The predictive power of narrative data in occupational therapy evaluation

Objective. This study examined whether adding the Canadian Occupational Per formance Measure (COPM) to existing occupational therapy evaluation measure s used in a subacute skilled nursing facility unit enhanced the accuracy of therapists' predictions of the functional status of clients at discharge. Method. This study utilized a prospective comparison design. Two independen t predictive variables were developed using the standard Functional indepen dent Measure (FIM), and an enhanced FIM that included narrative information from the Canadian Occupational Performance Measure (FIM/COPM). These varia bles were subsequently compared with the actual FIM discharge (DFIM scores for 31 clients. The primary author (D.S.) gathered data from chart review a nd conducted the statistical analysis. The data were analyzed using descrip tive correlations (Pearson r) and comparison statistics (Wilcoxon signed ra nk test). Results. Comparison statistics (Wilcoxon signed rank test) revealed a stati stically significant difference between the standard FIM predictive score a nd the discharge FIM score. No statistically significant difference was fou nd between the FIM/COPM predictive score and the discharge FIM score. These findings suggest that predictive scores based solely on information attain ed fr om the standard FIM resulted in less accuracy in outcome predictions. Correlational analyses further supported these conclusions. Conclusion. The findings support the study hypothesis that use of the COPM in combination with the FIM enhances accuracy in prediction of outcomes or rehabilitative services or persons in adult physical disabilities settings.