Interrater reliability of Algo used by non-occupational therapist members of homecare interdisciplinary teams

Abstract

Purpose: To determine if non-occupational therapists (non-OTs) with different job titles using Algo, a clinical algorithm for recommending bathroom modifications (e.g., bath seat) for community-dwelling elders in ''straightforward'' situations, will make clinically equivalent recommendations for standardized clients. Method: Eight non-OTs (three social workers, two physical rehabilitation therapists, two homecare aides and one auxiliary nurse) were trained on Algo and used it with six standardized clients. Bathroom adaptations recommended (one of nine options) by non-OTs were compared to assess interrater agreement using Fleiss adapted kappa. Results: Estimated kappa was 0.43 [0.36; 0.49] qualified as a moderate agreement, according to Landis and Koch's arbitrary divisions, among the recommendations of non-OTs. However, clinical equivalence is reached, since safety and client needs were met when raters selected two different options (e.g., with or without a seat back). Conclusions: Non-OTs using Algo in the same simulated clinical scenarios recommend clinically equivalent bathroom adaptations, increasing the confidence regarding the interrater reliability of Algo used by non-OT members of homecare interdisciplinary teamsIn homecare services, non-occupational therapists from different health care disciplines (e.g., homecare aides, social workers, physical rehabilitation therapists) may be asked to select assistive devices for the hygiene care of clients living at home. Algo was designed to guide non-occupational therapists in the selection of assistive devices when performed with clients in straightforward cases. This study indicates that non-occupational therapists using Algo recommend similar and acceptable bathroom adaptations to enhance client safety. ARTICLE HISTORY

Self-Selection of Bathroom-Assistive Technology: Development of an Electronic Decision Support System (Hygiene 2.0)

“…Older adults receive 1 of 9 possible recommendations [ 6 ], with or without assistive technology, specific to their bathing situation (ie, standing without a seat in the bathtub, sitting on a bath stool in the shower stall, or stop and refer to an OT). The content of the Algo was developed through an integrated knowledge approach [ 6 , 7 ], and psychometric studies [ 8 - 12 ] revealed, for example, that it guided non-OTs toward a bath seat that meets the needs of community-dwelling older adults in the majority of cases (mean 84%, SD 9%) [ 9 ]. The appropriateness rate of seats recommended by non-OTs did not statistically differ from that of 2 OTs [ 9 ].…”