Responsiveness of the COPM

The occupational therapists at a regional rehabilitation centre have heard about the COPM and wonder if it will meet their needs to have a tool that can evaluate change after intervention across several programs. They know that the COPM is designed for use across a variety of clients and across different ages. Before implementing the measure across programs, they seek information about the responsiveness of the COPM, that is, its ability to measure change in situations where change has actually occurred.

The responsiveness of a measure is an important characteristic if the tool is to be used to evaluate change over time. The COPM was developed as an outcome measure so the ability to detect change was built into its design. Measurement studies evaluating the responsiveness of the COPM have been completed across a range of client populations. Results from most studies indicate that the COPM is responsive and that differences in scores over two points are typically clinically important changes. For rehabilitation services similar to the scenario above, there are several examples of responsiveness studies that have been completed. Wressle and colleagues (1999) examined the responsiveness of the Swedish version of the COPM with 108 clients across several areas of rehabilitation. Clients identified 418 occupational performance problems and upon reassessment, 73% of these problems had change scores of two points or more. In 2004, Kjeken and colleagues used the COPM with 79 clients who had osteoarthritis in their hands. Mean change for performance was 1.51 points and 2.22 points for satisfaction. Eyssen and colleagues (2011) calculated the area under the curve for receiver operating curves to determine optimal cutoff values for COPM scores of 152 clients with various rehabilitation diagnoses who were actively receiving rehabilitation services. The optimal cutoff values were 0.9 for performance and 1.9 for satisfaction. Within this study, the Standardized Mean Response (SMR), a measure of responsiveness, for the COPM was >0.7 (large). They also looked at the responsiveness of the COPM by comparing changes on the measures to changes in scores on the Sickness Impact Profile, the Disability and Impact Profile, and the Impact on Participation and Autonomy assessment. Significant positive correlations were found between changes on the COPM and changes on these three other measures.

Eyssen, I. C., Steultjens, M. P., Oud, T. A., Bolt, E. M., Maasdam, A., & Dekker, J. (2011). Responsiveness of the Canadian occupational performance measure. J Rehabil Res Dev, 48(5), 517-528.

Kjeken, I., Slatkowsky‐Christensen, B., Kvien, T. K., & Uhlig, T. (2004). Norwegian version of the Canadian Occupational Performance Measure in patients with hand osteoarthritis: validity, responsiveness, and feasibility. Arthritis Rheumatism, 51(5), 709-715.

Wressle, E., Samuelsson, K., & Henriksson, C. (1999). Responsiveness of the Swedish version of the Canadian occupational performance measure. Scandinavian Journal of Occupational Therapy, 6(2), 84-89.

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