Fedme og dagliglivets aktiviteter: En eksplorerende studie om bruk av kartleggingsinstrumenter for å identifisere vansker i hverdagen

Abstract

Background: Increased prevalence of obesity among the population has resulted in greater need for measures of activities of daily living (ADL) and health-related quality of life (HRQOL). Canadian Occupational Performance Measure (COPM) is one of the most commonly used measurements within occupational therapy. The researcher is not familiar with any research using COPM among obese patients. Purpose: To describe difficulties in ADL related to obesity. Further more to examine whether COPM is able to reveal the same difficulties in ADL as the activity specific questions in Impact of Weight on Quality of Life-Lite (IWQOL-Lite). Material and Methods: A mixed methods design was used consisting of qualitative interviews, with quantitative data as supplementary. COPM was used as an interview guide to gather information about difficulties in ADL perceived by the informants. The interviews were later analysed using systematic text condensation. The quantitative data was solely intended to describe the results of the assessment with COPM and IWQOL-Lite. To compare and identify patterns and topics across the quantitative and qualitative data, a meta-matrix analysis was used for every informant. Results: Mean age among the informants was 43,5 years and mean body mass index (BMI) was 44,2. Nine men and seven women were interviewed. The results showed that the informants had difficulties within three areas: self-care, productivity and leisure. The difficulties were a result of physical function, the society ´s custom size, and as consequences of experienced norms. COPM and the activity specific questions in IWQOL-Lite correlates positively for some informants, for others the correlation is less or poor. Conclusions: Obesity has an impact on daily living. The results indicate that COPM is not able to reveal the same information as IWQOL-Lite among all informants. By combining COPM and IWQOL-Lite in a clinical context they could complement each other. Relevance: Research indicates that people with obesity have difficulties in ADL, but to what extent is less described. IWQOL-Lite is commonly used in assessing HRQOL. COPM is a patient-specific outcome measure developed to describe aspects of problems, limitations and restrictions as perceived by the individual, and is commonly used in occupational therapy. If an interview (COPM) provides similar or better information compared to a questionnaire (IWQOL-Lite) for difficulties in ADL in obese, it will provide a potential beneficial use of COPM due to the patients’ possibility to speak freely.