Development of Persian version of the Spinal Cord Independence Measure III assessed by interview: a psychometric study.

STUDY DESIGN: Cross-sectional psychometric study. OBJECTIVES: To translate the Spinal Cord Independence Measure III (SCIM-III) into Persian, to evaluate it culturally and to analyze the validity and reliability of the Persian version of the SCIM-III (P-SCIM). SETTING: Brain and Spinal Injury Research Center (BASIR), Tehran, Iran. METHODS: The P-SCIM was developed by forward translation, back-translation, and cultural equivalence assessment procedure. The authors studied: (a) correlation of P-SCIM with the Functional Independence Measure (FIM™) for determining convergence validity, (b) P-SCIM scores in neurological categories for comparison and evaluating discriminative validity, (c) Inter-rater reliability of P-SCIM, (d) Cronbach's alpha for measuring internal consistency of P-SCIM-III. RESULTS: The validity of the scale was supported by a Pearson correlation coefficient of > 0.9 (p < 0.001) between FIM™ and P-SCIM. The Persian SCIM was found to be valid in discriminating different neurological categories. The Inter-rater reliability was concluded by Intraclass correlations of a coefficient > 0.9. Bland-Altman analysis demonstrated good agreement between our raters (mean difference: 0.7, limit of agreement: - 8.09-9.58). Also internal consistency of the scale was shown by Cronbach's alpha to be > 0.7 (0.86). CONCLUSION: P-SCIM-III is a valid and consistent tool for determining functionality in Persian speaking people with spinal cord injury.

Development of a fidelity measure for community integration programmes for people with acquired brain injury.

OBJECTIVE: The paper describes development of the Assessment of Community Integration Programme Attributes (ACIPA) measure based on a descriptive community integration framework. The purpose of this measure is to allow evaluation of community integration programmes for adults with acquired brain injury (ABI). METHODS: The Community Integration Framework (CIF) was used to design a fidelity evaluation measure through consultation with 37 participants from five stakeholder groups (practitioners, researchers, policy-makers, people with ABI and family members of people with ABI) using semi-structured interviews, focus groups, iterative surveys and a multi-attribute utility (MAU) method. RESULTS: The resultant measure included seven themes and 21 attributes. Each attribute included indicators and probing questions. Weights were assigned to each theme and constituent attributes. CONCLUSION: Programme evaluation commonly focuses on outcomes, often overlooking analysis of programme processes. Although it requires further psychometric (reliability and validity) development, the Assessment of Community Integration Programme Attributes may be used to assess the relationship between programme processes and specific outcomes and also to inform the development of programmes aiming to enhance community integration for adults with ABI.

Framework for describing community integration for people with acquired brain injury.

BACKGROUND/AIM: Community integration is the ultimate goal of rehabilitation of adults with acquired brain injury which has a high incidence in the Australian population. The literature shows a need for a more comprehensive framework for community integration. This study developed a descriptive community integration framework drawn from views of five stakeholder groups and was compared with four similar frameworks. METHODS: Thirty-seven experts in acquired brain injury, including practitioners, researchers, policy makers, people with acquired brain injury and family members participated. Using a Delphi method, an iterative process of surveys, interviews, and focus groups sought their views on community integration. Responses were analysed in three stages systematically to reduce a large quantity of raw data into a core set of descriptive themes. A final member checking process rated participants' agreement with the importance of each theme. RESULTS: Seven themes were identified and described: Relationships, Community Access, Acceptance, Occupation, Being at Home, Picking up Life Again, and Heightened Risks and Vulnerability. Themes were congruent with elements of the frameworks from the literature. CONCLUSIONS: Rich data came from the diverse stakeholders in the participant groups. Two unique themes reflected the importance of re-integration and recovering important aspects of previous lives, and identifying risks and vulnerabilities and providing safeguards. The framework reflected emphases that may be specific to acquired brain injury. It can be used as a basis for development of community integration programmes and outcome measures.

Translation and validation of the Farsi version of the Wheelchair Outcome Measure (WhOM-Farsi) in individuals with spinal cord injury.

BACKGROUND: The Wheelchair Outcome Measure (WhOM) evaluates participation outcomes associated with wheelchair use. While English and French versions of this measure have shown appropriate psychometric properties, it is not clear whether this measure is valid and reliable when used in a culture significantly different from the western culture. OBJECTIVE: To establish validity and reliability for the WhOM-Farsi. METHODS: After a forward-backward translation using the International Quality of Life Assessment process, the WhOM-Farsi was administered to 75 Farsi speakers with spinal cord injury. The WhOM-Farsi was administered on two occasions to examine test-retest reliability. Two therapists rated the measure to evaluate inter-rater reliability. Construct validity was assessed by measuring associations between scores of the WhOM-Farsi, the 12-item short-form health survey (SF-12), the Beck Depression Index (BDI-II) and the Spinal Cord Independence Measure (SCIM-III). RESULTS: The intra class correlation coefficient (ICC) for inter-rater reliability for all scores was 0.99. For test-retest, the ICC was 0.91, 0.94 and 0.83 for Sat, Imp × Sat and body function, respectively. As hypothesized the scores were positively correlated with the SF-12 and SCIM-III scores and negatively correlated with the BDI-II scores. CONCLUSIONS: The results illustrated there is evidence to support the validity and reliability of the WhOM-Farsi scores.

Validating the wheelchair outcome measure for residents in long-term care.

PURPOSE: To determine the retest reliability and construct validity of the self-report and proxy versions of the wheelchair outcome measure (WhOM) among residents in long-term care. METHOD: The WhOM was administered to 55 wheelchair users living in residential care (38 self-respondents and 17 proxy respondents). Retest data were collected to estimate reliability using intraclass correlation coefficients (ICCs) for each of the tool scores (Importance, Satisfaction and Importance × Satisfaction). For construct validity testing, Spearman's correlation coefficients were used to assess whether WhOM scores were correlated with scores from the Late Life Function and Disability Instrument (LLDI) and Geriatric Depression Scale (GDS). RESULTS: The ICCs for the WhOM scores were between 0.68 and 0.84. Moderate correlations were found between the self-respondents and proxy respondents groups with Importance × Satisfaction and LLDI (r = 0.46-0.50). No other significant correlations were found. CONCLUSIONS: This study provides evidence for the reliability and validity of the WhOM for adults in residential care, but further testing is warranted to ensure it can facilitate prescription of the right device at the right time for residents in these settings. IMPLICATIONS FOR REHABILITATION: Clients who reside in long-term care (LTC) institutions represent a population who have unique needs because of the varied types of activities in which they participate. This study provides support for use of the WhOM on an individual basis among self-responding residents. The study provides some support and use of the WhOM with groups of residents who require proxy respondents. Additional studies with a larger sample size are needed to further explore the psychometrics of the measure.