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Development and assessment of a home environment checklist to evaluate mismatch between patients’ ability and home environment - 13/10/19

Doi : 10.1016/j.rehab.2019.09.004 
Masahiko Mukaino a, , Birgit Prodinger b, c , Yuki Okouchi d , Kouji Mizutani d , Yuki Senju e , Megumi Suzuki f , Eiichi Saitoh a
a Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan 
b Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences, Rosenheim, Germany 
c Swiss Paraplegic Research, Nottwil, Switzerland 
d Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan 
e Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, Tsu, Japan 
f Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan 

Corresponding author: Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, 470-1192 Toyoake, Aichi, JapanDepartment of Rehabilitation Medicine I, School of Medicine, Fujita Health University1-98 Dengakugakubo, KutsukakeToyoakeAichi470-1192Japan
En prensa. Manuscrito Aceptado. Disponible en línea desde el Sunday 13 October 2019
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Abstract

Background: Modification of the home environment, together with rehabilitative interventions, is important for maximizing the level of functioning after an individual with disability undergoes rehabilitation in the hospital.

Objectives: We developed a simple screening scale — the home environment checklist (HEC) — to identify any mismatch between an individual’s abilities and their home environment to help clinicians monitor the appropriateness of the home environment to which individuals with disability will be discharged. We also examined the psychometric properties of the HEC.

Methods: The HEC was developed by a multidisciplinary panel of rehabilitation experts using information routinely collected in rehabilitation clinics before discharge. The reliability of the checklist was assessed in 60 individuals undergoing rehabilitation. The inter-rater agreement and internal consistency of the scale were assessed by weighted kappa statistics and Cronbach’s alpha, respectively. Rasch analysis was performed with 244 rehabilitation individuals to evaluate the internal construct validity, and the known-groups validity was confirmed by a comparison of the daily activity levels of 30 individuals with disabilities under rehabilitation to the HEC score.

Results: The HEC was developed as a simple, 10-item checklist. The weighted kappa statistics ranged from 0.73 to 0.93, indicating excellent inter-rater reliability. Cronbach’s alpha was 0.92, indicating high internal consistency. Rasch analysis with a testlet approach on 3 subscales demonstrated a good fit with the Rasch model (χ2 = 13.2, p = 0.153), and the demonstrated unidimensionality and absence of differential item functioning supported the internal construct validity of the HEC. HEC scores were significantly different (p < .01) among individuals with disability and 3 levels of restrictions in their activities (no limitation, home-bound, and bed-bound), which demonstrates the known-groups validity of the HEC.

Conclusions: The HEC has good reliability and validity, which supports its utility in rehabilitation clinics.

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Keywords : ICF, environmental factors, activities of daily living



© 2019  Publicado por Elsevier Masson SAS.
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