Validity of the Utrecht scale for evaluation of rehabilitation-participation restrictions scale in a hospital-based stroke population 3 months after stroke
de Graaf, Joris A.; Volkers, Eline J.; Schepers, Vera P.M.; Visser-Meily, Johanna M.A.; Post, Marcel W.M.
(2022) Topics in Stroke Rehabilitation, volume 29, issue 7, pp. 516 - 525
(Article)
Abstract
Background:The Utrecht Scale for Evaluation of Rehabilitation-Participation Restrictions scale (USER-P-R) is a promising patient-reported outcome measure, but has currently not been validated in a hospital-based stroke population. Objective:To examine psychometric properties of the USER-P-R in a hospital-based stroke population 3 months after stroke onset. Methods:Cross-sectional study including 359 individuals with stroke
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recruited through 6 Dutch hospitals. The USER-P-R, EuroQol 5-dimensional 5-level questionnaire (EQ-5D-5 L), Patient Reported Outcomes Measurement Information System 10-Question Global Health Short Form (PROMIS-10), modified Rankin Scale (mRS) and two items on perceived decrease in health and activities post-stroke were administered in a telephone interview 3 months after stroke. The internal consistency, distribution, floor/ceiling effects, convergent validity and discriminant ability of the USER-P-R were calculated. Results:Of all participants, 96.9% were living at home and 50.9% experienced no or minimal disabilities (mRS 0–1). The USER-P-R showed high internal consistency (α = 0.90) and a non-normal left-skewed distribution with a ceiling effect (21.4% maximum scores). A substantial proportion of participants with minimal disabilities (mRS 1) experienced restrictions on USER-P-R items (range 11.9–48.5%). The USER-P-R correlated strongly with the EQ-5D-5 L, PROMIS-10 and mRS. The USER-P-R showed excellent discriminant ability in more severely affected individuals with stroke, whereas its discriminant ability in less affected individuals was moderate. Conclusions:The USER-P-R shows good measurement properties and provides additional patient-reported information, proving its usefulness as an instrument to evaluate participation after 3 months in a hospital-based stroke population.
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Keywords: community participation, patient reported outcome measures, quality indicators, social participation, Stroke, Rehabilitation, Community and Home Care, Clinical Neurology
ISSN: 1074-9357
Publisher: Thomas Land Publishers Inc.
Note: Funding Information: This research project is funded by the Stichting Kwaliteitsgelden Medisch Specialisten (SKMS) (grant number 46361589) and was commissioned by the Werkgroep CVA Nederland (WCN) and the Netherlands Society of Rehabilitation Medicine (NSRM). We would like to thank Corina Puppels (nurse practitioner), Wilma Pellikaan (nurse practitioner), Mariska de Kleuver (stroke nurse), Lianne van Bemmel (stroke nurse), Annemarie Mastenbroek (stroke nurse), Petra Zandbelt (nurse practitioner), Marloes van Mierlo (researcher), Ingrid den Besten (stroke nurse), Elly Greeve (stroke nurse), Hanneke van Langeveld-Pranger (stroke nurse) and Erna Bos-Verheij (stroke nurse) for including the participants, conducting telephone interviews and collecting data. This study was performed at the following institutions: Flevoziekenhuis, Department of Neurology, Almere, The Netherlands Franciscus Gasthuis, Department of Neurology, Rotterdam, The Netherlands Leiden University Medical Center, Leiden, The Netherlands Rijnstate hospital, Department of Neurology, Arnhem, The Netherlands St. Antonius hospital, Department of Neurology, Nieuwegein, The Netherlands University Medical Center Utrecht, Utrecht, the Netherlands Publisher Copyright: © 2021 UMC Utrecht. Published with license by Taylor & Francis Group, LLC.
(Peer reviewed)