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Measuring self-reported ability to perform activities of daily living: a Rasch analysis
Copenhagen Univ Hosp Bispebjerg Frederiksberg, Parker Inst, ADL Unit, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark.;Univ Southern Denmark, Dept Publ Hlth, Occupat Sci & Occupat Therapy, User Perspect & Community Based Res, JB Winslowsvej 9a, DK-5000 Odense, Denmark..ORCID iD: 0000-0002-0846-1659
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-8976-2612
Copenhagen Univ Hosp Bispebjerg Frederiksberg, Parker Inst, ADL Unit, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark.;Univ Coll Northern Denmark, Dept Occupat Therapy, Selma Lagerlorfsvej 2, DK-9220 Aalborg, Denmark..
2021 (English)In: Health and Quality of Life Outcomes, E-ISSN 1477-7525, Vol. 19, no 1, article id 243Article in journal (Refereed) Published
Abstract [en]

Background: Since the number of persons diagnosed with multi-morbidity is increasing, there is a need for generic instruments to be able to assess, measure and compare ADL ability across diagnoses. Accordingly, the ADL-Interview (ADL-I) was developed to be used in rehabilitation research and clinical practice. The aim of this study was to investigate if the ADL-I can be used to provide valid and reliable ADL ability measures across gender and diagnostic groups. Methods: ADL-I data were extracted from an existing research database on persons with chronic conditions including medical, rheumatological, oncological, neurological, geriatric and psychiatric diagnoses. Data were analysed based on Rasch Measurement methods to examine: the psychometric properties of the rating scale; ADL item and person fit to the Rasch model; if the difficulty of the ADL tasks differs across gender and diagnostic groups, and if the ADL-I provides precise and reliable measures of ADL ability. Results:Data on n = 2098 persons were included in the final analysis. Initial evaluation of the 0-3 rating scale revealed threshold disordering between categories 1 and 2. After removal of 16 underfitting items, the variance explained by the Rasch dimension increased from 54.3 to 58.0%, thresholds were ordered, but the proportion of persons with misfitting ADL-I measures increased slightly from 8.7 to 9.1%. The person separation index improved slightly from 2.75 to 2.99 (reliability = 0.90). Differential test function analysis, however, supported that the 16 underfitting items did not represent a threat to the measurement system. Similarly, ADL items displaying differential item functioning across gender and diagnoses did not represent a threat to the measurement system. The ADL items and participants were well distributed along the scale, with item and person measures well targeted to each other, indicating a small ceiling effect and no floor effect. Conclusions: The study results overall suggest that the ADL-I is producing valid and reliable measures across gender and diagnostic groups among persons within a broad range of ADL ability, providing evidence to support generic use of the ADL-I.

Place, publisher, year, edition, pages
BioMed Central, 2021. Vol. 19, no 1, article id 243
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Nursing
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URN: urn:nbn:se:mau:diva-46809DOI: 10.1186/s12955-021-01880-zISI: 000708471700003PubMedID: 34663347Scopus ID: 2-s2.0-85117462087OAI: oai:DiVA.org:mau-46809DiVA, id: diva2:1610484
Available from: 2021-11-11 Created: 2021-11-11 Last updated: 2024-07-04Bibliographically approved

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Kottorp, Anders

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