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| Relevant TDF domains | Belief statements | Sample quote |
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| Social influences | (i) My use of the COPM is influenced by my clients. | (i) “Normally I meet the patient and then decide if [the COPM] is an appropriate tool.” (D)
(ii) “[Using the COPM] really depends on the patient and what their, you know, how they present.” (D) |
| | (ii) Client characteristics can positively and negatively influence my use of the COPM. | (i) “Well again [using the COPM] depends on their diagnosis. If they had a chronic disability and there was ongoing issues for them that they wanted to work towards improving… I think that the [COPM] would be an appropriate tool.” (O)
(ii) “If I’m having a hard time establishing goals with somebody then I would go to [the COPM].” (D)
(iii) “Well they need to have insight, they need to be able to answer the questions independently…. and well they have to be cognitive.” (P)
(iv) “Well the client [affects my decision to use the COPM]. I mean if the client is really profoundly impaired and I know that they have severe comprehension difficulties you know they may not be a person that I want to use [the COPM] on.” (A) |
| | (iii) Perceptions that the client will have difficulty with the COPM will negatively influence my use. | (i) “Well [I might use the COPM] except for that client that is very abrupt and… it would take me too much energy to get his anger down because he gets angry easily.” (C)
(ii) “If [the client] starts to get the feeling [when using the COPM] that the outcome measure is more important [to me] and not what they are saying and they are reluctant to rate [the COPM] or they do not get it…I can lose them.” (I)
(iii) “[The clients] can be depressed or… angry, they are in this spectrum so do you want to agitate the anger more [using the COPM]…oh yeah you cannot do all those things so then you are like precipitating more depression, right.” (J)
(iv) “There are patients that when you say well I’m gonna ask you to rate on a scale of 1-10 how important it is or how you feel about it…they get angry because they say well what do you think, what a stupid question.. I cannot move anything on my right side and I can barely talk and then the patient would get angry so that did that stop me [using the COPM].” (Q) |
| | (iv) Other team members do not influence my use of the COPM. | (i) “Other team members do not influence my use of the COPM.” (A, B, E) |
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| Social professional role and identity | (i) As an OT, I can decide what type of measurement tools to use. | (i) “I guess it’s up to your discretion [using the COPM]…” (G)
(ii) “I think there is room for choice and for you to decide what type of tools you want to use to measure a specific item.” (G) |
| | (ii) I can choose to modify the COPM as needed. | (i) “And then there’s the [COPM] rating scale which sometimes I’ll ask [the clients] to just leave.” (H)
(ii) “…to be honest I rarely do it exactly the way it [the COPM] is supposed to be done.” (B) |
| | (iii) I am uncomfortable telling my peers what to use as an assessment. | (i) “So yeah I do not know how I would encourage the other team measures to use it. It’s pretty hard I find to just assume somebody’s gonna use it or I think everybody does their thing their own way so it’s not something I’d push.” (E)
(ii) “No, I do not know who uses [the COPM] in my department. It’s not a discussion that I have with other people.” (A)
(iii) “I did a study on the COPM, I have worked here for a long time. I have never presented, never been asked about its use and never have I done anything to assist the therapists who use the COPM even though my managers know of my experience and how I use it.” (I) |
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| Beliefs about consequences | (i) The COPM offers benefits to clients. | (i) “I think it helps my clients to maybe understand what information is important to me. I think it gives the client an opportunity to actually talk about the things that they’d like to be able to do better or to be able to do; so it gets at their personal goals.” (A)
(ii) “I’ll use the COPM midway sometimes to ask them where they are at now and then I show what they were at the beginning and that encourages them.” (C)
(iii) “I think there is the possibility that we could miss something and miss something that is important to them that maybe they do not have an opportunity or they do not feel like saying and then if you go through that [COPM] form maybe it would identify something.” (F)
(iv) “I would say the costs [of the COPM] are worth it for the benefits that are achieved through a certain group of clientele.” (J) |
| | (ii) The COPM offers no benefits to clients. | (i) “If I was to look at my ABI clients over the last 4-5 years and pull out every COPM I’ve done the irony is I would find the same first 3 goals constantly, it is well 90% of the case.” (E)
(ii) “There’s lots of very, very skilled therapists that I work with who are excellent at their jobs and have never touched the COPM.” (A)
(iii) “I’m not convinced that I would gain a lot more than what I’m actually doing right now [without the COPM].” (B)
(iv) “I do not use it [the COPM] with my current clients and it’s fine too.” (E)
(v) “…you end up with some goals [when using the COPM], some of them are good, some of them you cannot really work on.” (F)
(vi) “I do not feel that our patients are less, I do not think if I do not use it [the COPM] I do not think the clients are less what’s the word getting less of a treatment session.” (F)
(vii) “Nothing bad happens if somebody does not [use the COPM] because everybody is very skilled, very compassionate, very knowledgeable, motivated.” (Q)
(viii) “I know it sounds bad but like who will be looking at the [COPM] like we have so many things to do like it’s gonna not make a difference. I think if it was making a difference we would do the effort.” (P) |
| | (iii) The COPM takes too much time. | (i) “A negative aspect of using the COPM I think because of the time component with it then I probably would have to see less people.” (H) |
| | (iv) My clients will not like doing the COPM. | (i) “On the other hand, I can also get the opposite they get frustrated, angry, want to leave. I lose them in the interview which just means that I’ve pushed a bit hard and I’m pushing because I want the outcome. I want the numbers and they are not ready for it, cannot do it …and if they refuse after 3 questions then I’ve got to stop and then I may not get that opportunity again, right.” (I) |
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| Beliefs about capabilities | (i) I am confident and comfortable using the COPM.
(ii) The COPM is easy to use. | (i) “I’m fairly confident about it.” (A)
(ii) “I find it quite straightforward it’s easy to use.” (D)
(iii) “I have used it with patients before so yes I am comfortable with it.” (J)
(iv) “Using the COPM is easy.” (Q) |
| | (iii) I am not confident and comfortable using the COPM.
(iv) The COPM is difficult to use. | (i) “It’s not always easy to use.” (D)
(ii) “Because it’s so very seldom that I use it I would not say that it’s easy to use.” (B)
(iii) “If you want it to be standardized…to ask the question exactly how it’s said…I was not able to do it.” (C)
(iv) “It is more difficult because I even find that applying it is kind of like a process.” (F)
(v) “So I think I have to educate myself a little bit more just improve my skills to use the COPM and feel comfortable with using the COPM.” (G)
(vi) “…the hardest part about using the COPM is knowing the questions to ask. If you knew the questions to ask you could probably be more efficient using it.” (H)
(vii) “I would have to practice a few times I have not used it in a long time.” (J) |
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| Skills | (i) Few skills are needed to use the COPM. | (i) “But you know the fact that students are able to do it suggests to me that….you can use it [the COPM] without having a lot of prior experience.” (A)
(ii) “Not a lot of experience is needed to use the COPM.” (P) |
| | (ii) Many skills are needed to use the COPM. | (i) “Well I think your interviewing skills are obviously important. Your ability to keep the client on track is important. You know sometimes when you are talking about their previous life, sometimes they start crying…and there’s this element of being able to continue on with the [COPM] interview, not trying to avoid it because you know that the client’s uncomfortable with it.” (A)
(ii) “I think you need some clinical judgement and you know to be able to guide the patient on what might be realistic and not realistic depending on their overall condition.” (D)
(iii) “I think you need to be fairly experienced in your interviewing…in order to really just use the COPM in its form that it’s in now I think you’d probably need to have 2-3 years of experience.” (H)
(iv) “…the patients do not get the concept of occupation. And so it’s very hard as an OT… it’s not [just] using the COPM it’s going that one step further beyond to talk about occupation.” (I)
(v) “[The skills needed are…] interview skills, listening skills, knowing how to interview skills, knowing how to ask the question and giving the individual time to answer it.” (Q)
(vi) “I think you need some degree of clinical reasoning to be able to pull information you have gathered through the COPM and apply it to your interventions.” (R) |
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| Behavioural regulation | (i) Automatic processes for documenting the COPM after completion on the chart would increase my use of the COPM. | (i) “[What helps is] the fact that there’s a place on my initial assessment and then the discharge summary where I can sort of record the information fairly easily that I have information already that I just cut and paste you know a little blurb about the COPM.” (A)
(ii) “…who knows it might be actually you know you might be able to complete it on an iPad or something like that.” (A)
(iii) “I think it would have to be I would have to include it in my practice like in a structured way to that it’s not an extra like thought for me or an extra step it’s just it would be part of the assessment.” (R) |
| | (ii) Planning is necessary to use the COPM. | (i) “I think for me it [the COPM] just needs to be a little bit more in my face somehow like I need to have it be considered you know part of my plan.” (D)
(ii) “It would take a whole lot of planning ahead.” (R) |
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