Development of occupational therapy screening tool for clients with stroke

Abstract

Background: The number of new stroke cases in the Thai population increases every year. Occupational therapy has a crucial role in stroke rehabilitation. In Thailand, there is currently no standardized occupational therapy screening tool for gathering clients’ impairments to facilitate further evaluation and intervention. Objectives: To develop an occupational therapy screening tool for clients with stroke and investigate its psychometric properties. Materials and methods: The development of the screening tool was based on a literature review and opinions of registered occupational therapists (OTs) who have had at least five years of experience working with stroke clients. Five experts examined content validity. The Index of Congruence (IOC) was calculated, and the items that showed IOC scores of over 0.5 were incorporated into the target screening tool. Afterward, two types of reliability were measured, including test-retest and inter-rater reliability. Using purposive sampling, 44 participants with chronic stroke were selected to test each type of reliability. Intraclass correlation coefficient (ICC) models 3, 1, and 2, k were used to determine test-retest and inter-rater reliability, respectively. Results: Based on the literature review and 128 OTs’ opinions, the screening tool covers four domains: sensation, voluntary movement control of upper extremity and hand function, perception, and cognition. Content validity IOC scores were between 0.8 and 1.0 for all items. The screening tool had excellent test-retest reliability on all items, except memory. And the ICC between the two raters ranged from 0.91 to 1.00, which showed excellent inter-rater reliability. Conclusion: The occupational therapy screening tool for clients with stroke has proven valid and reliable as a screening tool in clinical settings. Further research is recommended for concurrent, sensitivity, and specificity studies.