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.

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.