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Development and validation of an outcome measure for orthopaedic trauma inpatientsMoghazy, Ezzat 12 1900 (has links)
Thesis (MScPhysio (Interdisciplinary Health Sciences))--Stellenbosch University, 2008. / Introduction
In clinical physiotherapy, there is a growing importance for the accuracy and
reliability of assessment and outcome measures. The purpose of this study is
to develop a valid outcome measure for orthopaedic trauma inpatients. Item
generation was done by conducting a systematic review of published
functional outcome measures and patients' interview. Item reduction was
conducted by using a panel of physiotherapists and patients.
Objectives
The overall study objectives were: 1) To determine if a functional outcome
measurement scale for trauma inpatients exists and has been published; 2)
To generate functional items for the construction of a new outcome
measurement tool for trauma inpatients; 3) To construct a new outcome
measurement tool for trauma inpatients and assess elements of validity and
reliability (face and content validity, response to change, internal consistency
and floor and ceiling effects) of the new developed outcome measure.
Methodology
Convenience sampling was applied to collect data from 35 trauma inpatients
in trauma wards at Rashid Hospital in Dubai, UAE. 88% of the trauma
inpatients were male (total sample n= 100), mean age =34.75, and the
standard deviation = 14.46. 21 functional activity items were generated from
the collated results of the patient interviews. Internal consistency reliability,
responsiveness and floor and ceiling effect were assessed. Data analysis was
conducted using Statistica Version 7.
Results
The final number of functional activity items included in the newly developed
Functional Scale outcome measure was 29 activity items relevant for trauma
inpatients. A Cronbach's alpha ranged between 0.76 and 0.97. The lowest
alpha result was for the 'ADL' activities at follow-up (0.76). The highest alpha
result was for 'out of bed' activity at admission and discharge (0.97).
The response to change of the Functional Scale for trauma inpatients over
time results illustrates that there was a significant difference in the mean
scores over three administrations of 'Bed', 'Out of bed' and 'ADL' activity
items of Functional Scale for trauma inpatients (p=O.OOOO). In general, there
was no significant floor and ceiling effects at admission or discharge for 'bed',
'out of bed' and 'ADL' activities, except there was a floor effect noted at
discharge for 'bed' activities and 'ADL' activities, and a ceiling effect noted at
admission for 'out of bed activities' only.
Discussion and Conclusion
The newly developed Functional Scale outcome measurement for trauma
inpatients has been shown to be internally consistent and appears to be valid
with respect to response to change in this sample of trauma inpatients. The
results of this study thus suggest that the Functional Scale for trauma
inpatients may be an appropriate tool when the goal is the assessment of
change in disability functions in trauma inpatients, although further
psychometric testing may be required.
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