Use of Measuring Tools in Practice Development Projects: A Critical Perspective.

Stinne Glasdam,Tobba Therkildsen Sudmann

doi:10.1177/0008417421994365

Abstract

Background.Occupational therapists are generally positive towards use of measuring tools. However, such use may be problematic.Purpose.To illuminate hidden and adverse effects of using measuring tools in occupational therapy.Method.A Foucauldian inspired thematic analysis of the use of measuring tools in 13 reports of practice development projects in Denmark.Findings.Three themes were constructed: “Categorisation of loss”, “Conduct of conduct: Self-tracking and competition”, and “Conforming to expected forms of everyday living”. Measuring tools tended to produce generalised truths about older adults and were used to predict outcome of or access to reablement programs. The measurements guided both older people and professionals, and measurements created both motivation and resistance. The tools served as an extension of the healthcare professionals’ authority.Implications.When appropriately situated, measuring tools have the potential to empower and enhance older adults’ lives and should be the focus of greater clinical attention.

Highlights

This article focuses on the use of measuring tools in time-limited practice development projects in homecare services for older adults in Danish municipalities during the past decade
The article was based on a thematic analysis of empirical material consisting of reports from 13 different practice development projects on reablement programs for older adults in Danish municipalities
The current study shows that the use of measuring tools does not take into consideration older adults’ own understandings of active ageing, such as being able to drink and play pool in an activity club or enjoy knitting and coffee with friends (Lassen, 2014)

Summary

Introduction

This article focuses on the use of measuring tools in time-limited practice development projects in homecare services for older adults in Danish municipalities during the past decade These projects offered short-term intensive home-based inter-disciplinary assessments, treatments, and activities—often referred to as reablement programs. Researchers use physical performance tests, observations, interviews/questionnaires, and rating scales to assess and document a baseline and changes in physical function and social participation, for example, Canadian Occupational Performance Measure (COPM; Law et al, 1998) and Barthel 20/100 (Mahoney & Barthel, 1965). Standardised use of assessment packages may hamper occupational therapists’ professional discretion and practice Interventions, such as reablement programs, may be designed to meet pre-set outcome measures, as opposed to documenting changes that are relevant for the individual in question. Interventions, such as reablement programs, may be designed to meet pre-set outcome measures, as opposed to documenting changes that are relevant for the individual in question. Timmermans and Epstein (2010) argue that promulgation and enforcement of standardised outcome measurements is a central form of social regulation, which is evident when older adults have to fit the program to be eligible

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