Examination of reliability and validity of the Self-Assessment Burden Scale-Motor for community-dwelling older adults in Japan: a validation study.

Background: The aging society in Japan is progressing rapidly compared with that in the United States and European countries. Aging limits activities of daily living (ADL) in older adults, declining their lives and functions at home. Therefore, improving their ADL to effectively support their functioning at home for as long as possible is vital. Consequently, supporters need to have a common understanding, be promptly aware of the decline in ADL, and quickly introduce rehabilitation. The Functional Independence Measure (FIM) and Barthel Index (BI) are the main scales used to quantitatively assess ADL. However, previous studies have reported that FIM requires specialized knowledge for evaluation, and BI does not appropriately capture changes in ADL. The Self-Assessment Burden Scale-Motor (SAB-M) was developed as a scale for family caregivers to appropriately assess changes in ADL in older adults. Previous studies using the SAB-M have confirmed its reliability and validity in hospitalized patients as assessed by their family caregivers. Therefore, this study aimed to investigate the reliability and validity of the SAB-M among community-dwelling older adults as assessed by their family caregivers. Methods: This study included community-dwelling older adults who received home-visit rehabilitation at the first author's facility between October 2020 and December 2020 in Japan. Following previous studies, the SAB-M was used by family caregivers to assess 20 older adults twice for intra-rater reliability. Furthermore, 168 older adults were evaluated by family caregivers for internal consistency using the SAB-M. For criterion validity, the SAB-M was used for the assessment by family caregivers, and therapists used the FIM-Motor (FIM-M). This study used the weighted kappa, Cronbach's alpha, and Spearman's rank correlation coefficients for the statistical analysis of intra-rater reliability, internal consistency, and criterion validity, respectively. Results: The weighted kappa coefficient for the total score was 0.98 (p < 0.01) and individual item, it was 0.93 for feeding (p < 0.01), 0.91 for bathing (p < 0.01), 0.98 for dressing (p < 0.01), 0.94 for transfer (p < 0.01), 0.94 for walking/wheelchair (p < 0.01), 0.95 for stairs (p < 0.01), and 0.96 for bladder management (p < 0.01). The Cronbach's alpha was 0.93 for the seven items. The Spearman's rank correlation coefficient between the SAB-M and FIM-M scores was 0.91 (p < 0.01). Conclusion: The SAB-M has sufficient reliability and validity among community-dwelling older adults. Family caregivers can routinely assess changes in the ADL of community-dwelling older adults using the SAB-M, enabling them to promptly consider introducing rehabilitation when older adults' ADL declines. Therefore, implementing SAB-M helps older adults live and function at home for as long as possible.

Development of toileting behaviour evaluation for Japanese older patients using wheelchairs in a hospital setting: a validation study.

BACKGROUND: Ageing limits the activities of daily living (ADLs). Among ADLs, a lack of toileting independence causes a decline in the quality of life, mental health, and social participation. Therefore, occupational therapists spend considerable time assessing toileting disability based on various assessment methods for toileting behaviour. However, these assessment methods have issues with the grading levels, number of items, and diseases covered, and they fail to evaluate toileting behaviour accurately and sensitively. Hence, this study developed a Toileting Behaviour Evaluation (TBE) on a 6-point ordinal scale for patients using wheelchairs, with 22 activity components for various diseases. METHODS: This study examined the reliability and validity of the TBE in acute and subacute hospitals in Japan. To this end, two occupational therapists assessed 50 patients for inter-rater reliability at different times and one assessed them twice within 7-10 days for intra-rater reliability using the TBE. Furthermore, occupational therapists assessed 100 patients for internal consistency using the TBE and for concurrent validity using the TBE and Functional Independence Measure (FIM). The patients had been diagnosed with various diseases. This study used the weighted kappa coefficient for statistical analysis of the inter-rater and intra-rater reliability, Cronbach's alpha coefficient for internal consistency, and Spearman's rank correlation coefficient for concurrent validity. We performed all statistical analyses using the IBM SPSS Statistics ver. 25 for Windows. All P-values < 0.05 were considered statistically significant. RESULTS: The minimum weighted kappa coefficients for the inter-rater and intra-rater reliability for each item were 0.67 and 0.79, respectively. Cronbach's alpha was 0.98 for the 22 items. The Spearman's rank correlation coefficient between the mean scores on the TBE and FIM for toilet-related items was 0.74 (P < .01). CONCLUSIONS: The TBE demonstrated good reliability and validity. This means that therapists can use it to identify impaired toileting behaviour. However, the relationship between impairments and each item of toileting behaviour should be explored in future studies. Additionally, studies should examine the creation of a specific index of functions of independence in each toileting behaviour.

Structural validity of the mealtime behaviour questionnaire for children with autism spectrum disorder in Japan.

[Purpose] Children with autism spectrum disorder (ASD) exhibit many problematic mealtime behaviours. Currently, there is no process for measuring the mealtime behaviours of children with ASD in Japan. Therefore, we developed the ASD-Mealtime Behaviour Questionnaire (ASD-MBQ) using the results of surveys measuring problematic mealtime behaviours in Japanese children with ASD aged 3-18 years. The objective of this study was to analyse the structural validity of the ASD-MBQ in Japan. [Participants and Methods] We recruited 378 children with ASD aged 3-18 years and performed a confirmatory factor analysis on the ASD-MBQ by using a five-factor structure. [Results] The confirmatory factor analysis demonstrated structural validity (χ2=796.5, degrees of freedom=265, comparative fit index=0.901, root mean square error of approximation [90% confidence interval]=0.073 [0.067-0.079]). [Conclusion] We have demonstrated the structural validity of the ASD-MBQ, which provided useful information for planning interventions and evaluations for children with ASD. Further studies need to consider cut-off score by age and inter-rater reliability.

Evaluation of psychometric properties of the activities of daily living scale of motor function used by caregivers using Rasch analysis.

[Purpose] We developed a prototype version of the Self-Assessment Burden Scale-Motor as a screening questionnaire for the need of care based on the evaluation of patients' activities of daily living. The questionnaire is comprised of seven items, each of which is scored on a 7-point Likert scale. This study aimed to examine the psychometric properties of the questionnaire using Rasch analysis. [Participants and Methods] A total of 200 individuals completed the questionnaire. Rasch analysis to investigate the rating scale structure and examine the structural validity and reliability of the scale. The unidimensionality of the items was examined using the mean square infit values and principal component analysis of residuals. The separation reliability of the scale was also examined. [Results] The rating scale structure can be improved by collapsing several categories (from seven categories to four categories). Unidimensionality was found for seven items. The separation reliability was acceptable for item calibrations and persons. [Conclusion] Inclusion of seven items with a 4-category rating scale was appropriate for the Self-Assessment Burden Scale-Motor questionnaire. Future studies should examine the intra-rater reliability and the criterion-related validity in more depth and develop a new scale to evaluate cognitive function.