Types of outcomes
The examples listed specify how the broad outcome of engagement in occupation may be operationalized. The examples are not intended to be all-inclusive.
Outcome - Description
The act of doing and accomplishing a selected activity or occupation that results from the dynamic transaction among the client, and the activity. Improving or enabling skills and patterns in occupational performance leads to engagement in occupations or activities.
Improvement - Used when performance limitation is present. These outcomes document increased occupational performance for the person, organization, or population. Outcome examples may include
(1) the ability of a child with autism to play interactively with a peer (person);
(2) the ability of an older adult to return to the home from a skilled-nursing facility (person);
(3) decreased incidence of back strain in nursing personnel as a result of an in-service education program in body mechanics for carrying out job duties that require bending, lifting, and so forth (organizations); and
(4) construction of accessible playground facilities for all children in local city parks (populations).
Enhancement - Used when a performance limitation is not currently present. These outcomes document the development of performance skills and performance patterns that augment existing performance or prevent potential problems from developing in life occupations. Outcome examples may include
(1) increased confidence and competence of teenage mothers to parent their children as a result of structured social groups and child development classes (person);
(2) increased membership of the local senior citizen center as a result of diverse social wellness and exercise programs (organization);
(3) increased ability by school staff to address and manage school-age youth violence as a result of conflict resolution training to address "bullying" (organizations); and
(4) increased opportunities for seniors to participate in community activities due to ride share programs (populations).
A change in response approach that the client makes when encountering an occupational challenge. "This change is implemented when the [client's] customary response approaches are found inadequate for producing some degree of mastery over the challenge". Examples of adaptation outcomes include
(1) clients modifying their behaviors to earn privileges at an adolescent treatment facility (person);
(2) a company redesigning the daily schedule to allow for an even workflow and to decrease times of high stress (organization);
(3) a community making available accessible public transportation and erecting public and "reserved" benches for older adults to socialize and rest (populations).
Health and wellness
Health is a resource for everyday life, not the objective of living. For individuals, it is a state of physical, mental, and social well-being, as well as a positive concept emphasizing social and personal resources and physical capacities. Health of organizations and populations includes these individual aspects but also includes social responsibility of members to society as a whole. Wellness is [a]n active process through which individuals [organizations or populations] become aware of and make choices toward a more successful existence". Wellness is more than a lack of disease symptoms; it is a state of mental and physical balance and fitness. Outcome examples may include
(1) participation in community outings by a client with schizophrenia in a group home (person);
(2) implementation of a company-wide program to identify problems and solutions for balance among work, leisure, and family life (organizations); and
(3) decreased incidence of childhood obesity (population).
Engagement in desired occupations in ways that are personally satisfying and congruent with expectations within the culture.
"[H]ealth promotion is equally and essentially concerned with creating the conditions necessary for health at individual, structural, social, and environmental levels through an understanding of the determinants of health: peace, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity". Occupational therapy promotes a healthy lifestyle at the individual, group, organizational, community (societal), and governmental or policy level. Outcome examples may include
(1) appropriate seating and play area for a child with orthopedic impairments (person);
(2) implementation of a program of leisure and educational activities for a drop-in center for adults with severe mental illness (organizations); and
(3) access to occupational therapy services in underserved areas regardless cultural or ethnic backgrounds (populations).
Quality of life
The dynamic appraisal of the client's life satisfaction (perceptions of progress toward one's goals), hope (the real or perceived belief that one can move toward a goal through selected pathways), self concept (the composite of beliefs and feelings about oneself), health and functioning (including health status, self-care capabilities, and socioeconomic factors, e.g., vocation, education, income). Outcomes may include
(1) full and active participation of a deaf child from a hearing family during a recreational activity (person);
(2) residents being able to prepare for outings and travel independently as a result of independent-living skills training for care providers of a group (organization); and
(3) formation of a lobby to support opportunities for social networking, advocacy activities, and sharing scientific information for stroke survivors and their families (population).
The ability to effectively meet the demands of roles in which the client engages.
Actively promoting or supporting oneself or others (individuals, organizations, or populations); requires an understanding of strengths and needs, identification of goals, knowledge of legal rights and responsibilities, and communicating these aspects to others. Outcomes may include
(1) a student with a learning disability requesting and receiving reasonable accommodations such as textbooks on tape (person);
(2) a grassroots employee committee requesting and procuring ergonomically designed keyboards for their computers at work (organization); and
(3) people with disabilities advocating for universal design with all public and private construction (population).
Access to and participation in the full range of meaningful and enriching occupations afforded to others. Includes opportunities for social inclusion and the resources to participate in occupations to satisfy personal, health, and societal needs. Outcomes may include
(1) people with intellectual disabilities serving on an advisory board to establish programs offered by a community recreation center (person);
(2) workers who have enough of break time to have lunch with their young children at day care centers (organization);
(3) people with persistent mental illness welcomed by community recreation center due to anti-stigma campaign (organization) ; and
(4) alternative adapted housing options for older adult to "age in place" (populations).