Achieving Best Practice: A Review of Evidence Linked to Occupation-Focused Practice Models

Abstract

The aim of this paper is to identify and synthesize evidence concerning the most widely used contemporary occupation-focused models including Ecology of human performance; Model of human occupation; Occupational adaptation; and Person-environment-occupational performance. The paper characterizes the amount and type of evidence. Evidence found includes illustrations of how the models can be applied to understand and address a particular problem or population, basic studies that test or expand theoretical concepts, psychometric studies, studies that document therapy outcomes, and studies that examine clinical reasoning and/or practice based on the models. The four models differed widely in the amount and type of evidence available.

Comparing and Using Occupation-Focused Models

“…The MOHO has the longest history of publication and is a widely used occupation-focused model (Kielhofner & Burke, 1980;Lee, 2010;Lee et al, 2008;Turpin & Iwama, 2011 Comparing and Using Occupation-Focused Models 5 adopting the reductionistic approach similar to the medical model, which reflected in a shift of focus from health and well-being to impairments and remediation (Kielhofner, 2009;Ludwig, 2004). Kielhofner, Reilly's student, developed MOHO in response to the profession's shift toward an alignment with the biomedical model of health.…”

“…The PEOP provides guidelines on selecting assessment measures but does not have any specific assessments developed (Christiansen et al, 2005;Lee, 2010). The Activity Card Sort and the Executive Function Performance Test are examples of assessments based on PEOP principles but not officially developed as PEOP assessments.…”

“…MOHO is acknowledged as the most researched model among the occupation-focused models (Ashby & Chandler, 2010, Turpin & Iwama, 2011. A literature review revealed the difference in research quantity of various occupation-focused models among which 433 peerreviewed journal articles focused on MOHO while 27 related to PEOP (Lee, 2010).…”

A process for developing sustainable evidence-based occupational therapy practice

“…Therefore, the occupational therapist has to rely on knowledge from other sources, such as knowledge from research that explores and develops OT models of practice (9,10). This implies that OT models of practice are an essential source in developing evidence-based practice, as they can guide occupational therapists in clinical decisionmaking in the intervention process in their daily practice (21)(22)(23)(24)(25)(26). The Occupational Therapy Intervention Process Model (OTIPM) (22,27) is an example of such a model of practice.…”

Assessing Volition in Pediatrics: Using the Volitional Questionnaire and the Pediatric Volitional Questionnaire

“…By specifically addressing a child's volition, guided by the use of the Model of Human Occupation (MOHO; Kielhofner, 2008), therapists create a more holistic occupational profile of the child and can more fully understand his or her strengths in addition to his or her needs. Additionally, therapists move toward evidence-based practice by using an occupation-centered model of practice that is well supported in the occupational therapy literature (Lee, 2010). The purpose of this paper is to discuss the importance of addressing volition when working with children and to illustrate how assessment tools of volition-the Volitional Questionnaire (de las Heras, Geist, Kielhofner, & Yi 2007) …”