Letra de cambio en blanco.

5.1.4.1 Format of the Occupational Performance and History Interview-II. The OPHI-II (Kielhofner et al. 1998) was designed to measure an individual’s level of occupational identity, occupational competence, and occupational behaviour. The OPHI-II consists of a semi- structured interview, which can be scored using the quantitative scale provided, and steps for completing a life history narrative. The life history narrative involves completing a narrative slope which represents the individual’s life course (an upward slope indicating a positive event, a downward slope for a negative event) and serves as a way to authenticate the life story of the individual (Kielhofner, Mallinson, Forsyth, & Lai, 2001).

The 32 semi-structured questions are designed to evoke rich discussion surrounding the individual’s past and current occupations, interests, and the physical environment including the home environment and the environment where occupations occur. The questions also create a discussion on central positive and negative events over the life course and directions for the future (see Table 5-1 for a sample question). The questions, which fit into the three sub- categories, can be scored using a scale system. Table 5-2 depicts the ratings and descriptive criteria for each rating. The 4-point rating system is provided to facilitate scoring of the OPHI-II. The rating scales are merely a guide to enhance the accuracy of the ratings given by the

researcher (Kielhofner et al. 1998).

5.1.4.2 Exploring past research utilizing the OPHI-II. Throughout the occupational science literature, the OPHI-II has been used to gather narrative, as well as, statistical data in a variety of populations. The following section discusses the populations that have been

Table 5-1 Sample Question of the OPHI-II (Kielhofner et al. 1998, p. 39)

Item Rating Criteria

Has personal goals and projects

4 Goals/personal projects challenge/extend/require effort Feels energized/excited about future goals/personal projects

3 Goals/personal projects fit strengths/limitations

Enough desire for future to overcome doubt/challenges Motivated to work on goals/personal projects

2 Goals/anticipated projects under/overestimate abilities Not very motivated to work on goals/personal projects Difficulty thinking about goals/personal projects/future Limited commitment/excitement/motivation

1 Cannot identify goals/personal projects

Personal goals/desired projects are unattainable given abilities Goals bear little/no relationship to strengths/limitations Lacks commitment or motivation to the future

Unmotivated due to conflicting/excessive goals/personal projects

Table 5-2 The 4-Point Rating System of the OPHI-II (Kielhofner et al. 1998, p 37)

Rating Criteria

4 Exceptionally competent occupational

functioning

3 Good, appropriate, satisfactory occupational

functioning

2 Some occupational functioning problems

Beginning in 2003, Gray and Fossey explored the impact of chronic fatigue on the experience of engaging in occupations. Shortly after, Levin & Helfrich (2004) looked at the perception of identity and occupational competence in young pregnant adolescents who were homeless. The OPHI-II was also given to a group of men diagnosed with HIV/AIDS to ascertain how the participants viewed their illness and if there was a shift in occupational identity,

competence, or the occupational settings after returning to work (Braveman et al. 2006).

Braveman et al.’s (2006) article is one of the few publications that employed the OPHI-II to explore quantitative differences in a sample population. The authors examined the difference in scores within participants in each of the three scale areas (occupational identity, occupational competence, and occupational behaviour) to explore the impact of returning to work on these areas. Two years later research by Ziv and Roitman (2008) utilized the OPHI-II to facilitate an understanding of the occupational lives of elderly individuals and Ennals and Fossey (2009) explored how best to support clients with mental health issues on the path to recovery.

Three articles were published in 2010 that utilized the OPHI-II: one to explore the impact of becoming a father on other occupational roles (Hamilton & de Jonge, 2010), one on the time use and lived experience of individual’s with schizophrenia (O’Connell, Farnworth, & Hanson, 2010),and one to explore the role of occupational participation on women with breast cancer (Palmadottir, 2010). One recent article explored the participant’s experience of being diagnosed with attention-deficit hyperactivity disorder and/or autism spectrum disorder (Sandell, Kjellberg, & Taylor, 2013).

Overall the central focus of past research using the OPHI-II has been to understand the narrative experiences of individuals who experience a disruption in their lives and the potential impact on their daily occupations. The majority of previous research using the OPHI-II has been

qualitative in nature with only one of the articles using the OPHI-II to gather quantitative data (Braveman et al. 2006). The OPHI-II has been utilized with a wide variety of populations (Kielhofner et al. 2001) however there has been little application of the OPHI-II to the brain injury survivor population. The OPHI-II has been described as easily administered to a wide variety of individuals and can be modified to meet the needs of the interview (Kielhofner et al. 1998) however, further research is necessary to suggest whether the OPHI-II is appropriate for brain injury survivors given the cognitive challenges associated with brain injury.

Cotton (2012) used a fictional case study utilizing the OPHI-II to suggest the role of an occupational therapist in treating a disruption in identity post brain injury. Although, Cotton (2012) suggested eight interview questions revised from the questions within the OPHI-II there was no indication how the questions were revised and whether brain injury survivors were involved in the review process.

According to past authors such as Cotton (2012) and Coetzer (2008) brain injury survivors often demonstrate poor communication skills and cognitive deficits such as shorter attention spans. Due to these complex issues brain injury survivors may find it difficult to participate in a semi-structured interview such as the OPHI-II. For example, brain injury survivors may experience difficulty with some of the wording used in the OPHI-II questions. Further exploration of the feasibility of utilizing assessment measures with brain injury survivors is necessary, however, before this assertion can be supported.