K EM EN TERIA N K ESIHA TA N M A LAY SIA

BUKU LOG CREDENTI A LING

PROFESSION OF OCCUPATIONAL THERAPY
JURUPULIH PERUBATAN (CARAKERJA)

C LIN IC A L PRA C TIC E REC ORD

VERSI 2021
 MINISTRY OF HEALTH MALAYSIA

PROFESSION OF
OCCUPATIONAL THERAPY
[JURUPULIH PERUBATAN
(CARAKERJA)]

CLINICAL PRACTICE RECORD

NAME:……………………………………………………………………………….................................

I/C NO:…………………………………………………………………………………………………….…

GRADE:………………………………………………………………………………………………………

CURRENT ACADEMIC QUALIFICATION:………………………………………………………………

TEL. NO:………………………………………….FAX NO:………………………………………………

MOBILE NO :……………………………………EMAIL :………………………………………………..

 TABLE OF CONTENT

NO CONTENT PAGE
1. General information 1
2. Basic Criteria for Credentialing in Advanced Procedures 3
3. Basic Criteria For Supervisor / Assessor 4
4. Performance Evaluation 5
5. List Of Procedures In Advanced Procedure
5.1 Advanced Procedure 1: Amputation Rehabilitation 7
5.2 Advanced Procedure 2: Cardiac Rehabilitation 7
5.3 Advanced Procedure 3: Geriatric Rehabilitation 8
5.4 Advanced Procedure 4: Hand and Upper Limbs Rehabilitation 9
5.5 Advanced Procedure 5: Neurology Rehabilitation (Adult)
5.5.1 Advanced Procedure 5 (A): Traumatic Brain Injury Rehabilitation 10
5.5.2 Advanced Procedure 5 (B): Stroke Rehabilitation 10
5.6 Advanced Procedure 6: Paediatric Rehabilitation 11
5.7 Advanced Procedure 7: Spinal Rehabilitation 12
5.8 Advanced Procedure 8: Pulmonary and Respiratory Rehabilitation 13
5.9 Advanced Procedure 9: Burn and Reconstructive Surgery
14
Rehabilitation
5.10 Advanced Procedure 10: Blind and Visual Impaired Rehabilitation 14
5.11 Advanced Procedure 11: Mental Health Rehabilitation 15
5.12 Advanced Procedure 12: Diabetic Foot Management 16
5.13 Advanced Procedure 13: Palliative Rehabilitation 17
5.14 Advanced Procedure 14: Psychological First Aids 18
6. Requirement of Cases in Advanced Procedures 19
7. Summary of Occupational Therapist’s Proficiency Level in Advanced 20
Procedures
 1. GENERAL INFORMATION

Occupational Therapy services is one of rehabilitative treatment which have strong

evidence to intervene physical, mental or/and psychosocial disable clients as a whole.
According to World Health Organization (WHO, 2012) defined ‘Occupational Therapist is a
client-centred health profession concerned with promoting health and well being through
occupation. The primary goal of occupational therapy is to enable people to participate in
the activities of everyday life.

Occupational therapist achieved this outcome by working with people and communities to
enhance their ability to engage in the occupation they want to, need to, or are expected to
do, or by modifying the occupation or the environment to better support their occupational
engagement.’ Knowledge and competence are important to carry out a safe and efficient
practice towards the clients.

The Clinical Practice Record will help to monitor an occupational therapist’s activities in
his/her respective areas. Occupational Therapists are expected to complete all the list of
assessment and intervention in an advanced procedures requested in the logbook. The
Advanced Procedures required the Occupational Therapists to obtain experience in a more
focused clinical area. Soft skills, professionalism and effective communication skills are
considered as good clinical skills and these skills will form part of the credentialing process
as well.

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This log book has 1 main procedure:

NO. PROCEDURE DESCRIPTION

1. Advanced Procedure
Available procedures at most of the Occupational Therapy
Department. Occupational Therapists with Postgraduate
Diploma with 5 years working services or Advanced diploma,
or bachelor degree with 3 years experiences in related
clinical field are eligible to apply for credentialing.
Procedures involved are Occupational Therapy Assessment
& Intervention Modalities. Advanced Procedures should be
completed within 36 months.

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 2. BASIC CRITERIA FOR CREDENTIALING IN ADVANCED PROCEDURES

CRITERIA ADVANCED PROCEDURE

Basic Bachelor Degree in Occupational Therapy / Advanced Diploma or equivalent

Academic /
Qualification Certified Certification Program (≥5 days)

Experience 1. Minimum 5 consecutive years of clinical working experience in Ministry of

Health (MOH) / University / Private Hospital
2. Minimum 3 consecutive years clinical working experience in the related
field
3. Completed advanced procedures requirement
4. Recommendation from Head of Occupational Therapy Unit / Department
/ Head of State (Occupational Therapy)

Log Book Compulsory for Occupational Therapist

Certification 1. Credentialed in Core Procedure by National Credentialing Committee of

MOH /
Have competency certificate by MOH
2. Minimum 20 point CPD for 3 consecutive years
3. Minimum 30 log cases in 36 months (10 cases every 12 months)

**Validity of certification is depends on the applicant’s area of practice, clinical

contact and requirements of service within 2 years of service. Reapplication
of credentialing is required if no clinical contact fulfilled after 2 years.

Renew 1. Renew every 3 years

2. Minimum 20 point CPD for 3 consecutive years
3. Minimum 10 log cases in 12 months (final year)

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 3. BASIC CRITERIA FOR SUPERVISOR / ASSESSOR

ACADEMIC REQUIREMENTS ADDITIONAL REQUIREMENTS

Advanced Bachelor Degree in Occupational 1. Minimum 7 years working

Procedure Therapy / Advanced Diploma or experience in Ministry of Health
equivalent / Diploma in Malaysia (Hospital/ Health Clinic/
Occupational Therapy Institution)
Certification Program with not 2. Involved in direct patient/ client
less than 5 days. management with minimum 5
consecutive years in related field

AND

1. Has been credentialed

(Advance Procedure) by
National Credentialing
Committee of MOH
2. Appointed by Head of
Occupational Therapy
Department

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 4. PERFORMANCE EVALUATION

SCORE PROFICIENCY LEVEL DESCRIPTION

● Common knowledge or an understanding of basic
Fundamental
1 techniques and concepts.
(Basic knowledge)
● Focus on learning.
● Level of experience gained in clinical setting with assistance
when performing this skill.
Elementary
2 ● Understand and able to discuss terminology, concepts,
(Limited Experience)
principles and issues related to this competency;
● Utilize resource materials in this competency.
● Able to successfully complete tasks in this competency as
requested. Help from an expert may be required from time
to time, but usually perform the skill independently.
● Focus is on applying and enhancing knowledge or skill;
Intermediate
3 ● Applied this competency to situations occasionally while
(Practical application)
needing minimal guidance to perform successfully;
● Understand and can discuss the application and
implications of changes to processes, policies, and
procedures in this area.
● Perform the actions associated with this skill without
assistance.
● Focus is on broad organizational/professional issues;
● Consistently provided practical/relevant ideas and
perspectives on process or implement evidence-based
practice which may easily be implemented;
Advanced
4 ● Capable of coaching others in the application of this
(Applied Theory)
competency by translating complex nuances relating to this
competency into easy to understand terms;
● Participate in senior level discussions regarding this
competency;
● Assist in the development of reference and resource
materials in this competency.
● You are known as an expert in this area. You can provide
guidance, troubleshoot and answer questions related to this
area of expertise and the field where the skill is used.
● Focus is strategic;
● Demonstrated consistent excellence in applying this
competency across multiple projects and/or organizations;
Expert
5 ● Create new applications for and/or lead the development of
(Recognized authority)
reference and resource materials for this competency;
● Able to diagram or explain the relevant process elements
and issues in relation to organizational issues and trends in
sufficient detail during discussions and presentations, to
foster a greater understanding among internal and external
colleagues and constituents.

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ADVANCED PROCEDURES

(A)

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 5.LIST OF PROCEDURES IN ADVANCED PROCEDURE

5.1 ADVANCED PROCEDURE 1: AMPUTATION REHABILITATION

ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental 1. Stump Care???

Activities of Daily Living Scale (IADL) 2. Activity of Daily Living (ADL) and Instrumental
i. Modified Barthel Index (MBI) Activities of Daily Living Scale (IADL) retraining
ii. The Lawton Instrumental Activities of Daily 3. Environment modification
Living Scale (IADL) i. Home / school/work visit
iii. Community Integration Questionnaire (CIQ) 4. Fabrication of aids and adaptation to facilitate
2. Physical independent in ADL and IADL
i. Muscle Strength (MMT) 5. Fatigue management intervention
ii. Sensation (Phantom Limb Sensation)
iii. Joint Range of Movement
a. Goniometer
iv. Pain Intensity Assessment
a. Pain Self-Efficacy- Questionnaire
(PSEQ) /VAS
v. Fatigue Assessment
vi. Hypersensitivity Assessment

a. Fatigue Severity Scale

vii. The Amputee Mobility Predictor (AmpPro /
AmpNoPro)
viii. Fall
a. Falls Risk Assessment Tool (FRAT)
3. Developing health-promoting habits and routines
i. Quality of life (WHO QOL /SF36/)

5.2 ADVANCED PROCEDURE 2: CARDIAC REHABILITATION

ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL):
i. Modified Barthel Index (MBI)
ii. The Lawton Instrumental Activities of Daily
Living Scale Community Integration
Questionnaire (CIQ)
2. Physical
i. Muscle Strength (MMT)
ii. Joint Range of Movement
a. Goniometer
iii. Pain Intensity Assessment
1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) retraining
2. Environment modification
i. Home / school /work visit
3. Fatigue management
4. Stress management
5. Lifestyle modification and redesign
6. Oedema management
7. Energy conservation and work simplification

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 a. Pain S-E- Questionnaire (PSEQ)
iv. Fatigue Assessment
a. Fatigue Severity Scale
???
3. Psychosocial:
i. Depression Anxiety Depression Scale
(DASS)
ii. Hamilton Anxiety Scale (HAS)
iii. Hospital Anxiety Depression Scale (HADS)

5.3 ADVANCED PROCEDURE 3: GERIATRIC REHABILITATION

ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL): 1. Activity of Daily Living (ADL) and Instrumental
i. Modified Barthel Index (MBI) Activities of Daily Living Scale (IADL) retraining
ii. Assessment of Living Skill and Resources 2. Home modification
2. Cognitive: 3. Aids and adaptation
i. Montreal Cognitive Assessment (MoCA) 4. Cognitive function retraining
ii. Lowenstein Occupational Therapy Cognitive 5. Relaxation therapy management
Assessment – Geriatric 6. Community resettlement program
(LOTCA –G) 7. Family support group
iii. Kendrick Assessment Scale for Cognitive 8. Leisure and recreational exploration
Aging (KASCA)
iv. Psychogeriatric Assessment Skill (PAS)
v. Dementia Severity Rating Scale (DSRS)
3. Balance:
i. Tinetti Balance Test
ii. Falls Self-efficacy Scale
iii. Modified Fall Self-Efficacy Scale (FES /
MFES / FES-I)
iv. Cohen Mansfield Agitation Inventory
4. Psychological:
i. Psychogeriatric Assessment Skill (PAS)
ii. Hamilton Depression Scale
iii. Beck Depression Inventory (BDI)
iv. Geriatric Depression Scale (GDS)
v. Rating Anxiety in Dementia (RAID)
5. Quality of Life in Alzheimer’s Disease (QOL-AD)
6. Home Visit & Assessment

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1. Behavioral
i. Tool for Cognition & Higher Function
(BATCH)

5.4 ADVANCED PROCEDURE 4: HAND AND UPPER LIMB REHABILITATION

ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental 1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL): Activities of Daily Living Scale (IADL) retraining
i. Modified Barthel Index (MBI) 2. Splint (static and dynamic)
ii. The Lawton Instrumental Activities of 3. Tendon gliding exercise
Daily Living Scale 4. Upper limb functional training
iii. Canadian Occupational Performance 5. Hand oedema management
Measure (COPM) 6. Sensory re-education / sensory desensitisation
iv. The Disabilities of the Arm, Shoulder and 7. Pain management (modification of activities of
Hand (DASH) daily living, play, leisure and work)
v. Health Assessment Questionnaire (HAQ) 8. Hand prehension training
2. Motor Function 9. Patient and family education
i. Type of deformities i. Joint protection & energy conservation
ii. Range of Motion (active and passive) technique
iii. Strength 10. Assistive devices technology
a. Hand Dynamometer 11. Modify environment / lifestyle adjustment and re-
b. Pinch Gauge Muscle Strength, design
c. Manual Muscle Test (MMT) 12. Physical Agent Modalities
iv. Dexterity 13. Scar Management
a. Moberg pick-up test
b. Purdue peg board Management of cases:
c. Jebsen Taylor Hand Function Test 1. Extensor Tendon Protocol
(JTHFT) 2. Flexor Tendon Protocol
d. Sequential Occupational Dexterity 3. Tendon Transfer Protocol
Assessment (SODA) 4. Brachial Plexus Rehabilitation
e. 9 hole pegboard 5. Hand Replantation Rehabilitation
v. Sensory 6. Complex Regional Pain Syndrome (CRPS)
a. Semmes monofilament test Rehabilitation
b. 2 point discrimination 7. Rehabilitation of Stiff Hand
vi. Oedema Assessment 8. Dynamic Splint Fabrication
a. Volumeter 9. Rehabilitation of Radial, Median and Ulnar
b. Tape measurement Nerve Injury
vii. Pain assessment 10. Rheumatology Arthritis
a. Numerical Rating Scale (NRS) - 0 to 11. Cumulative trauma disorder
10 12. Hand and upper limb fracture
b. Visual Analogue Score (VAS) - a 13. Reconstruction congenital hand deformities
mark made on a line 100 mm long
c. Categorical Score – mild/ moderate/ (Minimum consist 6 different type of diagnosis)
severe
d. Functional Score – ability to walk,
sit, cough etc.
e. FLACC Observational Pain Score
f. IASP Faces Scale
3. Hand Prehension

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 7 types prehension

5.5 ADVANCED PROCEDURE 5: NEUROLOGY REHABILITATION (ADULT)

5.5.1 ADVANCED PROCEDURE 5(A): TRAUMATIC BRAIN INJURY REHABILITATION
ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental 1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) Activities of Daily Living Scale (IADL) training
i. Modified Barthel Index (MBI) 2. Aids and adaptation
ii. The Lawton Instrumental Activities of Daily 3. Motor retraining and motor learning
Living Scale rehabilitation
2. Physical 4. Splinting
i. Muscle Strength (MMT) 5. Compression Therapy
ii. Active / Passive Range of Motion 6. Sensory stimulation
iii. Joint Position Sense Test (JPST) 7. Cognitive function retraining
iv. Motor Assessment Scale (MAS) 8. Relaxation therapy
v. Pain (NRS/VAS/Wong Becker 9. Community resettlement program
Faces/FLACC) 10. Enviromental modification (Home / school/work)
vi. Spasticity (Modified Ashworth Scale) [MAS] 11. Family support group
vii. Fugl Meyer Assessment (UE) 12. Behaviour Modification
viii. Berg Balance Scale (BBS)
ix. Tinneti Balance Assessment Tool
3. Sensory
4. Proprioception
5. Pyschological
i. The Beck Depression Inventory
ii. Behaviour Scale/assessment
6. Cognitive
i. Montreal Cognitive Assessment (MoCA)
ii. Ranchos Los Amigos Scale
iii. Post Traumatic Amnesia Scale (PTA)
iv. Glasgow Coma Scale (GSC)
v. Chessington Occupational Therapy
Neurological Assessment Battery (COTNAB)
vi. Rivermead Perceptual Assessment Battery
(RPAB)
vii. Lowenstein Occupational Therapy Cognitive
Assessment (LOTCA)
viii. MMSE
7. Environmental Assessment (Home / school/work)

5.5 ADVANCED PROCEDURE 5: NEUROLOGY REHABILITATION (ADULT)

5.5.2 ADVANCED PROCEDURE 5(B): STROKE REHABILITATION
ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental 1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) activities of daily living (IADL) retraining
i. Modified Barthel Index (MBI)
ii. The Lawton Instrumental Activities of 2. Motor retraining
Daily Living Scale i. Constraint Induced Movement Therapy
iii. Feeding/Oral Stimulation (CIMT)
2. Physical ii. Task oriented / specific training
i. Spasticity iii. NDT

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 i. Modified Ashworth Scale) (MAS)
ii. Muscle Power 3. Sensory motor stimulation
i. Manual Muscle Strength (MMT) 4. Cognitive / perceptual function training
ii. Motor Assessment Scale (MAS) 5. Aids and adaptations
iii. Joint Position Sense Test (JPST) 6. Splinting
iv. Pain Copy dari Hand 7. Carer and patient education
i. Numerical Rating Scale (NRS) 8. Home visit and recommendation
ii. Visual Analogue Score (VAS) 9. Home programme
iii. Face, Legs, Activity, Cry, 10.
Consolability Scale (FLACC)
v. Balance
i. Tinneti Balance Assessment Tool
ii. Berg Balance Scale (BBS)
3. Cognitive & Perceptual
i. Chessington Occupational Therapy
Neurological Assessment Battery
(COTNAB)
ii. Rivermead Perceptual Assessment
Battery (RPAB)
iii. Lowenstein Occupational Therapy
Cognitive Assessment (LOTCA)
iv. Unilateral Neglect
4. Psychological
i. Depression Anxiety Stress Scale (DASS)
ii. Patient Health Questionnaire - 9 (PHQ-9)
5. Wellness and Health
i. Quality of Life Assessment

5.6 ADVANCED PROCEDURE 6: PAEDIATRIC REHABILITATION

ASSESSMENT INTERVENTION

1. Client-Centred Assessment 1. Activity of Daily Living (ADL) / Self-care training

i. Canadian Occupational Performance 2. Instrumental activities of daily living and
Measure (COPM) community participation
ii. Goal Attainment Scale 3. Fine motor control – muscle strength, finger
2. Occupation-based Assessment isolations, in-hand manipulations, arching the
i. Child Assessment of Participation and palm of the hand, thumb opposition and pincer
Enjoyment (CAPE) / Preference for grasp.
Activities of Children (PAC) 4. Gross motor skill
ii. Short Child Occupational Profile (SCOPE) 5. Bilateral coordination
iii. School Function Assessment (SFA) 6. Upper body strength and stability
iv. Paediatric Evaluation of Disability 7. Crossing the midline
Inventory (PEDI) 8. Visual motor skills
3. Motor / Developmental Assessment 9. Visual perception skills
i. Denver Developmental Screening Test II 10. Splinting
ii. Erhardt Development Prehension 11. Sensory integration therapy / sensory-based
Assessment (EDPA) interventions
iii. Peabody Developmental Motor Scale 12. Intervention and strategies for challenging
iv. BOT Brunninks – Oseretsky Test of Motor behaviours
Proficiency 13. Oral motor stimulation
v. Quality of Upper Extremity Skills Test
(QUEST)

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 vi. Bayley Scales of Infant and Toddler
Development (BSID)
4. Visual Perception Assessment
i. Beery Buktenica Developmental Test of
Visual Motor Integration (Beery VMI)
ii. Preschool Visual Motor Integration
Assessment (PVMIA)
iii. Test of Visual Perceptual Skills (TVPS)
iv. Developmental Test of Visual Perception
(DTVP)
v. Rivermead Perceptual Assessment Battery
5. Sensory Processing Disorder:
i. Sensory Profile 2
ii. Sensory Processing Measure (SPM)

M Chart

Nota: Pilih

5.7 ADVANCED PROCEDURE 7: SPINAL REHABILITATION

ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL)
i. Modified Barthel Index (MBI)
ii. Spinal Cord Independent Measure (SCIM)
iii. Quadriplegic Index of Function
2. Physical
i. Manual Muscle Strength (MMT)
ii. Sensation (Light touch And pinprick)
iii. Joint Range of Movement (Goniometer)
iv. Pain (NRS/VAS/Wong Becker
Faces/FLACC)
v. Muscle Tone (Spasticity) (Modified Ashworth
Scale, MAS)
vi. Jebsen Hand Function Test (JHFT)
vii. Modified Functional Reach Test (MFRT)
viii. Tetraplegia Hand Activity
Questionnaire (THAQ)
ix. 6-Minute Walk Test (6MWT)
x. Berg Balance Scale (BBS)
xi. Tinneti Balance Test
3. Cognitive
i. Lowenstein Occupational Therapy Cognitive
Assessment (LOTCA)
ii. Chessington Occupational Therapy
Neurological Assessment Battery (COTNAB)
4. Mental Health
i. Patient Health Questionnaire-9 (PHQ-9)
ii. Hospital Anxiety and Depression Scale
(HADS)
iii. Depression Anxiety Stress Scale-21 (DASS-
21)
5. Neurological Impairment and Autonomic Dysfunction
i. American Spinal Injury Association (ASIA)
Impairment Scale (AIS): International
Standards for Neurological Classification of
Spinal Cord Injury (ISNCSCI)
6. Pressure Ulcer
i. Pressure Mapping (X-sensor)
1. Activity of Daily Living (ADL) and Instrumental
activities of daily living (IADL) retraining
2. Patient and caregivers education
3. Home programme
4. Adaptations / renovation to home
5. Assistive technology and adaptation
i. Feeding / dressing / transfer board, foot
drop check, writing/typing aid, etc.)
6. Splinting
i. Hand resting splint / Anti-spasticity splint /
Wrist cock up splint, Dynamic tenodesis
Splint
ii. Ankle Foot Orthosis (AFO) / Dynamic AFO
7. Transfers technique
8. Pressure relieve technique and positioning
9. Pain management
10. Stress management
11. Upper limb function retraining
12. Mobility skills training
13. Home visit and recommendation of home
adaptations/renovations and report
14. Patient Education / Home Programme
15. Leisure and social participation

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 ii. Braden Scale
7. Home Evaluation and recommendation
8. Community Reintegration
i. Craig Handicap Assessment And Reporting
Technique (CHART-SF)
ii. Community Integration Questionnaire (CIQ)
9. Quality Of Life and Health Status
i. World Health Organization Quality Of Life-
BREF (WHOQOL-BREF)
ii. Satisfaction with Life Scale (SWLS, Deiner
Scale)
iii. Short Form 36 (SF-36) Health Survey

5.8 ADVANCED PROCEDURE 8: PULMONARY AND RESPIRATORY REHABILITATION

ASSESSMENT INTERVENTION

1. Pulmonary function 1. Upper Limb and Lower Limb Function and

i. Oxygen cost of breathing: Endurance Training
i. Total oxygen consumption of i. Endurance Training
the body at rest ii. Resistive / strength Training
ii. Total oxygen consumption of iii. Flexibility Training
the body at the increase level 2. Breathing Retraining
of ventilation i. Pursed-lip Breathing
ii. Rate of Perceived Exertion (RPE) Scale ii. Pace Breathing
iii. Rate of Perceived Dyspnea (RPD) Scale iii. Diaphragmatic Breathing
iv. Heart Rate 3. Stress management
v. Respiratory Rate i. Visual imagery
vi. Oxyhemoglobin Saturation 4. Activity of Daily Living (ADL) and Instrumental
vii. Grade Level of Breathlessness with the Activities of Daily Living Scale (IADL) retraining
activities i. ADL/IADL management and education
i. The modified Medical 5. Home / School
Research Council i. Energy conservation technique / work
Breathlessness (mMRC) simplification technique / pacing technique
score ii. Activity modification
viii. Breathing Pattern i. Modification and
2. Upper Limb and Lower Limb function and compensation
endurance 6. Support and lifestyle modification
i. Joint Mobility
ii. Postural Deformity
iii. Strength
iv. Mobility
v. Endurance
vi. Sensation
vii. Coordination
3. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) Assessment
i. The London Chest Activity of Daily Living
Scale
ii. Pulmonary Functional Status and Dyspnea
Questionnaire – modified version (PFSDQ-
M)
iii. Visual Analogue Scale – Pain (VAS-F) /
Fatigue (VAS-F)
4. Psychosocial Assessment
i. Depression, Anxiety Stress Scale (DASS)
5. Home / School Assessment

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5.9 ADVANCED PROCEDURE 9: BURN AND RECONSTRUCTIVE SURGERY REHABILITATION
ASSESSMENT INTERVENTION

1. Activity of Daily Living (ADL) and Instrumental 1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) Activities of Daily Living Scale (IADL) retraining
i. Modified Barthel Index (MBI) 2. Splint
ii. Lawton Instrumental Activities of Daily Living i. Hand Splint - pan splint, finger extension
Scale (IADL) splint, resting hand splint, anti-deformity
2. Physical Assessment splint
i. Range of Motion (Goniometer) ii. Airplane or Axillary splint
ii. Grip strength (Dynamometer) iii. Leg splint - Ankle Foot Orthosis (AFO),
iii. Hand Function - Jebsen Hand Function Test Knee extension splint
/ Moberg pick up test / The Disabilities of the 3. Scar management
Arm, Shoulder and Hand (DASH) i. Pressure Garment
iv. Sensory – Semmes Weinstein Monofilament 1. Vest
Test (SWMT) / two-point discrimination / 2. Vest with arm
thermal sensibility (heat and cold) / heat pain 3. Glove
sensibility 4. Glove with web spaces
v. Oedema Assessment 5. Pant
3. Scar Assessment 6. Mask
i. Vancouver Scar Scale (VSS) 7. Chin strap
4. Patient and Observer Scar Assessment Scale 8. Stocking
(POSAS) 9. Stocking with toes
i. Manchester Scar Scale (MSS) 10. Sleeve
ii. The Stony Brook Scar Evaluation Scale ii. Compression Therapy
(SBSES) iii. Patient & Carer Education (Care of
5. Pain Assessment pressure garment and splint / Deep
i. Numeric rating scale (NRS) / Pain scale Circulatory massage
(Skala Kesakitan) 4. Pain Management
ii. Face Scale (Skala Kesakitan Muka) i. Desensitization technique
iii. FLACC (Skala Pemarkahan Kesakitan ii. Deep breathing
Melalui Pemerhatian Tingkah laku) iii. Compression therapy
6. Sleep Assessment 5. Remedial activities
7. Psychological 6. Sleep hygiene education
i. Depression, Anxiety Stress Scale (DASS) 7. Home modification / utensils modification
ii. Beck Depression Inventory 8. Psychological support
8. Home Assessment

5.10 ADVANCED PROCEDURE 10: BLIND AND VISUAL IMPAIRED REHABILITATION

ASSESSMENT INTERVENTION

1. Occupational based 1. Activities Of Daily Living (ADL) training

i. Activities of daily living (ADL) 2. Instrumental Activities Of Daily Living (IADL)
training

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 a. Canadian Occupational Performance 3. Orientation and mobility (O&M)
Measure (COPM) i. Orientation techniques
b. Self-Report Assessment Of Functional a. Sensory and perceptual training
Visual Performance (SRAFVP) b. Compass point
ii. Instrumental Activities Of Daily Living (IADL) c. Scanning technique
a. EVS Orientation And Mobility Screening ii. Mobility techniques
b. Indoor Independent Travel a. Sighted guide
Recommendation Form b. White cane
c. Outdoor Independent Travel c. Protective techniques
Recommendation Form 4. Assistive and adaptive technologies
d. Orientation & Mobility Severity Rating i. Optical and magnification devices:
Scale For Students With Additional Needs a. Advance spectacle or head-mounted
(O&MSRS+) magnifiers
2. Visual function b. Handheld magnifiers
i. Visual acuity test ii. Computers and electronic devices
ii. Visual field test a. Screen reader
iii. Occulomotor control b. Audiobooks and e-books
3. Cognitive function c. Smartphone accessibility functions
i. Montreal Cognitive Assessment For The Blind iii. Non-optical devices:
(MoCA-blind) a. Large-print books, newspapers,
4. Perceptual function magazines and other documents
i. Star Cancellation Test / Comb And Razor Test b. Telephones, thermostats, watches and
ii. Motor-Free Visual Perception Test (MFVPT) / remote controls with large-sized
Developmental Test Of Visual Perception numbers and high-contrast colors
(DTVP) / Test Of Visual Perceptual Skills / c. Watches, needle threader, magnifying
Beery Visual Motor Integration (VMI) mirrors and tactile (textured) labels
5. Psychosocial 5. Environmental modification
i. Emotional i. Home
a. Depression, Anxiety, Stress Scale (DASS) a. Lighting and glare
b. Patient Health Questionnaire-9 (PHQ-9) / b. Contrast
Beck Depression Inventory (BDI) / c. Organization
Geriatric Depression Scale (GDS) d. Clutter and pattern
c. Hamilton Anxiety Rating Scale (HAM-A) / 6. Psychosocial intervention and strategies
Beck Anxiety Inventory (BAI) / Zung Self- i. Stress management
Rating Anxiety Scale (SAS) ii. Support group
d. Perceived Stress Scale (PSS)
ii. Social support
a. Inventory Of Socially Supportive
Behaviors (ISSB)
b. Perceived Social Support – Family Scale
(PSS-Fa) / Perceived Social Support –
Friend Scale (PSS-Fr)
6. Environmental
i. Home Environment Lighting Assessment
(HELA)
ii. Home Occupational Environment
Assessment (HOEA)
7. Outcome measures
i. Occupational Performance:
a. Visual Function Index (VF-14)
8. Quality Of Life (QOL):
i. Impact Of Vision Impairment (IVI) / Impact Of
Vision Impairment For Children (IVI-C)

5.11 ADVANCED PROCEDURE 11: MENTAL HEALTH REHABILITATION

ASSESSMENT INTERVENTION

2. Activity of Daily Living (ADL) and Instrumental 1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) Activities of Daily Living Scale (IADL) training
i. Personal Social Performance Scale (PSP) 2. Group support

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 ii. Lawton Instrumental Activities of Daily 3. Social skill training
Living Scale 4. Family therapy
iii. Kohlman Evaluation of Living Skills 5. Graded exposure therapy
(KELS) 6. Sleep hygiene
3. Cognitive Assessment: 7. Stress management
i. Mini Mental State Examination (MMSE) 8. Employment programs
ii. Montreal Cognitive Assessment (MoCA) 9. Anger management
4. Mental Health 10. Coping skills
i. Mental state examination 11. Home / community / work visit
ii. Depression Anxiety Stress Scale21 12. Patient education / home programme
(DASS21) 13. Group therapy: medication adherence, social
iii. Patient Health Questionnaire9 (PHQ9) support, emotional regulation, etc.
iv. Hospital Anxiety and Depression Scale
(HADS)
v. Hamilton Anxiety Scale (HAS)
vi. Beck Depression Inventory (BDI)
vii. Threshold Assessment: Grid (TAG)
viii. Camberwell Assessment: of Need Short
Appraisal (CANSAS)
5. Quality of Life
i. World Health Organization Quality of Life
Instruments (WHOQOL)
6. Behavioral
i. Tool for Cognition & Higher Function
(BATCH)

5.12 ADVANCED PROCEDURE 12: DIABETIC FOOT MANAGEMENT

ASSESSMENT INTERVENTION

Primary Diagnosis 1. Activity of Daily Living (ADL) and Instrumental

1. Activity of Daily Living (ADL) and Instrumental Activities of Daily Living Scale (IADL) retraining
Activities of Daily Living Scale (IADL) – 2. Maintains physical ability
i. Kohlman Evaluation of living skill (KELS) 3. Diabetic Foot Ulcer (DFU) management
ii. Lawton Instrumental Activities of Daily Living
Scale
2. Physical examination (musculoskeletal, vascular,
neurological, footwear)
3. Foot examination (foot deformities, pedal pulses,
and skin condition).
4. Psychological issue - Emotional – Psychological
impact - Depression Anxiety Stress Scale (DASS)
5. Karnofsky Performance Status / Score (KPS)

Complication
1. Education on foot care and prevention foot
wear.

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1. Screening on peripheral neuropathy and sensory
foot examination using:
i. Semmes- Weinstein Monofilament
Examination (SWME)
2. Charcot neuropathy
3. Psychological/Emotional - The Beck Depression
Inventory
4. Peripheral sensory loss (neuropathy)
5. Sensory deficit – Balancing Assessment
5.13 ADVANCED PROCEDURE 13: PALLIATIVE REHABILITATION
ASSESSMENT
1. Activity of Daily Living (ADL)
i. Resource Utilization Groups (RUG) ADL
2. Home assessment / visit
3. Value, belief and spiritual assessment
4. Specific play & leisure
i. Interest checklist
ii. Leisure activities check list
iii. Play and leisure activities exploration
5. Physical
i. Chronic pain assessment
ii. DVT and oedema prevention
iii. Tinetti balance and gait evaluation
iv. Fatigue assessment
6. Psychological
i. Distress thermometer
ii. Depression Anxiety Stress Scales (DASS)
iii. Role Check List
iv. Beck Depression Inventory (BDI)
v. Assessment of Dying Patient
2. Promote education on foot wear advice (Burger
Splint / Clam Shell Splint)
3. Psychological Support / Relaxation Technique –
PMR or Biofeedback
4. Home Visit / Home Safety / Home Modification
i. Developing health-promoting habits and
routines
ii. Enhancing emotional well-being.
iii. Promote self-reflection and strategies to
maintain long-term health.
INTERVENTION
1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL) training
2. Home falls risk assessment
i. Safety measures and home rehabilitation
program
ii. Home environment modifications
3. Play & leisure
i. Therapeutic play activities
ii. Recreation activities
iii. Art and creative activities
4. Physical
i. Pain
ii. Fatigue / lethargy
iii. Breathlessness
iv. Limbs swelling
v. Insomnia
vi. Lower limbs weakness
vii. Upper limbs weakness
5. Psychological
i. Relaxation techniques
ii. Patient and caregiver support
iii. Behaviour modification technique
iv. Coping skill training
v. Group support activities
vi. Self-management
vii. Spiritual activity
6. Communication
7. Stress patient / carer
i. Angry patient / carer
ii. Goals setting discussion
iii. Dealing patient with hopelessness /
unrealistic hope / functional decline
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5.14 ADVANCED PROCEDURE 14: PSYCHOLOGICAL FIRST AIDS
ASSESSMENT
1. Initial Assessment:- Recognize sign of symptom/
post traumatic problem / burnout, compassion
fatigue
2. Activities of Daily Living and Instrumental of
Activities of Daily Living (ADL & IADL)
i. Canadian Occupational Performance
Measure (COPM)
3. Occupational assessment: : Occupational balance
assessment:
4. Wellness and health : Quality of life assessment:
5. Psychosocial : Hamilton Anxiety Scale / Hospital
Anxiety Depression Scale (HADS) / Beck
Depression Scale (BDI)
DASS
iv. Negotiating goals based on changing
condition
INTERVENTION
1. Activity of Daily Living (ADL) and Instrumental
Activities of Daily Living Scale (IADL):
Compensation and adaptation to increase
functional and participation in daily life
2. Occupational balance intervention
3. Lifestyle adaptation : modification and
adaptation of environment
4. Quality of life intervention : exploration & training
5. Relaxation therapy & mindfulness technique
6. Building resilience for disaster and trauma work
7. Patient and caregivers education
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 6. REQUIREMENT OF CASES IN ADVANCED PROCEDURE

ADVANCED PROCEDURE:
________________________________________________________________

ACTIVITY: PERFORM (30 cases) With at least 80% of the procedures listed

SIGNATURE PROFICIENCY
REG. NAME OF LEVEL
NO. DATE OF REMARKS
NO. ASSESSOR
ASSESSOR (1 – 5) *

1.

*Refer to performance evaluation index.

Case Report:

*Please list on separate sheet for case report.

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 7. SUMMARY OF OCCUPATIONAL THERAPIST’S PROFICIENCY LEVEL IN
ADVANCED PROCEDURES

NAME :

IC NO :

GRADE :

REQUIRED DONE
NO. ADVANCED PROCEDURES REMARKS
P P
OCCUPATIONAL THERAPY ASSESSMENT
AND INTERVENTION
Advanced Procedure:

1 30

_______________________________________

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LIST OF CASE REPORT:
CLIENT I/C PROFICIENCY LEVEL*
NO. DIAGNOSIS REMARKS
NO. 1 2 3 4 5

10

11

12

13

14

15

16

17

21
 18

19

20

21

22

23

24

25

26

27

28

29

30

TOTAL SCORE:

*Refer to performance evaluation index.

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Overall the therapist performance at the present setting is
…………………………………………………………………………………

……………………………………………………………………………………………………………
……………………………………………

……………………………………………………………………………………………………………
……………………………………………

(Fundamental, Elementary, Intermediate, Advanced, Expert)

Comments:

……………………………………………………………………………………………………………
……………………………………………

……………………………………………………………………………………………………………
……………………………………………

……………………………………………………………………………………………………………
……………………………………………

Positive points:

……………………………………………………………………………………………………………
……………………………………………

……………………………………………………………………………………………………………
……………………………………………

……………………………………………………………………………………………………………
……………………………………………

Areas of concern:

……………………………………………………………………………………………………………
……………………………………………

……………………………………………………………………………………………………………
……………………………………………

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……………………………………………………………………………………………………………

……………………………………………

Signature of Applicant Signature of Supervisor

………………………………………………. ……………………………………..
(Name / Stamp) (Name / Stamp)
Date: Date:

Verified by Head of Unit / State

………………………………………………….
(Name / Stamp)
Date:

24