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RehabMeasures

Model of Human Occupation Screening Tool

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Purpose

An assessment that addresses the majority of MOHO concepts:
volition (motivation for occupation), habituation (pattern of occupation), communication and interaction skills, motor skills, process skills, environment in order to gain an overview of occupational functioning.
 

Link to Instrument

Acronym MOHOST

Area of Assessment

Communication
Life Participation
Motivation
Reasoning/Problem Solving
Social Relationships

Assessment Type

Observer

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$40.00

Diagnosis/Conditions

  • Arthritis + Joint Conditions
  • Brain Injury Recovery
  • Cardiac Dysfunction
  • Cerebral Palsy
  • Multiple Sclerosis
  • Pain Management
  • Parkinson's Disease & Movement Disorders
  • Pulmonary Disorders
  • Spinal Cord Injury
  • Stroke Recovery
  • Vestibular Disorders

Key Descriptions

  • 24 items (4 items per section)
    Minimum score 24, Maximum score 96
  • Each item is scored on an ordinal rating scale:
    F= facilitates occupation participation;
    A= allows occupation participation;
    I= inhibits occupation participation;
    R= restricts occupation participation;
  • Can be translated into a 4-point interval rating scale where F=4, A=3, I=2, and R=1.
  • The MOHOST manual provides descriptions of criteria for each item.

Number of Items

24

Equipment Required

  • Pen/Pencil or Computer
  • MOHOST Observation Forms (4 Options)
  • Equipment required for observed activity

Time to Administer

40 minutes

Total administration time is from 10 to 40 minutes.

Required Training

Reading an Article/Manual

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Karen Lukaszewski, Ryan Thomure, and Jessica Weiler

ICF Domain

Participation

Measurement Domain

Activities of Daily Living
Cognition
Emotion
General Health
Motor
Sensory

Considerations

The MOHOST is available in many different languages.

 

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Non-Specific Patient Population

back to Populations

Interrater/Intrarater Reliability

Mental Health:

See: (Forsynth et al, 2011, n = 163; mean age = 40.10 years; 83.4% male, 16.56% female; 48% from UK, 52% from USA; Mental Health)

Internal Consistency

Mental Health:

(Kramer et al, 2009, n = 54; mean age = 58.13; 20 male, 34 female from inpatient rehabilitation unit; spent between 2 and 39 days on the unit M = 11.54, SD = 7.518; Mental Health)

 

Mixed Disabilities 
See: (Kielhofner, 2009, = 166; mean age = 40.1 years; 83.7% male and 16.3% female; 51.8% from the UK, 48.2% from the USA; Mixed Disabilities)

Construct Validity

Convergent Validity

  • MOHOST-C Volitional Scale & Volitional QuestionnaireAdequate r= 0.583
  • MOHOST-C Communication Scale & ACIS-C: Excellent r= 0.815
  • MOHOST-C Process Scale & MMSEAdequate r= 0.334 

 

Divergent Validity

Mental Health 
(Pan et al, 2011, = 101; mean age = 40.5 (9.6) years; n = 74 patients with schizophrenia, Mental Health)

  • Poor reliability between volition subscale of MOHOST and Volitional Questionnaire (r = -.048)
  • Poor reliability between habituation subscale of MOHOST and Volitional Questionnaire (r= .046)
  • Poor reliability between communication subscale of MOHOST and Volitional Questionnaire (r= .104)
  • Poor reliability between process subscale of MOHOST and Volitional Questionnaire (r = .005)
  • Poor reliability between motor subscale of MOHOST and Volitional Questionnaire (r = .042)
  • Poor reliability between environment subscale of MOHOST and Volitional Questionnaire (r = -.013)

Content Validity

Mental Health 
(Pan et al, 2011, Mental Health)

  • Excellent correlation between volition subscale of MOHOST and Volitional Questionnaire ( = .583)
  • Excellent correlation between communication and interaction subscale of MOHOST and the ACIS ( r =.815)
  • Adequate correlation between process subscale of MOHOST and MMSE (r = .334)

 

Mental Health: 
(Kielhofner, 2010; n= 1039; mean age= 61.83 (22.28) years, Mental Health)

  • All six subscales of the MOHOST were able to discriminate subjects into at least three statistically distinct levels. The reliability with which subjects were discriminated into levels ranged from .81 to .89
  • Poor correlation with MOHOST subscale volition with HoNOS-PbR item Problems with ADLs (r= .23)
  • Poor correlation with MOHOST subscale Habituation with HoNOS-PbR item Problems with ADLs (r= .29)
  • Poor correlation with MOHOST subscale Communication/ interaction skills with HoNOS-PbR item Problems with relationships (r= .20)
  • Adequate correlation with MOHOST subscale process skills with HoNOS-PbR item cognitive problems (r= .45)
  • Adequate correlation with MOHOST subscale Motor Skills with HoNOS-PbR item Physical illness or disability problems (r= .43)
  • Poor correlation with MOHOST subscale Environment with HoNOS-PbR item Problems with living conditions(r= .24)

Floor/Ceiling Effects

Mental Health 
(Forsynth et al, 2011, Mental health)

  • No ceiling or floor effects

Bibliography

Duncan, E. & Moody, K. (2003). Integrated care pathways in mentalhealth settings: An occupational therapy perspective. British Journal of Occupational Therapy, 66(10), 473-478.

Forsyth, K., Parkinson, S., Kielhofner, G., Kramer, J., Mann, L., S., & Duncan, E. (2011). The measurement properties of the model of human occupation screening tool and implications for practice. New Zealand Journal of Occupational Therapy, 58(2), 5-13. Retrieved from 

Hawes, D. & Houlder, D. (2010). Reflections on using the Model of Human Occupation Screening Tool in a joint learning disability team. British Journal of Occupational Therpy, 73(11), 564-567.

Kielhofner, G., Fan, W., Morley, M., Garnham, M., Heasman, D., Forsyth, K., Lee, S., & Taylor, R. (2010). Psychometric study of the Model of Human Occupation Screening Tool (MOHOST). Hong Kong Journal of Occupational Therapy, 20(2), 63-70.

Kielhofner, G., Fogg, L., Braveman, B., Forsyth, K., Kramer, J., & Duncan, E. (2009). A factor analytic study of the Model of Human Occupation Screening Tool of hypothesized variables. Occupational Therapy in Mental Health, 25(2), 127-137.

Kramer, J., Kielhofner, G., Lee, S. W., Ashpole, E., & Castle, L. (2009). Utility of the Model of Human Occupation Screening Tool for detecting client change. Occupational Therapy in Mental Health, 25(2), 181-191.

Mitchell, R. & Neish, J. (2007). The use of a ward-based art group to assess the occupational participation of adult acute mental health clients. British Journal of Occupational Therapy, 70(5), 215-217.

Notoh, H., Yamada, T., Kobayashi, N., Ishii, Y., & Forsyth, K. (2013). Examining the psychometric properties of the model of human occupation screening tool--japanese version. Hong Kong Journal of Occupational Therapy, 23(1), 26-31. doi:10.1016/j.hkjot.2013.03.001

Notoh, H., Yamada, T., Kobayashi, N., Ishii, Y., & Forsyth, K. (2014). Examine the structural aspect of the construct validity of the Japanese version of the Model of Human Occupation Screening Tool. British Journal of Occupational Therapy, 77(10), 516-525.

Lee, S. & Harris, M. (2010). The development of an effective occupational therapy assessment and treatment pathway for women with a diagnosis of borderline personality disorder in an inpatient setting: implementing the Model of Human Occupation. British Journal of Occupational Therapy, 73(11), 559-563.

Pan, A., Fan, C., Chung, L., Chen, T., Kielhofner, G., Wu, M., & Chen, Y. (2011). Examining the validity of the Model of Human Occupation Screening Tool: Using classical test theory and item response theory. The British Journal of Occupational Therapy, 74(1), 34-40.

Parkinson, S., Chester, A., Cratchley, S., & Rowbottom, J. (2008). Application of the Model of Human Occupation Screening Tool (MOHOST Assessment) in an acute psychiatric setting. Occupational Therapy in Health Care, 22(2–3), 63-75.