OTIE Adult Psych Worksheet 3

Demographic Data: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• I live with my older sister in Cavite.

• I'm a 28-year-old call center agent.

• My doctor referred me for occupational therapy.

• I started experiencing symptoms three years ago.

Occupational Profile: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• I miss working in my old job as a pastry chef.

• I need help taking care of my kids.

• I enjoy watching Korean dramas on weekends.

• I sleep too much and feel tired all the time.

History of Present Illness: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• I had a breakdown at school and was sent home.

• It started after I stopped taking my meds.

• I haven't gone outside in two months.

• I was diagnosed in college but didn’t follow up.

Subjective Findings (Contexts): For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• Our house is too crowded and noisy for me to concentrate.

• I get support from my church group every Sunday.

• My mom makes most of the decisions at home.

• I don’t feel safe in my neighborhood.

Performance Patterns: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• I always eat dinner with my family at 7 PM.

• Every Friday, I do grocery shopping with my cousin.

• I brush my teeth before going to sleep.

• I light candles every night before praying.

Mental Status Exam: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• Sometimes I hear voices telling me I’m worthless.

• I feel like someone is watching me all the time.

• I’ve been feeling very irritable lately.

• I can’t focus on what people are saying.

Objective Findings (Occupations): For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• I need help preparing meals and doing laundry.

• I struggle to manage my bills and expenses.

• I rarely go out for groceries anymore.

• I sometimes forget to take my meds on time.

Performance Skills: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• I often get confused with instructions involving more than one step.

• I can't seem to stay on task when there are distractions.

• I fidget a lot during conversations.

• I’m not good at keeping my things organized.

Client Factors: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• My right leg shakes when I stand for too long.

• I have poor eyesight, especially at night.

• I feel like my hands are getting weaker.

• I have scoliosis since I was 10 years old.

Assessment / Analysis of Occupational Performance: For each OT Initial Evaluation section listed, choose the most appropriate patient statement from the options provided.

• Client demonstrates good social interaction but struggles with time management.

• Client needs moderate assistance with self-care tasks.

• Client has limited attention span and poor memory recall.

• Client shows motivation but lacks focus in tasks.