Experiences with the COPM and client-centred practice in adult neurorehabilitation in Taiwan.

Abstract

The application of a client-centred approach and the Canadian Occupational Performance Measure (COPM) were investigated in a neurorehabilitation unit in Taiwan. Four Taiwanese occupational therapists were trained in the use of client-centred practice and the COPM before using them with 12 clients attending neurorehabilitation. The COPM and the Reintegration to Normal Living Index (RNL) were administered before treatment and after one month of neurorehabilitation to investigate the sensitivity of the COPM in measuring change. Pre and post interviews were also conducted with the participating occupational therapists to ascertain their perceptions of the clinical utility of the COPM, and to determine their views about the client-centred approach. Matched t-tests showed significant increases in clients' self-ratings of performance and satisfaction on the COPM and in RNL scores between pre and post tests. The qualitative findings highlighted issues regard-ing the administration, scoring and identification of problems in the COPM and client-centred practice, such as clients' willingness to manage their own health care and empowerment to participate in intervention, as well as therapists' knowledge of and confidence with this new approach. Although this study was limited by small sample size and the use of only one hospital neurorehabilitation unit, it has shown the utility of the COPM as an outcome measure in this setting. Further research is warranted to investigate cultural influences on client-centred practice.