Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults

Figures & data

Table 1 Construct validity hypotheses and results

Instrument	Dimension	COPM dimension	Hypothesesa	Results	Confirmed hypotheses (yes/no)
SPPB	Sum score physical function	Performance	Low	0.22*	Yes
SPPB	Single-item score, gait test	Performance	Low/moderate	0.13	Yes
EQ-5D	Single-item score, usual activities	Performance	Low/moderate	−0.36*	Yes
EQ-5D	VAS score health today	Performance	Low/moderate	0.23*	Yes
SOC-13	Sum score coping	Performance	Low	0.02	Yes
SOC-13	Sum score coping	Satisfaction	Low	0.04	Yes
MHC-SF	Sum score mental health	Performance	Low	0.03	Yes
MHC-SF	Sum score mental health	Satisfaction	Low	−0.02	Yes

Notes:

a Expected level of Spearman’s correlations.

* Correlation is significant at 0.01 level (two-tailed).

Abbreviations: COPM, Canadian Occupational Performance Measure; SPPB, Short Physical Performance Battery; EQ-5D, European Quality of Life Scale; VAS, visual analog scale; SOC-13, Sense of Coherence questionnaire; MHC-SF, Mental Health Continuum – Short Form.

Table 2 Responsiveness hypotheses and results

Instrument	Hypotheses	Result	Confirmed hypotheses (yes/no)
Global rating scale	Significant mean differencea in COPM-P change score for “no change” versus “a little improved”	−1.45*	Yes
Global rating scale	Significant differencea in mean COPM-S change score for “no change” versus “a little improved”	−1.12	No
Global rating scale	Significant differencea in mean COPM-P change score for “a little improved” versus “much improved”	−1.53**	Yes
Global rating scale	Significant differencea in mean COPM-S change score for “a little improved” versus “much improved”	−1.61**	Yes
SPPB (sum score)	Low correlationb between SPPB change scores and COPM-P change scores	0.40**	No
EQ-5D (single-item score)	Low correlationb between EQ-5D self-care change scores and COPM-P change scores	−0.33**	No
SOC-13 (sum score)	Low correlationb between SOC-13 change scores and COPM-P change scores	0.11	Yes
MHC-SF (sum score)	Low correlationb between MHC-SF change scores and COPM-P change scores	0.17	Yes

Notes:

a Independent samples t-test.

b Pearson’s correlation coefficient.

* Statistically significant at 0.05 level (two-tailed).

** Statistically significant at 0.01 level (two-tailed).

Abbreviations: COPM, Canadian Occupational Performance Measure; COPM-P, COPM measuring occupational performance; COPM-S, COPM measuring satisfaction with performance; SPPB, Short Physical Performance Battery; EQ-5D, European Quality of Life Scale; SOC-13, Sense of Coherence questionnaire; MHC-SF, Mental Health Continuum – Short Form.

Table 3 Baseline characteristics

Baseline characteristics (N=225)
Age, mean years (SD), range	80.8 (6.7), 65–95
Female, n (%)	162 (72.0)
Living alone, n (%)	171 (76.0)
Higher education ≥ university/university college, n (%)	48 (21.3)
Retired, n (%), n=221	219 (97.3)
Motivation for rehabilitation, scale 1–10, 10 is best, mean (SD), n=223	8.17 (2.0)
Occupational performance (COPM-P) sum score, mean (SD), n=223	3.52 (1.7)
Occupational satisfaction (COPM-S) sum score, mean (SD), n=223	3.38 (1.7)
Major health condition, n (%)
Fracture	53 (23.6)
Dizziness/balance problem	40 (17.8
Pain	24 (10.7)
Stroke	18 (8.0)
Cardiovascular disease	15 (6.7)
Problem/disease in back, hip, knee, or ankle	14 (6.2)
Rheumatoid arthritis/arthrosis	11 (4.9)
Respiratory disease	10 (4.4)
Unspecified functional decline	7 (3.1)
Vision problem/eye disease	4 (1.8)
Cancer	4 (1.8)
Mental illness	4 (1.8)
Other health condition	21 (9.3)
Number of additional health conditions, median (SD), IQR	3 (3.0), 0–9

Note: n is specified in the table only when the amount of participants was <225.

Abbreviations: COPM, Canadian Occupational Performance Measure; COPM-P, COPM measuring occupational performance; COPM-S, COPM measuring satisfaction with performance; IQR, interquartile range; SD, standard deviation.

Figure 1 Distribution of prioritized occupations according to sex and occupational area assessed with the COPM.

Note: Occupational areas described by >70 participants are listed under each category.
Abbreviation: COPM, Canadian Occupational Performance Measure.

Table 4 The mean change scores (SD) for occupational performance and satisfaction with performance scored on a numerical rating scale (range 1–10), according to participants’ answers in the global rating scale of perceived change

Global perceived change	Number of participants	Mean change score (SD)
COPM-P
Much improved	97	4.6 (2.1)
A little improved	74	3.0* (2.0)
No change	28	1.6 (2.2)
COPM-S
Much improved	96	4.8 (2.1)
A little improved	73	3.2* (2.1)
No change	28	2.2 (2.2)

Notes: Independent samples t-tests performed.

* The MIC.

Abbreviations: COPM, Canadian Occupational Performance Measure; COPM-P, COPM measuring occupational performance; COPM-S, COPM measuring satisfaction with performance; MIC, minimal important change; SD, standard deviation.

Table 5 Various health care professionals self-perceived experience and competence when conducting the COPM baseline interview

Characteristics	Total (n=78)	Nurses (n=12)	Occupational therapists (n=33)	Physiotherapists (n=27)	P-value	Auxiliary nurses (n=5)	Social educator (n=1)
Number of COPM interviews per professional, mean (SD), n=186	3.3 (3.4)	1.1 (0.3)	4.1 (4.0)	2.7 (2.5)	0.001	1.89 (0.9)	1.0 (NA)
Degree of COPM goals considered useful for planning and evaluation by health care provider, baseline, scale 1–10, 10 is the best, mean (SD), n=180a	8.2 (1.7)	7.9 (1.2)	8.4 (1.4)	8.2 (1.5)	0.3	4.4 (3.5)	9.0 (NA)
Degree of perceived difficulty assisting the participant during the baseline COPM interview, scale 1–10, 10 is the most simple, mean (SD), n=180a	7.5 (2.0)	7.3 (2.2)	7.7 (1.8)	7.3 (2.4)	0.4	6.8 (1.9)	6.0 (NA)
COPM assessor has taken COPM course, n (%) “yes”, n=170a	105 (61.8)	10 (58.8)	71 (72.4)	23 (47.9)	0.01	0	1 (100)
Number of course days in COPM, mean (SD), n=176a	2.0 (0.9)	1.3 (0.4)	2.2 (0.9)	1.6 (1.0)	0.003	0	1.0 (NA)
Other/additional COPM education taken, n (%) “yes”, n=145a	96 (66.2)	11 (100)	47 (58)	30 (66.7)	0.02	8 (100)	0
Self-perceived need for additional COPM education, n (%) “yes”, n=177a	51 (29.0)	8 (44.4)	22 (21.6)	14 (29.2)	0.1	7 (87.5)	1 (100)

Note:

a Each health care provider has performed several COPM assessments.

Abbreviations: COPM, Canadian Occupational Performance Measure; NA, not applicable; SD, standard deviation.