|Author:||Tam, Tai-wo Katharine|
|Title:||Domains of performance assessment of activities of daily living for chronic obstructive pulmonary disease patients in Hong Kong|
|Subject:||Lungs -- Diseases, Obstructive -- Patients -- Rehabilitation -- China -- Hong Kong|
Hong Kong Polytechnic University -- Dissertations
Department of Rehabilitation Sciences
|Pages:||xiii, 189 leaves ; 30 cm|
|Abstract:||Using a qualitative research design, this study explored and identified the domains of performance assessment of chronic obstructive pulmonary disease (COPD) patients in Hong Kong. The three key objectives of the study were: 1) to explore the problems and experience of performing activities of daily living from the perspective of COPD patients; 2) to identify the indicators used by local occupational therapists in performance assessment of COPD patients; 3) to specify the objective and subjective domains in performance assessment of COPD patients. The study consists of two stages. In stage one, it explored the domains of performance assessment from the perspective of COPD patients and occupational therapists. Two focus group interviews for sixteen COPD clients living in the community with a semi-structured interview guide and self-report open-ended questionnaires to seventeen frontline occupational therapists were completed. Content analysis was conducted for the transcripts of group interview and the returned questionnaires. Coding and computer excel software assisted in sorting and clustering the data into themes, domains and categories. Two independent judges were involved to assess the accuracy of the translation and transcription, as well As to give comments on the categorization system and the frequency counting on respondents. In stage two, a panel of six professional experts evaluated the relevancy and relative importance of prioritized domains by a self-administrated questionnaire, which was generated from stage one. Results of the content analysis showed that the problems of performing activities of daily living from the perspectives of chronic obstructive pulmonary disease (COPD) patients could be categorized into five main categories: underlying components of performance, functional integration skills of performance, functional activities of performance, environment and general relating to the disease. These categories had grouped twenty-nine domains. The variables currently used by occupational therapists in performance assessment of ADL for COPD patients were grouped into four categories similar with those identified in the perspective of COPD patients. 82.32% of the respondents of occupational therapists had tried to mention these variables in specific task situations, such as "Before Task", "During Task", "After Task". The rest of the respondents of occupational therapists mentioned indicators used in non-specific task situation. Saturated oxygen blood value and heart rate were the domains mentioned by most respondents (64.8%). The domains and the themes, which were mentioned by over 10% of respondents from both the patients and occupational therapists, were chosen and evaluated by the expert panel. The confirmed domains of performance assessment of activities of daily living of COPD patients found were similar to the areas of functional assessment of COPD in the literature review. They were breathing rate, blood pressure, pulse and saturated oxygen blood value. Patients' subjective feedback on dyspnea and exertion were emphasized. On the whole, the scope of and number of the functional activities identified in this study was smaller than that of overseas ADL scales. The domains of coping skills and stress management and environment, identified in this study, were not mentioned in other studies of functional assessment. The results of this study provide important information for the design of an instrument for ADL assessment of COPD patients. The categories, domains, and themes represent the possible content areas and assessment items of a measurement instrument in this specialty. Operational definition for these domains, an appropriate scoring system and further validation of the domains need to be developed in future.|
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