CHAPTER 82: CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM)

Description

The Canadian Occupational Performance Measure (COPM) is a standardized assessment that is delivered through a semi-structured interview as well as a questionnaire/rating scale designed to assess a client’s self-perception of occupational performance and satisfaction with that performance over time. It is based on the Canadian Model of Occupational Performance and is intended to help clients identify, prioritize, and evaluate important issues they encounter in occupational performance (Law et al., 2011). Through discussion, the client first identifies occupational performance issues that he or she would like to work on and then ranks each item (1 to 10) relative to their importance to the individual for the following general categories:

1. Self-care, which includes the following:
   

   a. Personal care

   
   

   b. Functional mobility

   
   

   c. Community management

   
   
2. Productivity, which is composed of the following:
   

   a. Paid/unpaid work

   
   

   b. Household management

   
   

   c. Play/school

   
   
3. Leisure, which is further delineated into the following subcategories:
   

   a. Quiet recreation

   
   

   b. Active recreation

   
   

   c. Socialization.

The next step of the assessment involves the identification of the 5 most important problems, which are then rated relative to performance and satisfaction and are scored along a scale of 1 to 10 with (1) not being able to do the activity and (10) being able to do the activity extremely well, which is then calculated as a total score (i.e., the sum of each problem area). Along with an overall score, a problem list is generated to focus treatment goals. The COPM can be completed in less than 20 minutes.

Psychometrics

A research study among persons with ankylosing spondylitis (n = 119) listed a total of 1495 occupational performance problems in their COPM interviews and prioritized 569 of them. The most frequent problems cited were associated with exercise and sports, sleeping, indoor mobility, and socializing (Kjeken et al., 2005). The same study found test-retest reliability, conducted in a number of formats, to be good to excellent with intra-class correlation coefficients for performance and satisfaction at r= 0.92 and 0.93 when rescored by personal interview, r = 0.73 and 0.73 when rescored by telephone interview, and lastly, r = 0.90 and 0.90 when rescored by mail (Kjeken et al., 2005). A study of 138 subjects referred to outpatient occupational therapy departments of an academic medical center found significant differences between the mean COPM assessment and reassessment scores as 78 of the 138 (57%) clients indicated an improvement, 40 clients (29%) indicated no change, and 20 clients (14%) indicated deterioration (Bolt et al., 2011). Another study of 113 with various tendon injuries or Dupuytren’s disease found that the correlations between the DASH Outcome assessment and COPM performance and satisfaction subscales were –0.48 and –0.58, whereas correlations with the Michigan Hand Questionnaire-29 were 0.42 and 0.60, respectively (van de Ven-Stevens, Graff, Peters, van der Linde, & Geurts, 2015).

Advantages

There is a significant amount of research in support of its use in clinical practice and it is considered to be a gold standard in the assessment of occupational performance as well as being client centered. The COPM is based on the Canadian Model of Occupational Performance and can deliver unique insights into client-perceived strengths, weaknesses, and goals. No special training or licensing are needed to administer the assessment and the COPM maintains an informative website devoted to the scale.

Disadvantages

The assessment generally takes less than 20 minutes to complete administration; however, time can be longer in certain populations. As the COPM is a loosely designed open-format assessment, its success relies on both input and motivation of the client to perform an honest appraisal of his or her strengths, weaknesses, and goals and to a lesser extent guidance from the clinician.

Administration

During assessment the client is asked to identify and rank problematic issues with everyday activities with regard to three domains of occupational performance outlined on the measure. Step 2 requires the client to further consider those identified areas and select 5 that he or she would like to address or make known to the clinician, which are then rated along a scale of 1 to 10 relative to performance and satisfaction with that performance. Information purveyed from the measure can then be used by the clinician to create treatment goals or to develop interventions. Reassessment using the same methods occurs after intervention where scores are then compared.

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