Activity Analysis

Chapter 2


Activity Analysis





Objectives



1 Describe the process of activity analysis.


2 Describe the process of activity configuration and activity synthesis.


3 Discuss the process of activity match.


4 Differentiate between occupation, activity, and tasks.


5 Compare and contrast a variety of activity analyses.


6 Discuss how Model of Human Occupation (MOHO) theory helps practitioners conduct activity analyses.


7 Identify a variety of therapeutic media and how they are used in practice.


8 Identify ways to “grade” and adapt activities.



Key Terms



Activity analysis is central to occupational therapy (OT) practice. Practitioners use knowledge of the steps and actions required to perform activities to design interventions for a variety of clients. Practitioners evaluate the specific steps, movements, and processes involved in an activity so they can help clients compensate, remediate, or adapt to be successful. The process of activity analysis is ongoing throughout intervention; OT practitioners continually grade or change the activity requirements to help clients engage in their desired occupations. This chapter provides a description of activity analysis and the process of activity configuration and synthesis. A review of types of activity analyses, including task-focused, biomechanical, and Model of Human Occupation (MOHO), is presented. The chapter concludes by describing the use of therapeutic media in activities and grading and adapting activities.



Overview of the Process of Activity Analysis


OT practitioners use activity to help clients regain function for their occupations. By thoroughly understanding all the steps, actions, and skills required to complete a given activity, practitioners clinically reason how they might adapt or change the demands for a given client. This process is ongoing. As clients develop skills and abilities, the practitioner adjusts the activity demands for success. Designing activities that challenge clients allows them to be successful without overwhelming them. Sometimes the practitioner wants to show the client that he or she can be successful and enjoy past activities. In this case, the practitioner may decide to adapt the activity completely so that the person is able to engage in this familiar pastime.



CASE STUDY


For example, Juan enjoyed fishing with his family before he had a stroke (Figure 2-1). His motivation for therapy is low and he does not seem invested in group activities. The practitioner, Raven, decides to help Juan take a field trip with his family (on the hospital grounds) to a small fishing pond. Prior to the event, Raven analyzes the activity and decides that Juan will need to use an adapted fishing pole and a supported seat, and will require help getting the bait on the hook. Raven concludes that Juan should participate in the activity in the morning when he is rested (and the fish are jumping). She reviews the steps with Juan and his son. As an added touch, Raven brings a camera and takes a photo of Juan and his family and their “catch.” She posts the photo in Juan’s room to remind him of the event. In therapy, they discuss how the activity went and decide to continue to work on his motor skills for fishing. Her careful analysis of the activity and its demands allowed her to make the adaptations needed so that Juan could be successful.



By thoughtfully analyzing the activity of fishing, the OT practitioner is able to make appropriate accommodations and plans so the client can be successful. On another day, the practitioner works with the client to improve his ability to hold objects. As Juan increases his ability to effectively hold objects in his right hand, the practitioner reasons that he will be better able to fish without the use of the adapted pole. This activity is close to the occupation of fishing, which Juan enjoyed with his family prior to his stroke. By reminding Juan (through the picture) that he may be able to reengage in this familiar past-time, the practitioner is helping to motivate him to continue with therapy and reestablish his identity. Understanding the demands of the activity through activity analysis sets the stage for many aspects of the OT intervention.


The process of activity analysis allows practitioners to consider many elements of the activities. For example, the practitioner considers the motor tasks involved in each step. When examining the requirements, the practitioner contemplates how the individual will perform each step and often questions:



The practitioner examines the cognitive aspects of the activity and determines how things may need to be changed for success (Box 2-1). For example, the practitioner explores how the directions are relayed to the client.



BOX 2-1   Analysis of Cognitive Skills





Practitioners also consider the psychosocial aspects to activities (Box 2-2). Understanding the client’s previous level of performance is important in determining the acceptable performance level for the activity. For example, if the client was a professional dancer prior to the injury, he or she may feel it is condescending to be asked to learn a few dance steps. Other clients may enjoy this activity as a way to reengage in leisure. The OT practitioner uses the process of activity analysis to explore all angles of the activity to be sure it is the right fit for the client. This process includes both the science and art of therapy. The science of therapy involves understanding the components and parts of activities, such as range of motion or movement required to perform. The art of therapy requires understanding how to deliver the directions, work with the client, and use one’s self therapeutically (see Chapter 4).



BOX 2-2   Psychosocial Skills Considered for Activity





Steps to Activity Analysis


OT practitioners engage in activity analysis to identify goals and to develop intervention plans. As such, activity analysis is an important tool for OT practitioners. The following steps describe the process involved:




Understand the Client’s Story: The Occupational Profile


Understanding the client’s story is the first step in designing effective intervention and conducting an activity analysis. This involves gathering information on the types of occupations in which the person has interest, routines, roles, family history, and medical history. Understanding the client’s desires and motivations (or what Kielhofner6 terms volition) is essential when designing individualized intervention. The occupational profile provides the first step in the activity analysis process. See Box 2-3 for sample questions that help to gain information for an occupational profile.1



BOX 2-3   Occupational Profile




(Adapted from the American Occupational Therapy Association: Occupational therapy practice framework: domain and process, Am J Occup Ther 62:650, 2008.)



Define the Client’s Goals and Objectives


After developing an understanding of the client through the occupational profile and an initial evaluation, the practitioner works with the client to define the goals and objectives for therapy. The goals and objectives may be specific to the setting in which the client is receiving intervention. Developing goals that are occupation-based ensures that the client will be invested in the outcomes.2,5,7,8 Consequently, practitioners are most effective when they develop occupation-based goals. The following questions may help practitioners develop these goals:


Related posts:

  1. Occupational and Group Analysis: Children
  2. Emerging Occupational Therapy Practice Areas
  3. Therapeutic Use of Self: Applying the Intentional Relationship Model in Group Therapy
  4. Interpersonal Relationships and Communication

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Apr 12, 2017 | Posted by in MEDICAL ASSISSTANT | Comments Off on Activity Analysis

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