Development of the Participation Measure-3 Domains, 4 Dimensions (PM-3D4D): A New Outcome Measure for Rehabilitation

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• 作者：Feng-Hang Chang ; ScD ; OTR/L^a ; ^{fhchang@tmu.edu.tw} ; Tsan-Hon Liou ; MD ; PhD^a ; ^b ; ^c ; Pengsheng Ni ; MD ; MPH^d ; Kwang-Hwa Chang ; MD^a ; ^e ; Chien-Hung Lai ; MD ; PhD^c ; ^f
• 关键词：Outpatients ; Patient outcome assessment ; Psychometrics ; Rehabilitation ; Social participation
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：98
• 期：2
• 页码：286-294
• 全文大小：496 K
• 卷排序：98

文摘

To describe the development of a participation measure that assesses 3 domains (productivity, social, and community) and 4 dimensions (frequency, diversity, desire for change, and perceived difficulty) of participation and to evaluate the initial psychometric properties in rehabilitation outpatients.DesignA mixed-method approach included a literature review, item selection, expert reviews, cognitive interviews, and field testing with rehabilitation outpatients. Confirmatory factor analysis (CFA) and Rasch analysis were used to validate the construct validity of the difficulty dimension of the instrument.SettingOutpatient rehabilitation programs.ParticipantsAn expert panel consisting of 12 rehabilitation and measurement experts contributed to measurement development; 20 rehabilitation outpatients participated in cognitive interviews; and a sample of rehabilitation outpatients (N=556) (average age, 61.36±23.62y; 53% men) participated in field testing.InterventionsNot applicable.Main Outcome MeasureThe Participation Measure–3 Domains, 4 Dimensions (PM-3D4D).ResultsA scoring method for each dimension of the PM-3D4D was established. The instrument displayed good overall model fit in the CFA and unidimensionality across 3 domains after removing and collapsing locally dependent items identified from a principal component analysis. However, considering the poor personal reliability of the social subscale and its high correlation with the community subscale, we decided to merge the 2 subscales into 1. The combined subscale showed improved reliability and good construct validity by demonstrating a good model fit (comparative fit index, .985; Tucker-Lewis Index, .982, root mean square error of approximation, .061) and item fit.ConclusionsThe PM-3D4D is a newly developed participation measure designed to assess multiple domains and dimensions of participation by rehabilitation patients. The psychometric analysis results supported the construct of the instrument and helped item revision. Further examination of the validity and reliability of the PM-3D4D will be conducted.