1. Patient Versus Clinician Proxy Reliability of the AM-PAC '6-Clicks' Basic Mobility and Daily Activity Short Forms
- Author
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Johnson, Joshua K., Lapin, Brittany, Bethoux, Francois, Skolaris, Alexis, Katzan, Irene, and Stilphen, Mary
- Subjects
Therapeutics, Physiological -- Evaluation ,Physical therapy -- Evaluation ,Proxy -- Evaluation ,Medical care -- Quality management ,Health - Abstract
Objective. The purpose of this study was to test the reliability of the Activity Measure for Post-Acute Care (AM-PAC) '6-Clicks' mobility and activity short forms between patients and therapist proxies. As a secondary aim, reliability was examined when patients completed their self-report before versus after the therapist evaluation. Methods. Patients being seen for an initial physical therapist (N =70) or occupational therapist (N =71) evaluation in the acute care hospital completed the '6-Clicks' mobility short form (if a physical therapist evaluation) or activity short form (if an occupational therapist evaluation). Whether patients completed their self-assessment before or after the evaluation was randomized. Patient- and therapist-rated '6-Clicks' raw scores were converted to AM-PAC T-scores for comparison. Reliability was assessed with intraclass correlation coefficients (ICCs) and Bland-Altman plots, and agreement was assessed with weighted kappa values. Results. The ICCs for the '6-Clicks' mobility and daily activity short forms were 0.57 (95% CI = 0.42-0.69) and 0.45 (95% CI =0.28-0.59), respectively. For both short forms, reliability was higher when the patient completed the self-assessment after versus before the therapist evaluation (ICC =0.67, 95% CI = 0.47-0.80 vs ICC=0.50, 95% CI = 0.26-0.67 for the mobility short form; and ICC = 0.52, 95% CI =0.29-0.70 vs ICC= 0.34, 95% CI = 0.06-0.56 for the activity short form). Conclusion. Reliability of the '6-Clicks' total scores was moderate for both the mobility and activity short forms, though higher for the mobility short form and when patients' self-report occurred after the therapist evaluation. Impact. Reliability of the AM-PAC '6-Clicks' short forms is moderate when comparing scores from patients with those of therapists responding as proxies. The short forms are useful for measuring participants' function in the acute care hospital; however, it is critical to recognize limitations in reliability between clinician- and patient-reported AM-PAC scores when evaluating longitudinal change and recovery. Keywords: Activities of Daily Living, Acute Care, Measurement: Basic Theory and Science, Mobility, Introduction Many individuals in acute care hospitals experience new or worsening deficits in physical function and their ability to participate in daily activities. (1,2) Individual's functional status in the hospital [...]
- Published
- 2022
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