Masahiro Ogawa, Haruna Shirai, Seiji Nishida, Hitoshi Tanimukai; Rasch Analysis of the Assessment of Quality of Activities (A-QOA), an Observational Tool for Clients With Dementia. Am J Occup Ther 2020;75(1):7501205040. https://doi.org/10.5014/ajot.2021.039917
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© 2021 American Occupational Therapy Association
Importance: The Assessment of Quality of Activities (A-QOA) is an observation-based tool for assessing the strength of engagement in an activity by the person performing it in a natural context. By quantifying the quality of engagement, the A-QOA can help occupational therapy practitioners be better able to select meaningful activities and more clearly understand the effectiveness of various choices.
Objective: To examine use of the A-QOA as a valid unidimensional scale and to clarify preliminary results on its internal scale validity and item reliability using the Rasch model.
Participants: One hundred thirty-one participants with dementia performing 262 activities.
Outcomes and Measures: We used the Rasch model to clarify the psychometric properties of A-QOA’s measurement quality.
Results: Rasch analysis revealed that 21 of the 25 items reached an acceptable level of fit, and 4 did not. After eliminating the 4 misfitting items, the resulting A-QOA was determined to have both acceptable internal scale validity and item separation reliability, which are fundamental psychometric properties of a clinical observational instrument.
Conclusions and Relevance: The A-QOA can be used to quantitatively assess the strength of engagement in an activity by the person performing it by using the observational method.
What This Article Adds: In clinical settings, the A-QOA can be used both to select activities for clients with dementia and to quantitatively show the effects of occupational therapy interventions.
Client bursts into loud laughter during an activity: scored 4 points, “observed as a strong or exceptional tendency.”
Client smiles temporarily during an activity, but the duration of the smile is short: scored 2 points, “observed to a limited or questionable extent.”
The A-QOA can be used to assess, verbalize, and quantitatively show the effectiveness of activities using an observational method with a client-centered viewpoint.
The A-QOA can help occupational therapists in clinical practice select optimal activities for clients with dementia and demonstrate the success of the corresponding interventions.
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