Measurement Spotlight – Original Article
Integrating Assessment into Clinical Practice: The Patient Specific Functional Scale
By Eron Bozec
Occupational Therapist
Northwestern Medicine Marianjoy Rehabilitation Hospital
As a hard-working outpatient neuro-rehabilitation Occupational Therapist, I have precious time with clients and I balance an increasing client caseload alongside decreasing time to complete all responsibilities. Clinically, it is important to spend the valuable time with clients in sessions to determine therapy priorities and goals. In the busy outpatient neurological clinical environment quick, efficient assessments are necessary. One timesaving outcome measure is the Patient Specific Functional Scale (PSFS). The PSFS assesses client perception of activity participation and performance, helps identify activities that are important and meaningful for the client, and measures their progress toward that activity. It is essential to obtain the client perspective on what is important and their perception of current performance on each activity and compare to their previous functional level. Thus, the PSFS quickly allows clinicians to address patient identified problems and focus on intervention priorities based on a patients self-rating. Combined with other client factors and skills assessments it can be used to determine and set realistic goals.
Reassessment of the PSFS allows patients to rate how their performance in the activity has improved. It gives patients a numerical value and may be more concrete to demonstrate progress in a neurologically and possibly cognitively impaired client population. It is important to assess the client’s perception of progress toward the chosen activities to determine progress and success of the intervention process. The process of determining progress in client activities is an ongoing process. The goal is to provide quality client centered occupational therapy to address both activity and participation. Client input is necessary to adapt, compensate, or remediate activities based on patient factors and skills which may impede quality of life and their ability to fully participate in meaningful and purposeful occupations.
The importance of identifying client activity participation influences client engagement in therapy and provides direction. It gives the client control of their therapy and I am able to create meaningful interventions that the client enjoys. The clinician’s interpretation of the PSFS results enables us to focus our sessions on the client priorities. Clients have an increased understanding on how concentrating on their goals will impact their lives to be more fulfilled and enriched, and increase participation to increase their quality of life. As an Occupational Therapist in a fast-paced outpatient clinic, the PSFS is a quick, efficient, easy to administer outcome measure, which our clinic has been incorporating to improve identification of client goals and priorities.
