DEVELOPMENT OF AN OUTCOME MEASURE BASED ON MOTIVATION AND ACTION FOR OCCUPATIONAL THERAPISTS WORKING IN NEUROLOGICAL REHABILITATION 

Introduction: Participation in essential occupations can be seen as a result of motivation, patterns, environmental influences and performance capacity factors. The major focus of any occupational therapy assessment and treatment should therefore include the client-centred, holistic determination of a patient’s level of motivation and action. Motivation following an acquired brain injury (ABI) is an area that has received little attention in literature, with therapists mostly determining a patient’s level of motivation informally or based on clinical judgement. 

Accurate assessment of the patient’s emotional, cognitive and physical abilities and their occupations is an essential element in the effective delivery of occupational therapy services. In order to justify intervention and its effectiveness, occupational therapists also require a way in which their services can be measured, hence the need for outcome measures. 

Method: A qualitative study was undertaken to close the gap in neurological rehabilitation by developing an outcome measure that assesses a patient’s motivation, while also addressing their corresponding action and therefore their engagement in occupations. The outcome measure had to be grounded in a theoretical framework that covers motivation and action. The Vona du Toit Model of Creative Ability (VdTMoCA) was chosen as the theoretical framework as it allows therapists to describe a patient’s participation in everyday occupations according to their motivation and action. 

Results: Domain descriptors for the outcome measure, according to the first six levels of Creative Ability, emerged during the study. This was achieved through the use of focus groups held with occupational therapists working in neurological rehabilitation. The outcome measure that was developed was named the Motivation and Action in Neurological Rehabilitation Outcome Measure (MANROM).