Janet Fricke

Measuring Outcomes in Rehabilitation: A Review

A review of literature is undertaken to consider the issue of outcome measures and their current position in rehabilitation. The use of such indices in measuring and estimating the benefits of a rehabilitation programme is discussed in relation to outcome and funding issues. The selection and evaluation of suitable assessments is reviewed by considering their usefulness, construction, availability of manuals and training, reliability, validity and scoring. It is concluded that occupational therapists must introduce and use standardised assessments as part of their rehabilitation programme. By measuring change in status between admission and discharge and again at follow-up, it is possible to compare status at one date with another and so estimate and demonstrate the value of the treatment programme.

A Comparison of Self-Report versus Observation of Performance Using the Assessment of Living Skills and Resources (ALSAR) with an Older Population

This study assessed the capacity of 15 older people to report their instrumental activities of daily living (IADL) function accurately. The Assessment of Living Skills and Resources (ALSAR) (Williams et al 1991) was used to measure IADL function in the clinical and home environments. The subjects self-reported function was also compared with performance-based measurement of three IADL tasks from the ALSAR (use of the telephone, meal preparation and medication management) in the subjects home environment. The sensitivity of the ALSAR 3-point scale was examined through comparison with the Medical Rehabilitation Follow Along scale (Granger et al 1995). The findings highlighted problems associated with the use of self-reporting for the assessment of IADL in the older population. The ALSAR 3-point scale was shown to be sufficiently sensitive to detect IADL function when used with performance observation; however, further research is required to ascertain sensitivity when it is used as a self-report tool. The findings suggest that occupational therapists attain more accurate results when carrying out IADL assessment procedures by using performance-based measures.

Interrater reliability of the Personal Care Participation Assessment and Resource Tool (PC-PART) in a rehabilitation setting.

BACKGROUND The Personal Care Participation Assessment and Resource Tool (PC-PART), formerly the Handicap Assessment and Resource Tool (HART), assesses the domains of clothing, hygiene, nutrition, mobility, safety, residence and supports. AIM To examine the interrater reliability of the PC-PART in a rehabilitation setting. METHODS Assessments made by the researcher were compared to the interdisciplinary rehabilitation team. The research and standard assessments occurred within three working days. Raters were blind to each others scores. Sample participants were a consecutive case-series of rehabilitation clients with varied diagnoses, activity limitations and participation restrictions. Of 66 consecutive patients seen during the a priori determined enrolment period, 25 were included in the study (nine males and 16 females, aged 44-85 years). The remaining 41 patients did not meet the inclusion criteria. CONCLUSION The PC-PART has good interrater reliability. Clinicians, administrators and researchers can be reassured about this aspect of the validity of the tool.