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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Staff ratings of occupational engagement among people with severe mental illness – psychometric properties of a screening tool in the day center context

Authors: Mona Eklund, Ulrika Bejerholm

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Staff who plan and organize day center activities may need to observe the attendees’ performance and progression. This led us to develop a tool for that purpose, termed General Occupational Engagement in people with Severe mental illness (GOES). The aim was to investigate its psychometric properties in terms of factor structure, internal consistency, corrected item-total correlations (CITC), convergent and discriminant validity, and test-retest stability.

Methods

Ninety-three day center attendees were assessed by the GOES and instruments addressing constructs hypothesized to be either similar to (activity level, motivation for day center attendance, perceptions of the worker role, hours spent in the day center) or divergent from the GOES (attendees’ ratings of engagement in specified occupations, self-rated health, psychosocial functioning, psychiatric symptoms). A second sample of 41 attendees were included for the test-retest analysis. Exploratory factor analysis, Cronbach’s alpha analysis, Pearson correlations and paired-samples t-tests were performed.

Results

Exploratory factor analysis indicated one factor, which was in line with the intentions of the scale. The alpha value was 0.85 and all CITC were above 0.30. The tests for convergent validity resulted in correlations ranging between 0.23 and 0.47, most of which were moderately strong and mainly confirmed the hypotheses. Discriminant validity was clearly indicated, since all correlations with the selected constructs were <0.20. GOES also showed preliminary test-retest stability (r = 0.32).

Conclusions

The GOES is ready for use in rehabilitation services and research where productive and other types of activities are of interest. It may serve as an important supplement to attendees’ self-reported occupational engagement.
Literature
1.
Hasson H, Andersson M, Bejerholm U. Barriers in implementation of evidence-based practice: supported employment in Swedish context. J Health Organ Manag. 2011;25(3):332–45.CrossRefPubMed
2.
Leufstadius C, Eklund M, Erlandsson LK. Meaningfulness in work - experiences among employed individuals with persistent mental illness. Work. 2009;34(1):21–32.PubMed
3.
Gewurtz R, Kirsh B. How consumers of mental health services come to understand their potential for work: doing and becoming revisited. Can J Occup Ther. 2007;74(3):195–207.PubMed
4.
Provencher HL, Gregg R, Mead S, Mueser KT. The role of work in the recovery of persons with psychiatric disabilities. Psychiatr Rehabil J. 2002;26(2):132–44.CrossRefPubMed
5.
Modini M, Tan L, Brinchmann B, Wang MJ, Killackey E, Glozier N, Mykletun A, Harvey SB. Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence. Br J Psychiatry. 2016;209(1):14–22.CrossRefPubMed
6.
Argentzell E, Hakansson C, Eklund M. Experience of meaning in everyday occupations among unemployed people with severe mental illness. Scand J Occup Ther. 2012;19(1):49–58.CrossRefPubMed
7.
Raponi RA, Kirsh B. What can community support programs do to promote productivity?: Perspectives of service users. Can J Commun Ment Health. 2004;23(2):81–94.CrossRefPubMed
8.
Gahnström-Strandqvist K, Liukko A, Tham K. The meaning of the working cooperative for persons with long-term mental illness: a phenomenological study. Am J Occup Ther. 2003;57:262–72.CrossRefPubMed
9.
Tjörnstrand C, Bejerholm U, Eklund M. Participation in day centres for people with psychiatric disabilities: characteristics of occupations. Scand J Occup Ther. 2011;18(4):243–53.CrossRefPubMed
10.
Rebeiro K, Day D, Semeniuk B, O’Brien M, Wilson B. Northern Initiative for Social Action: an occupation-based mental health program. Am J Occup Ther. 2001;55(5):493–500.CrossRefPubMed
11.
Drake RE, Becker DR, Biesanz JC, Torrey WC, McHugo GJ, Wyzik PF. Rehabilitative day treatment vs. supported employment: I. Vocational outcomes. Community Ment Health J. 1994;30(5):519–32.CrossRefPubMed
12.
Kilian R, Lindenbach I, Lobig U, Uhle M, Angermeyer MC. Self-perceived social integration and the use of day centers of persons with severe and persistent schizophrenia living in the community: a qualitative analysis. Soc Psychiatry Psychiatr Epidemiol. 2001;36(11):545–52.CrossRefPubMed
13.
Bryant W, Craik C, McKay EA. Perspectives of day and accommodation services for people with enduring mental illness. J Ment Health. 2005;14(2):109–20.CrossRef
14.
Crosse C. A meaningful day: integrating psychosocial rehabilitation into community treatment of schizophrenia. Med J Aust. 2003;178 Suppl:S76–8.PubMed
15.
Tjörnstrand C, Bejerholm U, Eklund M. Participation in day centres for people with psychiatric disabilities – a focus on occupational engagement. Br J Occup Ther. 2013;73(3):144–50.CrossRef
16.
National Board of Health and Welfare. Nationella riktlinjer för psykosociala insatser vid schizofreni och schizofreniliknande tillstånd - stöd för styrning och ledning. [National guidelines for psychosocial interventions for schizophrenia and related disorder - support for management and leadership]. Stockholm: National Board of Health and Welfare; 2011.
17.
Eklund M, Sandlund M. Work experiences among attendees of day centres for people with psychiatric disabilities. Work. 2015;53(2):377–85.CrossRefPubMed
18.
Tjörnstrand C, Bejerholm U, Eklund M. Psychometric testing of a self-report measure of engagement in productive occupations. Can J Occup Ther. 2013;80(2):101–10.PubMed
19.
Bejerholm U, Hansson L, Eklund M. Profiles of occupational engagement among people with schizophrenia: instrument development, content validity, inter-rater reliability, and internal consistency. Br J Occup Ther. 2006;69:58–68.CrossRef
20.
Bejerholm U, Eklund M. Construct validity of a newly developed instrument: profile of occupational engagement in people with schizophrenia, POES. Nord J Psychiatry. 2006;60(3):200–6.CrossRefPubMed
21.
Slade M, Phelan M, Thornicroft G, Parkman S. The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Soc Psychiatry Psychiatr Epidemiol. 1996;31(3–4):109–13.CrossRefPubMed
22.
Eklund M, Hansson L. Subjectively and independently assessed quality of life for the long-term mentally ill. Nord J Psychiatry. 1998;52:285–94.CrossRef
23.
Eklund M, Hansson L. Perceptions of the real and the ideal ward atmosphere among trainees and staff before and after the introduction of a new work rehabilitation model. Eur Psychiatry. 2001;16(5):299–306.CrossRefPubMed
24.
Swedish Government Official Reports. Vad är psykiskt funktionshinder? [What is a psychiatric disability?]. In: Rapport 2006:5 från Nationell psykiatrisamordning. Stockholm: National Board of Health and Welfare; 2006.
25.
Argentzell E, Leufstadius C, Eklund M. Factors influencing subjective perceptions of everyday occupations: comparing day centre attendees with non-attendees. Scand J Occup Ther. 2012;19(1):68–77.CrossRefPubMed
26.
Eklund M, Markström U. Outcomes of a freedom of choice reform in community mental health day center services. Adm Policy Ment Health. 2015;42(6):664–71.CrossRefPubMed
27.
Bengtsson-Tops A, Hansson L, Sandlund M, Bjarnason O, Korkeila J, Merinder L, Nilsson L, Sorgaard KW, Vinding HR, Middelboe T. Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study. Qual Life Res. 2005;14(1):221–9.CrossRefPubMed
28.
Eklund M. Occupational factors and characteristics of the social network in people with persistent mental illness. Am J Occup Ther. 2006;60(5):587–94.CrossRefPubMed
29.
Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. 4th ed. Oxford: Oxford University Press; 2008.CrossRef
30.
31.
32.
Bejerholm U, Lundgren-Nilsson A. Rasch analysis of the Profiles of Occupational Engagement in people with Severe mental illness (POES) instrument. Health Qual Life Outcomes. 2015;13:130.CrossRefPubMedPubMedCentral
33.
Eklund M. Satisfaction with daily occupations – a tool for client evaluation in mental health care. Scand J Occup Ther. 2004;11(3):136–42.CrossRef
34.
Eklund M, Gunnarsson AB. Content validity, discriminant validity and responsiveness of the Satisfaction with Daily Occupations (SDO) instrument: a screening tool for people with mental disorders. Br J Occup Ther. 2008;71(11):487–95.CrossRef
35.
Eklund M, Gunnarsson AB. Satisfaction with Daily Occupations (SDO): construct validity and test-retest reliability of a screening tool for people with mental disorders. Aust Occup Ther J. 2007;54(1):59–65.
36.
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.CrossRefPubMed
37.
Eklund M, Tjornstrand C. Psychiatric rehabilitation in community-based day centres: motivation and satisfaction. Scand J Occup Ther. 2013;20(6):438–45.CrossRefPubMed
38.
Bryant W, Vacher G, Beresford P, McKay EA. The modernisation of mental health day services: participatory action research exploring social networking. Ment Health Rev J. 2010;15(3):11–21.CrossRef
39.
Sweeney A, Davies J, McLaren S, Whittock M, Lemma F, Belling R, Clement S, Burns T, Catty J, Jones IR, et al. Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study. Health Expect. 2016;19(4):973-87.
40.
Wastberg BA, Haglund L, Eklund M. Psychometric properties of the Worker Role Self-assessment instrument used to evaluate unemployed people in Sweden. Scand J Occup Ther. 2009;16(4):238–46.CrossRefPubMed
41.
Forsyth K, Braveman B, Kielhofner G, Ekbladh E, Haglund L, Fenger K, Keller J. Psychometric properties of the Worker Role Interview. Work. 2006;27(3):313–8.PubMed
42.
Eklund M, Backstrom M. Factor structure and construct validity of the Worker Role Self-assessment (WRS) when used for people with psychiatric disabilities in Sweden. Eval Health Prof. 2016;39(3):299–316.CrossRefPubMed
43.
Eklund M, Leufstadius C. Relationships between occupational factors and health and well-being in individuals with persistent mental illness living in the community. Can J Occup Ther. 2007;74(4):303–13.CrossRefPubMed
44.
Tungström S, Söderberg P, Armelius B-Å. Relationships between the global assessment of functioning and other DSM axes in routine clinical work. Psychiatr Serv. 2005;56:439–43.CrossRefPubMed
45.
Endicott J, Spitzer RL, Fleiss JL, Cohen J. The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976;33(6):766–71.CrossRefPubMed
46.
Startup M, Jackson MC, Bendix S. The concurrent validity of the Global Assessment of Functioning (GAF). Br J Clin Psychol. 2002;41(4):417–22.CrossRefPubMed
47.
Kolakowska T. BPRS. Oxford: Oxford University; 1976.
48.
Crippa JA, Sanches RF, Hallak JE, Loureiro SR, Zuardi AW. A structured interview guide increases Brief Psychiatric Rating Scale reliability in raters with low clinical experience. Acta Psychiatr Scand. 2001;103(6):465–70.CrossRefPubMed
49.
Lykke J, Hesse M, Austin SF, Oestrich I. Validity of the BPRS, the BDI and the BAI in dual diagnosis patients. Addict Behav. 2008;33(2):292–300.CrossRefPubMed
50.
Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed
51.
Jenkinson C, Wright L, Coulter A. Criterion validity and reliability of the SF-36 in a population sample. Qual Life Res. 1994;3(1):7–12.CrossRefPubMed
52.
53.
Thompson B. Exploratory and confirmatory factor analysis: understanding concepts and applications. Washington, DC: American Psychological Association; 2010.
54.
Stevens J. Applied multivariate statistics for the social sciences. 5th ed. New York: Routledge; 2009.
55.
Altman DG. Practical statistics for medical research. London: Chapman & Hall; 1993.
56.
Wampold BE. The great psychotherapy debate: models, methods, and findings. Mahwah: Lawrence Erlbaum Associates; 2001.
57.
Costello AB, Osborne JW. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10(7):1–9.
58.
Eklund M, Erlandsson LK, Persson D. Occupational value among individuals with long-term mental illness. Can J Occup Ther. 2003;70(5):276–84.CrossRefPubMed
59.
Eklund M, Argentzell E. Perception of occupational balance by people with mental illness: a new methodology. Scand J Occup Ther. 2016;23(4):304–13.CrossRefPubMed
60.
Andersson M, Eklund M, Sandlund M, Markström U. Freedom of choice or cost efficiency? The implementation of a free-choice market system in community mental health services in Sweden. Scand J Disabil Res. 2016;18(2):129–41.
Metadata
Title
Staff ratings of occupational engagement among people with severe mental illness – psychometric properties of a screening tool in the day center context
Authors
Mona Eklund
Ulrika Bejerholm
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2283-3

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