Background Acquiring toileting independence is an important target of stroke rehabilitation. In planning an intervention for acquiring toileting independence, developing an assessment for individual subtasks that comprise toileting would assist in identifying specific tasks that prevent independence in patients and would facilitate interventions to improve toileting independence. Objective To examine the reliability and validity of a newly developed toileting assessment form, the Toileting Tasks Assessment Form (TTAF), for assessing toileting subtasks in hemiparetic stroke. Design Validation and test‐retest study. Setting Subacute rehabilitation wards in Japan. Participants Eighty‐two therapists verified the form's content validity; 30 stroke patients who were using a wheelchair participated in the validation and test‐retest study. Interventions Not applicable. Main Outcome Measures The content validity of the assessment form was initially assessed based on a questionnaire. Subsequently, four occupational therapists used the form to evaluate video‐recorded toileting performances simulated by participants with hemiparetic stroke. Two assessors evaluated each video‐recorded performance once and repeated the evaluation of the same performance at 2 weeks later. The interrater reliability, intrarater reliability, internal consistency, and concurrent validity of the form were examined. Results Fleiss’ κ coefficient for interrater reliability for each form item was 0.61 or more. Cohen's κ coefficient for intrarater reliability for each item was 0.60 or more. Cronbach's coefficient alpha ranged from 0.94 to 0.95. Spearman's rank correlation coefficients for the mean score on the form and the Functional Independence Measure (FIM) score for “toileting” ranged from 0.88 to 0.93 (P < .001). Spearman's rank correlation coefficients for the mean score on the form and the FIM score for “toilet transfer” ranged from 0.91 to 0.93 (P < .001). Conclusions The TTAF demonstrated good reliability and validity. Further multicenter studies involving patients at different stroke phases are required to verify the reliability and validity of TTAF and confirm the generalizability of these findings.
Introduction Transferring is a basic skill that is essential for mobility independence and indispensable for expanding activities of daily living of stroke patients using a wheelchair. Therefore, transfer independence is an important issue that greatly affects daily life in the hospital and at home. To offer an effective intervention to acquire a skill, developing an assessment for individual subtasks that comprise transferring would assist the identification of specific tasks that prevent independence in patients and facilitate interventions to improve transferring independence. Objective To examine the reliability and validity of a newly developed transfer assessment form, the Bed‐wheelchair transfer Tasks Assessment Form (BTAF), for stroke patients to evaluate subtasks required for transferring. Design Validation and test‐retest studies. Setting Subacute rehabilitation wards in Japan. Participants A total of 82 therapists for verifying content validity; 30 patients for validation and test‐retest study. Interventions Not applicable. Main Outcome Measures The content validity was initially assessed based on a questionnaire. Subsequently, four occupational therapists used the form to evaluate the video‐recorded transferring performances of stroke participants. Two assessors evaluated each performance once and then 2 weeks later. The inter‐rater reliability, intra‐rater reliability, internal consistency, and concurrent validity were examined. Results Fleiss's κ coefficient for inter‐rater reliability for each item of the form was 0.66 or more. Cohen's κ coefficient for intra‐rater reliability for each item was 0.73 or more. Cronbach's coefficient alpha ranged from 0.90 to 0.93. Spearman's rank correlation coefficients between the mean scores of our form and scores of the functional independence measure item “transfer to bed/chair/wheelchair” ranged from 0.53 to 0.78 (P < .01). Conclusions The form demonstrated good reliability and validity. Its usefulness and efficacy should be further investigated in stroke patients to facilitate rehabilitation.
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