Item validity of the physical demands from the Dictionary of Occupational Titles for functional capacity evaluation of clients with chronic back pain

This study assessed the item validity of 15 of the physical demands from the Dictionary of Occupational Titles (DOT), as evaluated in a new approach to functional capacity evaluation (FCE) for clients with chronic back pain, the Gibson Approach to FCE (GAPP FCE). Fifty-two occupational therapists were sent the specifications of the items in the GAPP FCE procedures and were asked to rate the items in terms of item-objective congruence, relevance and difficulty. A response rate of 59.2% was obtained. The majority of the therapists agreed that most of the items were congruent with the objectives based on the definition of the physical demands from the DOT. The items evaluating Balancing and Pushing and Pulling had the lowest item-objective congruence. The evaluation of Balancing and the Lifting, Carrying and Pushing and Pulling of loads greater than light-medium weight (10-16 kg) were not considered significantly relevant. Concerns were raised about the difficulty and safety of the evaluation of Lifting, Carrying and Pushing and Pulling with clients with chronic back pain, particularly if the therapist evaluates the manual handling of medium to heavy loads. These results may have implications for other FCEs, particularly those which are based on the DOT, or when assessing clients with chronic back pain.     

Functional capacity evaluation: Ecological validity of three static endurance tests

Functional Capacity Evaluation's (FCE's) are designed to measure the functional capacity of injured workers. Static endurance tests are integrated aspects of FCE's. Little is known about the validity of the tests. In this study, three static endurance tests (overhead work, crouching and kneeling) of the Isernhagen Work Systems FCE are studied for ecological validity. By manipulating the environment in an experiment using three different conditions (normal, loud noise, high production requirement), the ecological validity of the tests was investigated. Results: the different conditions did not seem to influence the holding times, the perceived exertion and the productivity of the subjects. The results are discussed and it is concluded that the three static endurance tests meet conditions of ecological validity. In order to be able to state that the tests of the IWS FCE are ecologically valid, more research is needed to enable a generalization.     

Interobjectivity,Ideality, and Dialectics

Researchers working in Cultural Historical Activity Theory (CHAT) need to develop criteria for the adequacy of the processes and products of research that is founded on the central tenets of that theory. Criteria like validity and generalizability are not universal, but have been developed from a specific theory of knowledge use. This relation is explained both for the nomological and the interpretive paradigms, and suggestions are made for the development of criteria in the CHAT paradigm on a similar basis.     

Disability management and functional capacity evaluations: A dynamic resource

Functional capacity evaluation (FCE), as an objective resource for disability managers, is an invaluable tool in the return to work process. Effective communication of expectations between the employee, employer, medical providers, disability management team, and the FCE provider contributes to enhancing the benefits of the FCE to all participants. Careful review of the results of the FCE as compared to the employee's other pertinent medical/functional information provides clarity for that person's rehabilitation goals and RTW potential. Finally, future opportunities and proactive uses for the FCE are shared.     

The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment

OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses.     

Content validation on the Work Performance Rating Scale for sheltered workshop workers

The purpose of this study was to revise the content of the Work Performance Rating Scale (WPRS) as a valid assessment tool for sheltered workshop workers. A focus group of 11 sheltered workshop workers was recruited to collect their opinions about the relevance of the WPRS from the service users' perspectives. A panel of 23 frontline practitioners who had experience in using various work assessment instruments provided at their work setting was recruited to review the content of the WPRS. A 14-item amended version of the WPRS with five new items added was proposed based on the opinions of service users, frontline practitioners, and the concept of the Minnesota Theory of Work Adjustment (MTWA). An expert panel of 12 professionals at the senior level from various vocational rehabilitation settings was recruited to comment on the content validity of the 14-item amended version of the WPRS. The expert panel agreed that the amended version of the WPRS was related to the concept of job satisfactoriness which could be used to assess the work performance of sheltered workshop workers. Thus, the use of the MTWA for improving the content validity of the WPRS to assess the employability of sheltered workshop workers was supported by the findings of the study.     

The functional capacity of healthcare workers with history of severe acute respiratory distress syndrome (SARS) complicated with avascular necrosis--case report

Two years after the SARS outbreak in Hong Kong, 128 healthcare workers continued to present with musculoskeletal complaints and 38 workers were diagnosed with avascular necrosis (AVN) in different joints. 13 healthcare workers were referred to six designated Physiotherapy Departments of the Hospital Authority for a tailor-made standardized Functional Capacity Evaluation (FCE) from 2004 to 2005 on a voluntary basis. Job analysis, workers' self-perceived disability and functional capacity, non-material handling tests, and the cardiopulmonary fitness test were performed. Retrospective review of the FCE data showed that there were 17 AVN of hips, 16 AVN of knees, 3 AVN of shoulders. All patients had AVN of lower limb joints. Nearly full ranges of movement (ROM) were observed in the knees involved, but the hip range was decreased for most subjects suffering from hip AVNs. Most workers (n=12) could not complete the cardiopulmonary test due to intolerable joint pain. Six workers' self-perceived physical demands level (PDC) matched with the physical demands level identified by the FCE. 12 healthcare workers attained a sedentary physical demands level and were unable to match with their previous job demands. One staff was classified as light physical demands and managed his original duty. Four workers had returned to work at the time FCE was performed. The tailor-made FCE added information to facilitate the return-to-work planning for the staff. Four more workers returned to work with modified duties one year after the FCE.     

Teachers' Attitudes toward Reporting Child Sexual Abuse: Problems with Existing Research Leading to New Scale Development

This paper details a systematic literature review identifying problems in extant research relating to teachers' attitudes toward reporting child sexual abuse and offers a model for new attitude scale development and testing. Scale development comprised a five-phase process grounded in contemporary attitude theories, including (a) developing the initial item pool, (b) conducting a panel review, (c) refining the scale via an expert focus group, (d) building content validity through cognitive interviews, and (e) assessing internal consistency via field testing. The resulting 21-item scale displayed construct validity in preliminary testing. The scale may prove useful as a research tool, given the theoretical supposition that attitudes may be changed with time, context, experience, and education. Further investigation with a larger sample is warranted.     

Functional capacity evaluation: An essential component of South African occupational therapy work practice services

South African occupational therapists have been involved in the delivery of work practice services since the inception of the profession in this country. Initial development in this area of practice appeared slow but following the acceptance of South Africa's first democratic Constitution in 1996, many opportunities for service delivery were facilitated by the implementation of disability equity legislation. One of the key services offered by practitioners is Functional Capacity Evaluation (FCE). Although the outcomes of FCE are many, the process in essentially the same. This entails: referral, the initial interview, evaluation of performance components and ADL, vocational evaluation, obtaining collateral and the closure interview, the work visit, hypothesis testing and reporting. This article reports on the Functional Capacity Evaluation process as followed by South African occupational therapists in various contexts.     

Social Work Assessment of Adaptive Functioning Using the Vineland Adaptive Behavior Scales

Abstract

The assessment of client adaptive functioning is often an important component of a comprehensive social work evaluation. The Vineland Adaptive Behavior Scales (VABS) are the most commonly used quantitative measures of adaptive functioning for clients meeting the criteria for a wide range of disorders. We review the development of the VABS and current knowledge pertaining to the instrument's reliability and validity. We conclude that the ability to administer and interpret the VABS is an important skill for clinical social workers to acquire.     

Functional testing: Approaches and injury management integration

Functional Capacity Evaluations (FCEs) have become the standard for identifying an individual's physical abilities and/or limitations following injury or illness. While philosophies and approaches differ, the focus of most FCE systems is to identify the individual's maximum capabilities. This article will discuss the usefulness of the FCE information and how FCEs are impacted by multiple factors including APTA guidelines, machine based testing, therapist expertise, medical legal credibility and court testimony, IMEs and FCE, and return to work/return to function.     

Ratings checklist for warnings: a prototype tool to aid experts in the adequacy evaluation of proposed or existing warnings

In the field of forensic human factors, experts are often called upon to assess and evaluate the adequacy of new or existing products' warnings or warnings systems. The usual goal of this evaluation is to arrive at a simple binary decision regarding the warning in question (i.e., does it "pass/fail", or is it "adequate/inadequate"). However, such a warning assessment process may in fact be quite complex and multidimensional in its execution. The existing warnings research literature has identified a fairly large number of warnings features or factors likely to have an impact on a given warning's effectiveness or adequacy. The tool addressed in this article is intended for use by a warnings expert (as opposed to one less knowledgeable and informed about complex warnings issues), and can serve as a reminder checklist to help ensure that the expert has taken into consideration the most relevant features or factors during such a warnings adequacy assessment.     

Enhancing Information Literacy in an Interdisciplinary Collaboration

ABSTRACT

The study examined the impact of an interdisciplinary collaborative on the information literacy of its participants by using legitimate peripheral participation (Lave & Wenger, 1991) as a conceptual framework. The objectives of this exploratory study were to document participants' qualitative gains in information technology knowledge and uses, and to analyze expert involvement in supporting learning by novices. Data were gathered by using a participation observation approach, interviews, and survey. Participants cited more frequently the non-technical aspects of information literacy as being more beneficial than gains in technical know-how. Varying degrees of expert involvement ranging from enabling to instructing were identified. The implications in terms of convening and managing communities of practice and the development of legitimate peripheral participation theory are discussed.     

Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting

Abstract

Patient satisfaction with health care services is an important factor in health care delivery. It will significantly influence whether or not a patient seeks medical care, complies with prescribed treatment, and/or maintains a continuing relationship with a medical practitioner.

A survey questionnaire, relating patient satisfaction with a number of variables identified through a literature review, was mailed to a random sample of 500 students utilizing Student Health Service (SHS) at Kent State University (KSU) during the five week study period. The data obtained would be utilized to help with planning future health care services and staff inservice education programs.

The findings of this survey indicate that patient satisfaction has a statistically significant correlation with perceived technical competence of the practitioner and perceived adequacy of the interpersonal aspects of the practitioner-patient relationship. A significant relationship did not exist between satisfaction and expectations the patient holds of the practitioner's role performance. A statistically significant relationship was found to exist between receiving health information/education related to diagnosis, prognosis, and treatment plan and satisfaction with health care services. This relationship did not hold for health information/education related to activity restrictions or preventive measures. The study also revealed that time waited during the medical care encounter was inversely related to satisfaction. Last, stepwise regression found that perceived technical competence of the practitioner was the most important variable influencing patient satisfaction with health care services.

This study provides data about factors important to personal satisfaction with health care services for a selected group of college students.     

The theory evaluation scale: An epistemological tool for analyzing social work theories

The profession of social work places a strong emphasis on the utilization of theories in classroom settings as well as in clinical milieus. Therefore, it is understandable that social work students, scholars, researchers, and practitioners feel compelled to make sense of theoretical underpinnings in their professional lives. This study sought to develop an instrument to critically appraise social work theories. Through Qualtrics, a panel of 14 internationally recognized experts in social work theories assessed the content of 16 items, which emanated from the literature on scale development. All of these items were described in accordance with Lawshe’s (1975) content-validity framework. Nine of the original 16 criteria survived expert scrutiny to constitute the Theory Evaluation Scale. Coherence, conceptual clarity, philosophical assumptions, connection with previous research, testability, empiricism, limitations, client context, and human agency were the final criteria on the empirically supported instrument. Implications for research, practice, and social work education are discussed.     

Applying the use of activity in the assessment of malingering: A case illustration

The assessment of malingering has predominantly been considered within the domains of neuropsychologists and psychiatrists, who use consistency of performance criteria similar to those used in functional capacity evaluations (FCE). The use of activity has traditionally been used in occupational therapy as an assessment and treatment modality with goals not always considered obvious and which could easily be used for diversional reasons. The appropriate use of activity adds an additional dimension to a layered approach of using multiple data sources and methods as recommended by FCE practitioners and neuropsychologists alike. The case illustration aims to explain the above using a layered model.     

Health professionals' attitudes and practices in relation to Functional Capacity Evaluations

Functional Capacity Evaluations (FCE's) are part of practice in work injury prevention and rehabilitation, and are designed to define an individual's functional abilities or limitations in the context of safe, productive work tasks. Qualitative research methodology was used to investigate the attitudes and behaviours of health professionals in relation to FCE use. The study aimed to identify why health professionals chose a particular FCE, and to identify what factors influence health professionals' clinical judgements when providing results and recommendations for the individual being assessed. Five health professionals from the Hunter Region of New South Wales, Australia, participated in semi-structured, individual interviews using a phenomenological approach. Following inductive analysis of the data, four themes reflecting participants' attitudes and behaviours of FCE use emerged: i) referrals and expectations, including why and when the assessment is completed ii) outcomes, -- what the results aim to provide iii) workplace/practice/usage issues and iv) skills of the assessor. The results indicate the need for further research on the clinical utility of FCE's. A large scale quantitative study would allow results to be generalised to a wider community of FCE users.     

Enhancing program review for evaluation and management

Program review has not received the attention it warrants as a program evaluation tool despite its wide use for evaluation and management purposes. The use of the program review will probably endure on the strength of its face validity and irrespective of other developments in the field of program evaluation. Evaluators should realize this and, accordingly, attempt to improve its effectiveness. This paper presents one organization's approach to achieving this objective through the explication of development principles, implementation guidelines and review items. This paper also discusses benefits that can be expected from a systematic development of this tool and presents various research directions and potentials in this area.     

The Responsible Use of Psychological Testing in Child Custody Evaluations: Selection of Tests

SUMMARY

The responsible use of psychological tests in child custody evaluations requires an advanced understanding of both psychological issues of test selection and legal criteria regarding admissibility of expert testimony. This paper discusses the psychological and legal issues associated with test selection and with admissibility of expert testimony pertaining to psychological test data. It is argued that the legal standards of relevance and helpfulness require the methodology underlying an expert's testimony to be both reliable and valid. Therefore, it is essential to select psychological tests with demonstrated reliability and validity. Case law regarding expert testimony and the integration of professional practice guidelines pertaining to the use of psychological tests with ethical standards will be discussed.     

Determining Attainment of the Epas Foundation Program Objectives

Building on research related to social cognitive theory and its construct of self-efficacy, this article describes the development of the Foundation Practice Self-Efficacy scale. This measure is designed to assess graduate social work programs' attempts to achieve the educational policy objectives for foundation-year graduate study set by the Council on Social Work Education. Preliminary evidence regarding the reliability, validity, and sensitivity to change of this measure are presented. The authors discuss changes in MSW students' self-efficacy over the course of the foundation year.