Mahsa Meimandi, PhD, is Clinician, Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Ghorban Taghizadeh, PhD, is Associate Professor, Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Am J Occup Ther. 2024 May 1;78(3). doi: 10.5014/ajot.2024.050463.
A sense of agency is associated with complex occupation-related responsibilities. A taxonomy can guide clinicians in enhancing responsibility in patients with Parkinson's disease (PwPD).
To (1) discover levels of responsibility in occupations for PwPD and (2) propose a taxonomy for occupations.
A two-round Delphi study with PwPD and a one-round Delphi study with international experts.
Electronic survey.
PwPD (N = 75) and international experts (N = 8).
PwPD expressed their levels of an inherent sense of responsibility for each occupation (1 = very low responsibility, 5 = very high responsibility). International experts rated their level of agreement (5 = strongly agree, 1 = strongly disagree) with each dimension of the taxonomy. A consensus was determined to have been reached if the interquartile range was ≤1 and 70% agreement in two adjacent categories was achieved.
Thirty-three occupation categories were deemed as having very high to moderate responsibility for PwPD. Consequences of actions and the presence of others made up the two-dimensional responsibility taxonomy. Occupations have more challenging responsibility characteristics when they are performed with free choice, a level of high physical effort, alone, and with moral consequences.
This study yielded the first consensus among PwPD regarding responsibility in occupations as well as a classification system for charting the complexity of responsibility in occupations. The occupation list we have created can be beneficial to health care professionals when providing interventions or conducting outcome assessments. Plain-Language Summary: When planning interventions for patients with Parkinson's disease, it can be helpful for clinicians to be aware of patients' perspectives regarding their sense of responsibility to perform occupations. The use of a systematic sequence of challenging occupations with responsibility attributes ranging from less complex to more complex can help enhance patient occupational participation.
能动性与复杂的与职业相关的责任有关。分类法可以指导临床医生增强帕金森病患者（PwPD）的责任感。
（1）发现 PwPD 职业中的责任水平，（2）提出职业分类法。
一项包含 PwPD 的两轮德尔菲研究和一项包含国际专家的一轮德尔菲研究。
电子调查。
PwPD（N=75）和国际专家（N=8）。
PwPD 对每项职业的内在责任感水平进行了表达（1=非常低的责任，5=非常高的责任）。国际专家对分类法每个维度的同意程度进行了评分（5=非常同意，1=非常不同意）。如果四分位距≤1，并且在两个相邻类别中达到 70%的一致，则确定达成共识。
33 种职业类别被认为对 PwPD 具有非常高到中等的责任。行动的后果和他人的存在构成了二维责任分类法。当职业具有自由选择、高水平的体力劳动、单独完成和道德后果时，其责任特征更具挑战性。
这项研究在 PwPD 中首次就职业责任达成共识，并提出了一种职业责任复杂性分类系统。我们创建的职业清单在为患者提供干预或进行结果评估时，对医疗保健专业人员非常有益。
