Assessments

The American Occupational Therapy Association's position on assessment (below) is poignant to consider alongside the role of occupational therapy outlined in the Occupational Therapy Practice Framework (OTPF-4) (See Appendix C: The OTPF-4). The OTPF-4 repeatedly discusses quality of life as an area to consider during evaluation, intervention planning, and identifies improved or enhanced quality of life as a desired outcome for occupational therapy (AOTA, 2020). If we accept that quality of life is a desired outcome of occupational therapy, then it must be fluidly incorporated into evaluation to enhance the delivery and outcome of OT services. Additionally, occupational therapists have a tendency to treat what they measure (Hammell, 1995). Using valid and reliable assessments is a crucial step to achieving desired outcomes, including quality of life.

“Note that each area should be addressed by occupational therapy. This does not necessarily mean that each area must be assessed. Using the Occupational Therapy Practice Framework: Domain & Process (OTPF), the clinician should also address other relevant occupations, performance skills, client factors, performance patterns, contexts, and environments throughout the treatment plan, based on each individual client.”

(AOTA, 2022)

High caliber QOL assessments that fit with the domain and process of occupational therapy provide not only an understanding of quality of life, but also reveal subjective experiences, discrete personal and environmental contexts, and identify potential occupational performance areas of concern. The quality of life (QOL) measures included here meet those criteria. Importantly, the Neuro-QOL and WHOQOL-BREF offer fast and reliable ways to assess QOL that can influence the nature of OT services while revealing areas where additional OT services may be beneficial. Both assessments are available with no associated costs, are appropriate for clinical use, are translated into multiple languages, and most importantly exhibit excellent psychometric properties. The assessments described here are also appropriate to use with the PEO model described in the previous section as both the PEO and the QOL assessments use a top-down approach to understanding subjective client experience.