The missions of our center:
1.To conduct research of the MOHO in Chinese
2.To promote the cross-cultural interchange of the MOHO application
3. To disseminate the MOHO in Chinese community.
Dr. Ay-Woan Pan.
May 4, 2016
MOHO center in Taiwan visitors- from JAMK University of Finland and from School of Occupational Therapy of National Taiwan University
The new research results of Volitional Questionnaire (traditional Chinese version)- Inter-rater reliability for persons with mental illness
Title: The Inter-rater Reliability of theVolitionalQuestionnaire-Chinese Version(VQ-C)
Author: Wei-Ann Chen
Major Finding: The Study confirmed that the Chinese version of VQ has acceptable inter-rater reliability.
Participants: N=100 subjects, 3 licensed OT who were trained to use VQ • 59 males,41females • Mean age of the subjects: 47.8 years (SD=12.6) • Diagnosis Condition: 37 subjects with Schizophrenia, 32 subjects with Depression, 31 subjects with alcohol use disorder. • Setting: A medical center in northern Taiwan. • Ethnicity:100 Asian (Taiwan) • IRB approval: TSGHIRB: 1-102-05-056
Method: Three raters was trained to use VQ-C. They read the manual and co-assessed a standard subject. Then a meeting was called to discuss the ratings until unanimity was reached. Five standardized manual activities was designed to be chosen by the subjects. By observing the performance of the activities the subject chooses, the rater can rate him(her) on VQ-C. Each subject would participate in 2 activities which one was chosen by the subject and the other one was assigned by the therapist. Each subject was rated by at least 2 raters. The subjects also filled out the other measures including BAI, BDI-II, OSA and TSCL.
Analysis: Multi-faceted Rasch measurement model, intraclass correlation coefficient (ICC), and multiple rater Kappa were used to examine the inter-rater reliability. The statistical analysis were conducted by FACETS (version 3.71.4)and SPSS (version 17.0).
Findings: Implications for future research: Evidence–basedpractice implications: • The internal consistency of the VQ-C was 89%, ICC=0.84, and Kappa value of individual item of the VQ-C was between 0.348 and 0.663, showing that the VQ-C had acceptable inter-rater reliability. • There were differential item functioning (DIF) of the VQ-C for diagnosis and activity type. • There were no correlations between the VQ-C and the other related measures revealed that VQ measures distinctive construct differing from symptoms and capability.
• The rating criteria of selected items need to be defined in more detail in order to reach consistent rating. • There is a need to describe typical activity content and procedure to be observed for VQ ratings in order to provide standard settings. • In order to apply VQ for a different population, there is needs to conduct psychometric study for different diagnostic groups with bigger sample size.
• The study suggested that the VQ-C had acceptable inter-rater reliability and can be used consistently by trained occupational therapists.
Chen, W. A. (2016). The Inter-rater Reliability of Volitional Questionnaire Chinese Version.[MasterThesis of the School of OccupationalTherapy,National TaiwanUniversity, unpublished].
Chen, Y.L., Pan, A.W*.,
Hsiung, P.C., Chung, L., Lai, J.S., Gau, S.S.F., & Chen, T.J. (2015). Life Adaptation Skills Training (LAST) for persons with depression:
A randomized controlled study. Journal of
Affective Disorders, 185, 108-114.
Background:To investigate the efficacy of the “Life Adaptation Skills Training (LAST)” program for persons with depression.
Methods: Sixty-eight subjects
with depressive disorder were recruited from psychiatric outpatient clinics in Taipei city and were randomly assigned to either an intervention group (N=33),
or a control group (N=35). The intervention group received 24-sessions of the LAST
program, as well as phone contact mainly related to support for a total of 24 times. The
control group only received phone contact 24 times. The primary outcome measure utilized was theWorld Health Organization Quality of
Life-BREF-Taiwan version. Secondary outcome measures included the Occupational
self-assessment, the Mastery scale, the Social support questionnaire, the Beck
anxiety inventory, the Beck depression inventory-II, and the Beck scale for
suicide ideation. The mixed-effects linear model was
applied to analyze the incremental efficacy of the LAST
program, and the partial eta squared (ηp2) was used to examine
the within- and between- group effect size.
subjects who participated in the LAST program showed significant incremental improvements
with moderate to large between-group
effect sizes on their level of anxiety (-5.45±2.34, p<0 .05="" span=""> ηp2=0.083) and level of suicidal ideation (-3.09±1.11, p<0 .01="" span=""> ηp2=0.157) when compared to the control group. The
reduction of suicidal ideations had a maintenance effect for three months after
the end of intervention (-3.44±1.09,
p<0 .01="" between-group="" moderate="" span="" with="">effect
sizes (ηp2=0.101). Both groups showed significant improvement on overall QOL, overall
health, physical QOL, psychological QOL, level of anxiety, and level of
depression. The within-group effect sizes achieved large effects in the
intervention group (ηp2=0.328~0.544),
and were larger than that of the control group.0>0>0>
Limitations: A small sample size in the study, a high dropout rate, lower compliance rates
for the intervention group, and lacking of true control group.
Conclusions: The occupation-based LAST program, which focuses on lifestyle rearrangement and coping skills enhancement, could significantly improve the level of
anxiety and suicidal ideations for persons with depression.
Title: The Effectiveness of
Remotivation Protocol for Persons with Schizophrenia
Author: Sheng-Hui Wang
Thesis Advisor: Ay-Woan Pan
Major findings: The
results from this study show that utilization of a remotivation protocol helps
to increase the patient's volitional performance, increase motivation to
participate in occupational performance, and improves negative symptoms.
*7 males, 3 females
*Age: 42+ 11.52 (range: 23-56)
*Setting: Inpatient acute ward in a psychiatric institute
*Ethnicity: Asian (Taiwan)
Methods: The researchers translated the English edition of the
remotivation process manual into Mandarin. In order to ensure the Mandarin
version of the manual was consistent with the English version, the manuscript
was corrected by a senior psychiatric occupational therapist experienced in
scale translation. The researchers wrote a remotivation group manual based on the
principle of the Chinese version of the manual, and referred to activities and
types of activities that clients of schizophrenia participated in prior to the clinical trials. The researchers then invited persons with schizophrenia to engage
in this therapeutic intervention. Pre-assessment
protocol had subjects filling out self-report scales, including the Occupational
Self-Assessment (OSA),Beck Depression Inventory Chinese Version of the second
edition (BDI-Ⅱ), the Brief Symptom Rating Scale
(BSRS-50). Psychiatrists then assessed patients using the Positive and Negative Syndrome Scale (PANSS), followed by an occupational therapist
who further assessed patients through the Volitional Questionnaire (VQ)
and the work behavior subscale of Comprehensive Occupational
Analysis: The data was
analyzed by SPSS 20 and Excel. The sign Test and Wilcoxon
Signed-Rank Test (nonparametric) and a Paired-Sample t Test (parametric) were
Findings: The pretest and
posttest scores of subjects in each scaled score all progressed except BSRS-50.
The scores of Volitional Questionnaire were statistically
significant in the Sign Test, Wilcoxon Signed-Rank Test and the Paired-Sample t
Test. The negative scale, total scores of the Positive and Negative Syndrome Scale were statistically significant in the
Wilcoxon Signed-Rank Test and the Paired-Sample t Test. The scores of the own competence
of the Occupational Self-Assessment were statistically significant in the
Paired-Sample t Test.
Conclusions: In general, patients
with schizophrenia display motivation problems, however, a lack of theory
driven occupational therapy intervention strategies hinders them from receiving
the treatment they need. Through the design of theoretical basis remotivation
protocol and a manualized approach, the standardization of occupational therapy
intervention to enhance evidence-based mental occupational therapy can be
promoted. The results from this study show that utilization of a
remotivation protocol benefits patient's volitional performance, motivation to
participate in occupational performance, and negative symptoms.
for future research: Larger sample size and apply to various diagnostic groups.
Wang, S.H. (2014). The Effectiveness of
Remotivation Protocol for Persons with Schizophrenia. [Master Thesis of the School of Occupational Therapy, National Taiwan