior theories, theories of occupation, and client centered practice (p. 123)
• The model is conceptualized as the person, his/her envir. and occupaions dynamically interacting over time. The main diminsions are represented by inter-related circles or spheres. The amount of overlap demonstrated the amount of congruence in the areas. the more they overlap the more the harmont or fit. The area in the center of the overlap represents occupational performance (p. 124)
• The level of satisfaction of an experience is usually related to the fit
• There are internal/local and external/macro changes that can occur and impact fit
• Ex. over time there is change in peoples age, health as they move through the life cycle and developmental phases. The changes require changes within the PEO transaction in order to result in a satisfying functional outcome (p. 124)
• An Example of PEO with a client:
• Person = interests, values, sensory and motor abilities, decision-making, problem-solving, and finances
• Environment = resources available from the hospital and at home
• physical characteristics of home and community
• friends
• Occupation = meal choices, time demands, organizational and physical requirements of meal preparation, and options for obtaining meal
• When applying the model it allows therapists to analyze complicated situations, plan interventions, and focus on what is important for enabling optimal occ. performance (p. 125)
• The PEO is being used by OTs in a variety of settings and has been found to be a practical too to assist practice (p. 131)
• A strength of the model is that it allows therapist to consider the complex nature of human functioning and experience in the day to day lives
• It allows the consideration of human development and change. (p. 132) PEO elements trasacting over the lifespan across changing situations
• It allows a systematic approach to analyze occupational performance issues
• It assists therapists to put their activities into a framwork that has a broad scope of occupational therapy practice and offers multiple options for intervention
• This model encourages communication within and outside the profession (p.132)
• It allows therapists to explain themselves and others what they do
• The model is easy to understand and does not appear to be culturally bound (p. 132)
• It embodies principles of client-centered practice and supports collaboration working partnership (CAOT, 1997)
• The PEO facilitates practice by:
• considering the complexities of human function and experience
• offering a systematic approach to the analysis of occupational performance issues
• Expanding the scope of practice and options for inervention
• Facilitating communication within and outside the profession
• Supporting the pursuit and continued development of client-centered community based practice(p.133)

-Carla

Aging in context across the adut life course: Integrating physical and social environmenta research perspectives

http://books.google.com/books?id=B7hHE0s5l6kC&printsec=frontcover#PPA5,M1

Wahl, H., & Lang, F.R., (2oo3). Aging in context across the adut life course: Integrating physical and social environmenta research perspectives. In H. Wahl, R. Scheidt, & P. Windley, Focus on aging in context (pp. 1-33). New York: Springer Publishing Company.

(Wahl & Lang, 2003)

-Carla