1503 Kjeken, et al: Reliability of COPM Reliability of the Canadian Occupational Performance Measure in Patients with Ankylosing Spondylitis INGVILD KJEKEN, HANNE DAGFINRUD, TILL UHLIG, PETTER MOWINCKEL, TORE K. KVIEN, and ARNSTEIN FINSET ABSTRACT. Objective. The Canadian Occupational Performance Measure (COPM) is a client-centered measure, designed to detect changes in occupational performance over time. The main aim of our study was to examine the test-retest reliability of the Norwegian version of the COPM in patients with anky- losing spondylitis (AS) in 3 different retest modes of data collection. Methods. A total of 119 patients with AS completed the baseline COPM interview before random- ization into one of 3 modes of retest data collection performed 2 weeks later: by personal interview, telephone interview, or mailed questionnaire. Scores were computed for Performance and Satisfaction, and the 2 sets of scores were examined for reliability by intraclass correlations (ICC), and by the Bland-Altman procedure for calculation of smallest detectable difference (SDD). Results. The ICC coefficients for Performance and Satisfaction were as follows: 0.92 and 0.93 (rescoring by personal interview), 0.73 and 0.73 (rescoring by telephone interview), and 0.90 and 0.90 (rescoring by mail). SDD for the Performance and Satisfaction scores were 1.47 and 1.80, respectively, for rescoring by personal interview; 3.14 and 4.00 for rescoring by telephone interview; and 2.20 and 2.41 for rescoring by mailed survey. Conclusion. The results confirm that the COPM is a reliable instrument for use in clinical practice in patients with AS, and may serve as an instrument to promote a patient-centered approach in the planning and evaluation of rehabilitation programs. Mailed questionnaires may replace personal interview in followup examinations, while rescoring by telephone interview is less reliable. (J Rheumatol 2005;32:1503–9) Key Indexing Terms: OUTCOME RELIABILITY REHABILITATION CANADIAN OCCUPATIONAL PERFORMANCE MEASURE ANKYLOSING SPONDYLITIS OCCUPATIONAL THERAPY From the National Resource Center for Rehabilitation in Rheumatology and Department of Rheumatology, Diakonhjemmet Hospital; and the Section of Health Science and Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway. I. Kjeken, OTR, MSc, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital; H. Dagfinrud, RPT, MSc, Section of Health Science, University of Oslo; T. Uhlig, PhD, MD; P. Mowinckel, MSc, Statistician, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital; T.K. Kvien, PhD, MD, Professor, Department of Rheumatology, Diakonhjemmet Hospital; A. Finset, PhD, Professor, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo. Address reprint requests to I. Kjeken, Diakonhjemmet sykehus, boks 23 Vinderen, 0319 Oslo, Norway. E-mail: ingvild.kjeken@nrrk.no Accepted for publication March 7, 2005. The focus in rehabilitation is moving from emphasis on normalization and functional improvement to greater aware- ness of activity, participation, and fulfilment of life roles 1-3 . At the same time, the importance of including patient per- spective in both the rehabilitation process and the research agenda has gained widespread recognition 4,5 . The demand to develop an evidence-based practice actualizes the need for models, methods, and instruments that capture and inte- grate these elements 6 . The Canadian Occupational Performance Measure (COPM) is an individualized instrument developed to describe and measure both the qualitative and quantitative aspects of occupational performance, life roles, environ- ment, and the needs of the individual 2,7,8 . The COPM is the- oretically based on the Canadian Model of Occupational Performance 9 , in which occupational performance is defined as “consisting of self-care, productivity, and leisure; being influenced by the environment, one’s social roles, and one’s developmental level; being client-defined; and con- sisting of both a performance (objective) dimension and a satisfaction (subjective) dimension” 10 . Since its introduc- tion the COPM has been used frequently as an outcome measure in rehabilitation of persons with chronic condi- tions, among them patients with rheumatic diseases 11-13 . Ankylosing spondylitis (AS) is a progressive rheumatic inflammatory disease, usually starting in early adulthood 14 . The disease process results in various degrees of impairment due to changes in the axial skeleton, stiffness, pain, and fatigue. This in turn may lead to activity limitation, such as difficulty performing self-care activities, and reduced par- ticipation in work and leisure time activities 15 . The OMERACT Filter for Outcome Measures in Rheumatology recommends that all outcome measures be evaluated according to the criteria of truth, discrimination, and feasibility 16 . The psychometric properties of the COPM Personal non-commercial use only. The Journal of Rheumatology Copyright © 2005. All rights reserved. www.jrheum.org Downloaded on October 7, 2021 from