Client Understanding, Expectations, and Intern Performance in Occupational Therapy

Investigating Clients' Understanding and Expectation Reasonableness in Occupational Therapy and Interns' Performance in Health Education and Chief Complaint/Expectation Interviews.

This study aims to investigate psychiatric clients' understanding of occupational therapy (OT), the reasonableness of their expectations regarding OT services, and OT interns' performance in Occupational Therapy Knowledge (OTK) health education and chief complaint/expectation interviews. The project includes developing assessment instruments for client OT knowledge, expectation reasonableness, and intern communication/education performance, followed by data collection in real clinical settings. Clients, clinical supervisors, and external experts will contribute ratings to evaluate instrument validity and reliability. The study will provide foundational evidence for improving OT health education, communication training, and clinical teaching practices.

Study Overview

• Status: Not yet recruiting
• Conditions: Communication
• Intervention / Treatment: Other: Clinical Interview and Occupational Therapy Knowledge (OTK) Health Education Session

Detailed Description

This study examines (1) psychiatric clients' understanding of occupational therapy (OT), (2) the reasonableness of their expectations toward OT, and (3) OT interns' performance in OTK health education and chief complaint/expectation interviews. The project includes instrument development and clinical data collection in the Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital.

Substudy 1: Client OT Knowledge and Expectation Reasonableness

Substudy 1 consists of two phases. Phase 1 focuses on developing two tools-the OT Knowledge Assessment and the OT Expectation Reasonableness Scale. A team of clinical OT experts and a psychometrics specialist will identify key domains, generate items, and establish scoring guidelines. Content and face validity will be evaluated by external experts and psychiatric clients.

The OT Knowledge Assessment will measure clients' understanding of OT concepts and service scope. The OT Expectation Reasonableness Scale will assess whether clients' expectations for OT processes and outcomes are clinically appropriate.

Phase 2 collects data from psychiatric clients. OT interns will conduct initial interviews exploring clients' chief complaints and expectations. Clients will complete the OT Knowledge Assessment, and both clinical supervisors and external experts will independently evaluate expectation reasonableness using standardized scoring guidelines. Descriptive statistics will summarize clients' knowledge levels and expectation patterns.

Substudy 2: Intern OTK Health Education and Interview Performance

Substudy 2 includes three phases. Phase 1 develops two performance measures: the OTK Health Education Performance Scale and the Chief Complaint/Expectation Interview Performance Scale. Preliminary domains include communication clarity, individualized education, understanding-checking, information-gathering, clarification, and empathy. Expert review will ensure content and face validity.

Phase 2 evaluates 30 OT interns who will conduct initial interviews with psychiatric clients after receiving standardized training. Clinical supervisors will provide real-time ratings, and external experts will score audio recordings and transcripts. Combined evaluations will provide a more comprehensive assessment of intern performance.

Phase 3 examines reliability of the new scales. Inter-rater reliability (supervisors vs. experts) and intra-rater reliability (experts' repeated scoring) will be assessed using weighted Kappa and intraclass correlation coefficients (ICC).

• Study Type: Observational
• Enrollment (Estimated): 139

Contacts and Locations

• Study Contact: Name: HUNG-FEI WU; Phone Number: 8766 886-7-7317123; Email: feifei@cgmh.org.tw

Study Locations

• Taiwan
  • Niaosong Dist
    • Kaohsiung City, Niaosong Dist, Taiwan, 833401
      • Chang Gung Medical Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Psychiatric clients receiving occupational therapy services in the Department of Psychiatry at Kaohsiung Chang Gung Memorial Hospital.

Occupational therapy interns completing clinical internships in psychiatric settings.

Clinical supervisors who observe and evaluate intern performance during clinical interactions.

Description

Inclusion Criteria:

1. Occupational Therapy Students: Currently completing a clinical internship in psychiatric occupational therapy.
2. Clinical Supervisors: Willing to participate in the study.
3. Psychiatric Clients:

(1) Age 20 years or older. (2) Diagnosed with a psychiatric disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

(3) Able to understand simple questions and follow three-step commands.

Exclusion Criteria:

1. Occupational Therapy Students: Unwilling to be audio-recorded.
2. Clinical Supervisors: No exclusion criteria.
3. Psychiatric Clients: Unwilling to be audio-recorded.

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Psychiatric Clients; Adult psychiatric clients receiving occupational therapy services at the Department of Psychiatry.	Other: Clinical Interview and Occupational Therapy Knowledge (OTK) Health Education Session; This study involves observational procedures, including: (1) a health education session on occupational therapy knowledge (OTK) delivered by occupational therapy interns, and (2) a semi-structured chief complaint and expectation interview conducted with psychiatric clients by interns. Clinical supervisors and external experts evaluate interns' performance using standardized rating scales, which are developed in this study. No therapeutic or experimental interventions are provided to participants.
Occupational Therapy Interns; OT students completing clinical internships in psychiatry.	Other: Clinical Interview and Occupational Therapy Knowledge (OTK) Health Education Session; This study involves observational procedures, including: (1) a health education session on occupational therapy knowledge (OTK) delivered by occupational therapy interns, and (2) a semi-structured chief complaint and expectation interview conducted with psychiatric clients by interns. Clinical supervisors and external experts evaluate interns' performance using standardized rating scales, which are developed in this study. No therapeutic or experimental interventions are provided to participants.
Clinical Supervisors; Licensed occupational therapists serving as clinical supervisors.	Other: Clinical Interview and Occupational Therapy Knowledge (OTK) Health Education Session; This study involves observational procedures, including: (1) a health education session on occupational therapy knowledge (OTK) delivered by occupational therapy interns, and (2) a semi-structured chief complaint and expectation interview conducted with psychiatric clients by interns. Clinical supervisors and external experts evaluate interns' performance using standardized rating scales, which are developed in this study. No therapeutic or experimental interventions are provided to participants.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Occupational Therapy Knowledge Score	Clients' level of understanding of occupational therapy, measured using the Occupational Therapy Knowledge Assessment, which will be developed in this study. Higher scores will indicate greater knowledge of occupational therapy. The score range is not yet finalized.	Baseline
Occupational Therapy Expectation Reasonableness Score	Clients' expectations regarding occupational therapy processes and outcomes will be evaluated using the Occupational Therapy Expectation Reasonableness Scale, which will be developed in this study. Higher scores will indicate more clinically appropriate expectations. The score range is not yet finalized.	Baseline
Occupational Therapy Knowledge Health Education Performance Score	Occupational Therapy interns' performance in delivering occupational therapy health education to psychiatric clients will be evaluated using the Occupational Therapy Knowledge Health Education Performance Scale, which will be developed in this study. Higher scores will indicate better performance in delivering health education. The score range is not yet finalized.	Baseline
Chief Complaint/Expectation Interview Performance Score	Occupational Therapy interns' performance in conducting chief complaint and expectation interviews will be evaluated using the Interview Performance Scale, which will be developed in this study. Higher scores will indicate better interview performance. The score range is not yet finalized.	Baseline

Collaborators and Investigators

• Sponsor: Chang Gung Memorial Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2026
• Primary Completion (Estimated): May 1, 2026
• Study Completion (Estimated): May 31, 2026

Study Registration Dates

• First Submitted: December 24, 2025
• First Submitted That Met QC Criteria: January 8, 2026
• First Posted (Estimated): January 12, 2026

Study Record Updates

• Last Update Posted (Estimated): January 12, 2026
• Last Update Submitted That Met QC Criteria: January 8, 2026
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: Occupational Therapy; Health Education; Interview
• Additional Relevant MeSH Terms: Behavior; Treatment Adherence and Compliance; Health Behavior; Patient Compliance; Patient Acceptance of Health Care; Adherence Interventions; Medication Adherence; Communication; Health Education
• Other Study ID Numbers: 202500540B0

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No