Evaluating ADL measures from an occupational therapy perspective.

BACKGROUND Measures reflecting occupational therapy's conceptualization of occupational performance support the profession's contribution to evidence-based practice and fiscal accountability. PURPOSE This study compared measures of performance-based activities of daily living (ADL) with principles of occupational therapy practice and intended outcomes. METHODS Using an action research study design, occupational therapists and researchers (N= 13) systematically clarified the clinical problem, identified occupational therapy principles inherent to the assessment of daily living activity via nominal group technique; defined the key principles as constructs; and reframed these constructs as a questionnaire against which 18 published standardized ADL measures were evaluated. FINDINGS Participants identified six measures as most congruent with principles of occupational therapy practice: ADL Profile, Assessment of Motor and Process Skills, Functional Performance Measure, Rivermead ADL Assessment, Edmans ADL Index, and Melville-Nelson Self-Care Assessment. IMPLICATIONS Findings guide occupational therapists' search and use of performance-based ADL measures that demonstrate the profession's distinct health care contribution.