Background – Every competent person in Ontario has the right to decide whether or not he or she will be admitted to long-term care. If your capacity to make such a decision is in doubt, then it is evaluated. The current evaluation process is inaccessible to people with aphasia or other communication barriers, and social work evaluators report significant problems in communicating with this population. Competent individuals have been found lacking in capacity because of communication barriers. Aims – To create a communicatively accessible capacity evaluation process with training in specialized communication techniques. Also, to test the validity and effectiveness of the Communication Aid to Capacity Evaluation (CACE) to reveal the inherent capacity of participants with aphasia using social work evaluators. Methods – 32 social workers were partnered with 32 competent participants with aphasia. They were randomly divided into an experimental and control group. Both groups administered the current ‘Capacity to Make Admissions Decisions’ questionnaire to establish a baseline measurement of capacity. The social workers in the experimental group were introduced to CACE and received communication training. Following a two-week interval they administered CACE and the control group re-administered the current capacity questionnaire. The 64 capacity evaluations were video recorded and 3 independent speech-language pathologists administered standardized assessment measures on the recordings. Finally, the participants completed surveys measuring confidence and communication abilities. Outcomes - Using the current capacity questionnaire, one social worker found a competent participant lacking in capacity and one third of social workers were unable to determine capacity. Following the introduction of CACE with communication training, analyses of the standardized measures and survey results showed a statistically significant difference between the participants in the experimental group and the control group. The social workers in the experimental group had significantly better communication skills, (‘Revealing Competence’ f (2, 29) = 12.03, p = 0.002), the participants with aphasia’ abilities to ‘Transfer Information’ increased, (f (2, 29) = 10.51, p < 0.003), and the evaluators’ confidence in their determinations of capacity improved (f (2, 29) = 13.511, p = .001). The use of CACE with communication training resulted in accurate determinations of capacity in competent participants with aphasia. Conclusions - CACE was an effective tool to evaluate the capacity to make a decision regarding admission to long-term care. It was communicatively accessible for this research population with aphasia, enhancing comprehension of the capacity process and enabling the person to communicate a response. Improved communication skills, transfer of information and confidence allowed the evaluators to accurately determine capacity.

Background – Every competent person in Ontario has the right to decide whether or not he or she will be admitted to long-term care. If your capacity to make such a decision is in doubt, then it is evaluated. The current evaluation process is inaccessible to people with aphasia or other communication barriers, and social work evaluators report significant problems in communicating with this population. Competent individuals have been found lacking in capacity because of communication barriers. Aims – To create a communicatively accessible capacity evaluation process with training in specialized communication techniques. Also, to test the validity and effectiveness of the Communication Aid to Capacity Evaluation (CACE) to reveal the inherent capacity of participants with aphasia using social work evaluators. Methods – 32 social workers were partnered with 32 competent participants with aphasia. They were randomly divided into an experimental and control group. Both groups administered the current ‘Capacity to Make Admissions Decisions’ questionnaire to establish a baseline measurement of capacity. The social workers in the experimental group were introduced to CACE and received communication training. Following a two-week interval they administered CACE and the control group re-administered the current capacity questionnaire. The 64 capacity evaluations were video recorded and 3 independent speech-language pathologists administered standardized assessment measures on the recordings. Finally, the participants completed surveys measuring confidence and communication abilities. Outcomes - Using the current capacity questionnaire, one social worker found a competent participant lacking in capacity and one third of social workers were unable to determine capacity. Following the introduction of CACE with communication training, analyses of the standardized measures and survey results showed a statistically significant difference between the participants in the experimental group and the control group. The social workers in the experimental group had significantly better communication skills, (‘Revealing Competence’ f (2, 29) = 12.03, p = 0.002), the participants with aphasia’ abilities to ‘Transfer Information’ increased, (f (2, 29) = 10.51, p < 0.003), and the evaluators’ confidence in their determinations of capacity improved (f (2, 29) = 13.511, p = .001). The use of CACE with communication training resulted in accurate determinations of capacity in competent participants with aphasia. Conclusions - CACE was an effective tool to evaluate the capacity to make a decision regarding admission to long-term care. It was communicatively accessible for this research population with aphasia, enhancing comprehension of the capacity process and enabling the person to communicate a response. Improved communication skills, transfer of information and confidence allowed the evaluators to accurately determine capacity.

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. Includes bibliographical references (leaves 72-73). Also available via the Internet.

For over 20 years occupational therapists have been using functional capacity evaluations to provide information about individuals’ ability to work after a musculoskeletal injury. An important component of these evaluations is the determination of the clients’ level of effort during the assessment. Only when a client puts forth high effort are the results considered an accurate measure of their work ability. This qualitative study explored therapists’ perception of the process of determining effort. Consistent with the literature, the results show that effort is a complex construct that is not easily defined, understood, or consistently assessed in practice. The participants in this study spoke about their own struggles defining, explaining, and assessing effort within the medico-legal context of an insurance system. The study results suggest support is needed for clinicians to navigate multiple client contexts, and the term ‘effort’ needs to be conceptualized in line with current knowledge about disability.

D.Phil.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 4 uppsatser.

The role of engineering in the rehabilitation of the disabled has been steadily increasing in recent years. With the enactment of the Americans with Disabilities Act, that role has taken on a new level of importance. Uncomfortable with the qualitative, disability-oriented assessment tools of their special education, occupational and physical therapists, and medical teammates, engineers have come to rely more and more on their own quantitative assessment devices. Among these, the Available Motions Inventory (AMI) has shown great promise as a tool for the development of job modifications for the moderately disabled individual. From its seventy-one sub-tests, the AMI provides raw and processed data on an individual's capability to manipulate switches, orient settings, and demonstrate strength, as well as perform light assembly tasks. Included in the output is a weighted set of scores showing the subject's strength, range of motion, and reach/reaction capabilities. However, the AMI has its drawbacks. The scoring algorithms can underestimate the capabilities of subjects who fail to perform certain tasks, and it will not permit recombination or selective omission of the various sub-tests. This study examined the feasibility of employing the AMI analysis algorithms using a spreadsheet format for the purpose of better analyzing the data generated by persons with limited range of motion disabilities. Ten Subject Matter Experts (SMEs) were asked to analyze a series of data profiles and place the individuals described by the profiles into one of four job options. The data profiles are the AMI scores for individuals falling into one of three categories of disability: normal, hemiplegic, and limited range of motion. The jobs increase in difficulty from a position of non-feasible employment to employment as a pizza chef. The data generated were analyzed using the Sign Test. The results showed that a difference does exist between the current scoring system and the updated system in the placement of individuals. A difference between the systems was established for the case involving individuals with a limited range of motion. More importantly, the SMEs frequently chose more complex jobs for individuals with limited range of motion, suggesting that the new system provides a more realistic picture of this category of disabled persons. The results of this research permit a more effective use of the AMI by implementing an updated scoring system. The new system allows for several increased benefits during analysis. The scoring system is based on an EXCEL spreadsheet, thus it is operable in both the PC, Windows and Apple environments. Better data control and manipulation allows for better representation of an individual's capabilities. The system operates in the same manner as the existing system; however, the spreadsheet design allows for customization of the data output. Finally, it is believed that the use of the new system will increase the chance of job placement for severely disabled individuals with a limited range of motion. / Master of Science

Thesis (M.Sc.)--Memorial University of Newfoundland, 2005. / Includes bibliographical references.

Thesis (D.Phil.(Biokinetics, Sport and Leisure Sciences))--University of Pretoria, 2008. / Summary in English and Afrikaans. Includes bibliographical references.

Thesis (Ph.D.) - University of Queensland, 2005. / Includes bibliography.