Construct Validity, Test-Retest Reliability, Sensitivity to Change, and Feasibility of the Patient-Specific Functional Scale in Acutely Hospitalized Older Patients With and Without Cognitive Impairment

Heldmann, Patrick; Hummel, Saskia; Bauknecht, Laura; Bauer, Jürgen; Werner, Christian

doi:10.1519/jpt.0000000000000303

Cited by 3 publications

(14 citation statements)

References 73 publications

(209 reference statements)

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“…Similarly, the SDC 95 values were 1.80 and 1.90 points for older patients with and without cognitive impairments and hospitalized for acute stroke, respectively, and 0.64 to 3.30 for individuals with musculoskeletal disorders. 23 In the present study, the minimal important change was 1.58 points, which is similar to the minimal important change range of 0.80 to 2.90 points identified in other studies. 19 , 23 …”

Section: Discussionsupporting

confidence: 91%

“…An acute care study of older adults with and without cognitive impairments acknowledged a known rapid change in function during the first days. 23 Therefore, the study investigators used a 24-hour period for assessing the test–retest reliability. Despite a shorter time from test to retest, the ICC was lower (0.76) than in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is consistent with previous studies of patients with musculoskeletal disorders (SEM = 0.35–1.50) 19 and older patients in an acute care setting with and without cognitive impairment (SEM = 0.78 and 0.83). 23 …”

Section: Discussionmentioning

confidence: 99%

“…We established construct validity using hypotheses for correlation between the PSFS and comparators mRS, BI, FAC, and 4MWT. The hypotheses were based on previous studies 22 , 23 , 42–44 and consensus among the investigators. Table 2 describes the hypotheses.…”

Section: Methodsmentioning

confidence: 99%

“…A barrier to PSFS administration in patients with neurologic conditions is the potential impact of cognition, self-awareness, and language impairments. 10 , 21 , 22 Heldmann et al 23 reported that the PSFS has satisfactory measurement properties for assessing patient-specific functional limitations and changes in older patients with and without cognitive impairment hospitalized for acute stroke. The authors found good to excellent relative reliability, and construct validity was supported in both groups.…”

Section: Introductionmentioning

confidence: 99%

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Measurement Properties of the Patient-Specific Functional Scale in Rehabilitation for Patients With Stroke: A Prospective Observational Study

et al. 2023

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Objective This study investigated the validity, reliability, responsiveness, and interpretability of the Patient-Specific Functional Scale (PSFS) in subacute stroke rehabilitation to determine its suitability to measure patient-identified rehabilitation goals. Methods A prospective observational study was designed according to the checklist from Consensus-Based Standards for Selecting Health Measurement Instruments (COSMIN). Seventy-one patients diagnosed with stroke were recruited in the subacute phase from a rehabilitation unit in Norway. The International Classification of Functioning, Disability and Health was used to assess the content validity. Assessment of construct validity was based on hypotheses for correlation of the PSFS and comparator measurements. We assessed reliability by calculating the ICC (3.1) and the standard error of measurement. The assessment of responsiveness was based on hypotheses for the correlation of change scores between the PSFS and the comparator measurements. A receiver operating characteristic analysis was conducted to assess responsiveness. The smallest detectable change and minimal important change were calculated. Results Eighty percent of the PSFS items were classified as activities and participation in the International Classification of Functioning, Disability and Health, indicating satisfactory content validity. The reliability was satisfactory with an ICC of 0.81 (95% CI = 0.69–0.89). The standard error of measurement was 0.70 point, and the smallest detectable change was 1.94 points. Five of 7 hypotheses were confirmed for construct validity, and 5 of 6 were confirmed for responsiveness, indicating moderate construct validity and high responsiveness. Assessing responsiveness with a criterion approach resulted in an area under the curve of 0.74. A ceiling effect was identified for 25% of the participants 3 months after discharge. The minimal important change was estimated to be 1.58 points. Conclusion This study demonstrates satisfactory measurement properties for the PSFS in individuals undergoing inpatient stroke rehabilitation. Impact This study supports the use of the PSFS to document and monitor patient-identified rehabilitation goals in patients receiving subacute stroke rehabilitation when applied using a shared decision approach.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Measurement Properties of the Patient-Specific Functional Scale in Rehabilitation for Patients With Stroke: A Prospective Observational Study

et al. 2023

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Individualized goals expressed by patients undergoing stroke rehabilitation: an observational study

Evensen,

Soberg,

Sveen

et al. 2024

JRM

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Objectives: To explore the rehabilitation goals measured with the Patient-Specific Functional Scale (PSFS) in patients undergoing acute and subacute stroke rehabilitation. In addition, to assess whether PSFS goals corresponded to impairments and activity limitations, as identified by standardized measures. Design: Observational study. Participants: A total of 71 participants undergoing inpatient stroke rehabilitation. Methods: The PSFS goals were linked to second-level categories in the International Classification of Functioning, Disability and Health (ICF), using established linking rules. Frequencies of the linked ICF categories were calculated. Frequencies of participants with limitations in walking, activities of daily living (ADL), vision, language, and cognition, were calculated, along with goals in corresponding areas of functioning. Results: The participants’ goals were linked to 50 second-level ICF categories, comprising areas such as walking and moving, ADL, language, vision, and cognition. The most frequent ICF categories were “Moving around in different locations” (n = 24), “Walking” (n = 23), “Toileting” (n = 16), “Hand and arm use (n = 12) and “Fine hand use (n = 12)”. Of participants with limitations in walking, cognition, and vision, 85%, 10%, and 16%, respectively, had goals in these areas. Conclusion: Participants’ goals included walking, ADL, language, vision, and cognition. Few with impairments in cognition or vision had goals in these corresponding areas on the PSFS.

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Measurement Property Evaluation of the Arabic Version of the Patient-Specific Functional Scale for Patients with Stroke

ALMohiza,

Khafaji,

Asiri

et al. 2023

Healthcare

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Neurological disorders refer to disorders that occur due to disease or damage to the nervous system. Stroke is one of the most common neurological disorders in which individuals commonly present with motor and sensory deficits, leading to the limitations on the activities of daily life. Outcome measures are used to assess and monitor patients’ condition change. The patient-specific functional scale (PSFS) is an outcome measure used to assess changes in performance levels in participants with a functional disability during daily activities. This study aimed to assess the reliability and validity of the Arabic version of the patient-specific functional scale (PSFS-Ar) in individuals with stroke. A longitudinal cohort study was used to examine the reliability and validity of the PSFS-Ar in patients with stroke. All participants completed the PSFS-Ar in addition to other outcome measures. Fifty-five individuals participated (fifty male, five female). The PSFS-Ar showed excellent test–retest reliability, with ICC2,1 = 0.96, p < 0.001. The SEM and MDC95 of the PSFS-Ar were 0.37 and 1.03, respectively. No floor and ceiling effect was observed in this study. Additionally, the construct validity of the PSFS-Ar showed 100% satisfaction with the pre-defined hypotheses. Since the number of female participants was very small in this study, the findings were established for male individuals with stroke. This study showed that the PSFS-Ar is a reliable and valid outcome measure for male individuals with stroke.

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Construct Validity, Test-Retest Reliability, Sensitivity to Change, and Feasibility of the Patient-Specific Functional Scale in Acutely Hospitalized Older Patients With and Without Cognitive Impairment

Cited by 3 publications

References 73 publications

Measurement Properties of the Patient-Specific Functional Scale in Rehabilitation for Patients With Stroke: A Prospective Observational Study

Measurement Properties of the Patient-Specific Functional Scale in Rehabilitation for Patients With Stroke: A Prospective Observational Study

Individualized goals expressed by patients undergoing stroke rehabilitation: an observational study

Measurement Property Evaluation of the Arabic Version of the Patient-Specific Functional Scale for Patients with Stroke

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