TY - JOUR A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Challenges and care strategies associated with the admission to nursing homes in Germany: a scoping review JF - BMC Nursing N2 - Background The admission to a nursing home is a critical life-event for affected persons as well as their families. Admission related processes are lacking adequate participation of older people and their families. To improve transitions to nursing homes, context- and country-specific knowledge about the current practice is needed. Hence, our aim was to summarize available evidence on challenges and care strategies associated with the admission to nursing homes in Germany. Methods We conducted a scoping review and searched eight major international and German-specific electronic databases for journal articles and grey literature published in German or English language since 1995. Further inclusion criteria were focus on challenges or care strategies in the context of nursing home admissions of older persons and comprehensive and replicable information on methods and results. Posters, only-abstract publications and articles dealing with mixed populations including younger adults were excluded. Challenges and care strategies were identified and analysed by structured content analysis using the TRANSCIT model. Results Twelve studies of 1,384 records were finally included. Among those, seven were qualitative studies, three quantitative observational studies and two mixed methods studies. As major challenges neglected participation of older people, psychosocial burden among family caregivers, inadequate professional cooperation and a lack of shared decision-making and evidence-based practice were identified. Identified care strategies included strengthening shared decision-making and evidence-based practice, improvement in professional cooperation, introduction of specialized transitional care staff and enabling participation for older people. Conclusion Although the process of nursing home admission is considered challenging and tends to neglect the needs of older people, little research is available for the German health care system. The perspective of the older people seems to be underrepresented, as most of the studies focused on caregivers and health professionals. Reported care strategies addressed important challenges, however, these were not developed and evaluated in a comprehensive and systematic way. Future research is needed to examine perspectives of all the involved groups to gain a comprehensive picture of the needs and challenges. Interventions based on existing care strategies should be systematically developed and evaluated to provide the basis of adequate support for older persons and their informal caregivers. KW - transition to nursing home Y1 - 2023 U6 - https://doi.org/10.1186/s12912-022-01139-y VL - 22 ER - TY - GEN A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Herausforderungen und Versorgungsstrategien im Kontext von Pflegeheimeinzügen in Deutschland: Ein Scoping Review. Poster für den EbM-Kongress vom 22.-24. März 2023 in Potsdam KW - Pflegeheimeinzug Y1 - 2023 ER - TY - GEN A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Challenges and care strategies during the transition to nursing home in Germany: A scoping review. European Nursing Kongress am 5. Oktober 2022, online KW - transition to nursing home Y1 - 2022 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Coenen, Michaela A1 - Hammond, Alison A1 - Küçükdeveci, Ayşe A. A1 - Tennant, Alan T1 - Scale Banking for Patient-Reported Outcome Measures That Measure Functioning in Rheumatoid Arthritis: A Daily Activities Metric JF - Arthritis Care & Research N2 - Objective Functioning is an important outcome for the management of rheumatoid arthritis (RA). Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability. Methods Common-item nonequivalent group design with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (including the UK, Turkey, and Germany) to establish a common metric was used. Other PROMs included are the physical function items of the Multidimensional HAQ (MDHAQ), the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the World Health Organization Disability Assessment Schedule II (WHODAS II), the Medical Outcomes Study Short Form 36 (SF-36) health survey, and 4 short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System. As the HAQ includes mobility, self-care, and domestic life items, this study focuses on these 3 domains. PROMs were described using standard error of measurement (SEM) and smallest detectable difference (SDD). A Rasch measurement model was used to create the common metric. Results The range of the SEM was 0.2 (MDHAQ) to 7.4 (SF-36 health survey physical functioning domain). The SDD revealed a range from 9.7% (WOMAC rating scale) to 33.5% (WHODAS physical functioning domain). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROM scores. Conclusion Scores between the daily activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help to determine the choice of a PROM in clinical practice and research. KW - rheumatoid arthritis KW - patient-reported outcome measures Y1 - 2022 UR - https://doi.org/10.1002/acr.24503 VL - 74 IS - 4 SP - 579 EP - 587 ER - TY - CHAP A1 - Prodinger, Birgit ED - Hayre, Christopher M. ED - Muller, Dave J. ED - Hackett, Paul M. W. T1 - Institutional Ethnography T2 - Rehabilitation in Practice N2 - Rehabilitation aims to enable people with disabilities or who are likely to experience disability to participate fully in their daily lives through a set of interprofessional and multimodal measures. Yet, rehabilitation services are embedded within social and healthcare systems that shape what individuals, who are active within these systems, can and may have to do. This chapter introduces Institutional Ethnography, a critical method of inquiry, which aims to explicate what people actually do and experience and how their doings and experiences become organized within textually mediated social relations. For rehabilitation practice and research, Institutional Ethnography is a powerful method to delineate which concepts are dominating institutional practices and to explicate whether these concepts are comprehensive enough to serve not only institutional purposes but account for and respond to the realities of people’s daily lives. KW - Institutional Ethnography KW - Ruling relations KW - Standpoint KW - Social organization KW - Work KW - Ontology of the social Y1 - 2022 UR - https://doi.org/10.1007/978-981-16-8317-6_5 SP - 55 EP - 66 PB - Springer CY - Singapore ER - TY - JOUR A1 - Hodel, Jsabel A1 - Stucki, Gerold A1 - Prodinger, Birgit T1 - The potential of prediction models of functioning remains to be fully exploited: A scoping review in the field of spinal cord injury rehabilitation JF - Journal of Clinical Epidemiology N2 - Objective: The study aimed to explore existing prediction models of functioning in spinal cord injury (SCI). Study design and setting: The databases PubMed, EBSCOhost CINAHL Complete, and IEEE Xplore were searched for relevant literature. The search strategy included published search filters for prediction model and impact studies, index terms and keywords for SCI, and relevant outcome measures able to assess functioning as reflected in the International Classification of Functioning, Disability and Health (ICF). The search was completed in October 2020. Results: We identified seven prediction model studies reporting twelve prediction models of functioning. The identified prediction models were mainly envisioned to be used for rehabilitation planning, however, also other possible applications were stated. The method predominantly used was regression analysis and the investigated predictors covered mainly the ICF components of body functions and activities and participation, next to characteristics of the health condition and health interventions. Conclusion: Findings suggest that the development of prediction models of functioning for use in clinical practice remains to be fully exploited. By providing a comprehensive overview of what has been done, this review informs future research on prediction models of functioning in SCI and contributes to an efficient use of research evidence. KW - Spinal Cord Injuries KW - Rehabilitation KW - Prognosis KW - Diagnosis KW - Clinical Decision Rules KW - Forecasting Y1 - 2021 UR - https://doi.org/10.1016/j.jclinepi.2021.07.015 VL - 139 SP - 177 EP - 190 ER - TY - JOUR A1 - Hodel, Jsabel A1 - Ehrmann, Cristina A1 - Scheel-Sailer, Anke A1 - Stucki, Gerold A1 - Bickenbach, Jerome E. A1 - Prodinger, Birgit T1 - Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland JF - Archives of Rehabilitation Research and Clinical Translation N2 - Objectives: To identify classes of functioning trajectories in individuals with spinal cord injury (SCI) undergoing initial rehabilitation after injury and to examine potential predictors of class membership to inform clinical planning of the rehabilitation process. Design: Longitudinal analysis of the individual's rehabilitation stay using data from the Inception Cohort of the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Setting: Initial rehabilitation in specialized centers in Switzerland. Participants: Individuals with newly acquired SCI (N=748; mean age, 54.66±18.38y) who completed initial rehabilitation between May 2013 and September 2019. The cohort was primarily composed of men (67.51%), persons with paraplegia (56.15%), incomplete injuries (67.51%), and traumatic etiologies (55.48%). Interventions: Not applicable. Main Outcome Measures: Functioning was operationalized with the interval-based sum score of the Spinal Cord Independence Measure version III (SCIM III). For each individual, the SCIM III sum score was assessed at up to 4 time points during rehabilitation stay. The corresponding time of assessment was recorded by the difference in days between the SCIM III assessment and admission to the rehabilitation program. Results: Latent process mixed model analysis revealed 4 classes of functioning trajectories within the present sample. Class-specific predicted mean functioning trajectories describe stable high functioning (n=307; 41.04%), early functioning improvement (n=39; 5.21%), moderate functioning improvement (n=287; 38.37%), and slow functioning improvement (n=115; 15.37%), respectively. Out of 12 tested factors, multinomial logistic regression showed that age, injury level, injury severity, and ventilator assistance were robust predictors that could distinguish between identified classes of functioning trajectories in the present sample. Conclusions: The current study establishes a foundation for future research on the course of functioning of individuals with SCI in initial rehabilitation by identifying classes of functioning trajectories. This supports the development of specifically tailored rehabilitation programs and prediction models, which can be integrated into clinical rehabilitation planning. KW - Latent class analysis KW - Logistic models KW - Longitudinal studies KW - Observational study KW - Rehabilitation KW - Spinal cord injuries Y1 - 2021 UR - https://doi.org/10.1016/j.arrct.2021.100121 VL - 3 IS - 2 SP - 100121 ER - TY - JOUR A1 - Senju, Y A1 - Mukaino, M A1 - Prodinger, Birgit A1 - Selb, M A1 - Okouchi, Y A1 - Mizutani, K A1 - Suzuki, M A1 - Yamada, S A1 - Izumi, SI A1 - Sonoda, S A1 - Otaka, Y A1 - Saitoh, E A1 - Stucki, G T1 - Development of a clinical tool for rating the body function categories of the ICF generic-30/rehabilitation set in Japanese rehabilitation practice and examination of its interrater reliability JF - BMC Medical Research Methodology N2 - Background: The International Classification of Functioning, Disability, and Health (ICF) Generic-30 (Rehabilitation) Set is a tool used to assess the functioning of a clinical population in rehabilitation. The ICF Generic-30 consists of nine ICF categories from the component "body functions" and 21 from the component "activities and participation". This study aimed to develop a rating reference guide for the nine body function categories of the ICF Generic-30 Set using a predefined, structured process and to examine the interrater reliability of the ratings using the rating reference guide. Methods: The development of the first version of the rating reference guide involved the following steps: (1) a trial of rating patients by several raters; (2) cognitive interviews with each rater to analyze the thought process involved in each rating; (3) the drafting of the rating reference guide by a multidisciplinary panel; and (4) a review by ICF specialists to confirm consistency with the ICF. Subsequently, we conducted a first field test to gain insight into the use of the guide in practice. The reference guide was modified based on the raters' feedback in the field test, and an inter-rater reliability test was conducted thereafter. Interrater agreement was evaluated using weighted kappa statistics with linear weights. Results: The first version of the rating reference guide was successfully developed and tested. The weighted kappa coefficient in the field testing ranged from 0.25 to 0.92. The interrater reliability testing of the rating reference guide modified based on the field test results yielded an improved weighted kappa coefficient ranging from 0.53 to 0.78. Relative improvements in the weighted kappa coefficients were observed in seven out of the nine categories. Consequently, seven out of nine categories were found to have a weighted kappa coefficient of 0.61 or higher. Conclusions: In this study, we developed and modified a rating reference guide for the body function categories of the ICF Generic-30 Set. The interrater reliability test using the final version of the rating reference guide showed moderate to substantial interrater agreement, which encouraged the use of the ICF in rehabilitation practice. KW - Clinical tool KW - International Classification of Functioning, Disability, and Health KW - Interrater reliability KW - Rehabilitation Y1 - 2021 UR - https://doi.org/10.1186/s12874-021-01302-0 VL - 21 IS - 1 SP - 121 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Coenen, Michaela A1 - Hammond, Alison A1 - Küçükdeveci, Ayse A. A1 - Tennant, Alan T1 - Scale-Banking for Patient Reported Outcome Measures (PROMs) Measuring Functioning in Rheumatoid Arthritis: A Daily Activities Metric JF - Arthritis Care & Research N2 - Objective: Functioning is an important outcome for rheumatoid arthritis (RA) management. Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability. Methods: Common Item Non-Equivalent Groups Design (NEAT) with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (incl. UK, Turkey and Germany) to establish a common metric. Other PROMs included are the Physical Function items of the Multidimensional Health Assessment Questionnaire (MDHAQ), Disabilities of Arm, Shoulder and Hand (DASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0), and four short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System (PROMIS). As the HAQ includes mobility, self-care and domestic life items, this study focuses on these three domains. PROMs were described using Standard Error of Measurement (SEM) and Smallest Detectable Difference (SDD). Rasch Measurement model was used to create the common metric. Results: Range of SEM is 0.2 (MDHAQ) to 7.4 (SF36-PF). SDD revealed a range from 9.7 % (WOMAC-RAT) to 33.5 % (WHODAS-PF). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROMs scores. Discussion: Scores between the Daily Activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help determine choice of PROM in clinical practice and research. KW - Common metric KW - DASH KW - HAQ KW - International Classification of Functioning KW - Multidimensional HAQ KW - PROMIS-SF KW - Rasch measurement model KW - Scale banking KW - WHODAS 2.0 KW - WOMAC Y1 - 2020 UR - https://doi.org/10.1002/acr.24503 ER - TY - JOUR A1 - Nicol, R A1 - Yu, H A1 - Selb, M A1 - Prodinger, Birgit A1 - Hartvigsen, J A1 - Côté, P T1 - How Does the Measurement of Disability in Low Back Pain Map Unto the International Classification of Functioning, Disability and Health?: A Scoping Review of the Manual Medicine Literature JF - American Journal of Physical Medicine & Rehabilitation N2 - The objective of this study was to catalog items from instruments used to measure functioning, disability, and contextual factors in patients with low back pain treated with manual medicine (manipulation and mobilization) according to the International Classification of Functioning, Disability and Health. This catalog will be used to inform the development of an International Classification of Functioning, Disability and Health-based assessment schedule for low back pain patients treated with manual medicine. In this scoping review, we systematically searched MEDLINE, Embase, PsycINFO, and CINAHL. We identified instruments (questionnaires, clinical tests, single questions) used to measure functioning, disability, and contextual factors, extracted the relevant items, and then linked these items to the International Classification of Functioning, Disability and Health. We included 95 articles and identified 1510 meaningful concepts. All but 70 items were linked to the International Classification of Functioning, Disability and Health. Of the concepts linked to the International Classification of Functioning, Disability and Health, body functions accounted for 34.7%, body structures accounted for 0%, activities and participation accounted for 41%, environmental factors accounted for 3.6%, and personal factors accounted for 16%. Most items used to measure functioning and disability in low back pain patient treated with manual medicine focus on body functions, as well as activities and participation. The lack of measures that address environmental factors warrants further investigation. KW - Low Back Pain KW - International Classification of Functioning, Disability, and Health KW - Musculoskeletal Manipulations KW - Disability Evaluation Y1 - 2021 UR - https://doi.org/10.1097/PHM.0000000000001636 VL - 100 IS - 4 SP - 367 EP - 395 ER - TY - JOUR A1 - Nicol, R A1 - Yu, H A1 - Selb, M A1 - Prodinger, Birgit A1 - Hartvigsen, J A1 - Côté, P T1 - How does the measurement of disability in low back pain map unto the International Classification of Functioning, Disability and Health (ICF)? A scoping review of the manual medicine literature JF - American Journal of Physical Medicine and Rehabilitation N2 - The objective of this study was to catalogue items from instruments used to measure functioning, disability, and contextual factors in patients with low back pain (LBP) treated with manual medicine (manipulation and mobilization) according to the International Classification of Functioning, Disability and Health (ICF). This catalogue will be used to inform the development of an ICF-based assessment schedule for LBP patients treated with manual medicine. In this scoping review we systematically searched MEDLINE, Embase, PsycINFO and CINAHL. We identified instruments (questionnaires, clinical tests, single questions) used to measure functioning, disability and contextual factors, extracted the relevant items and then linked these items to the ICF. We included 95 articles and identified 1510 meaningful concepts. All but 70 items were linked to the ICF. Of the concepts linked to the ICF, body functions accounted for 34.7%, body structures accounted for 0%, activities and participation accounted for 41%, environmental factors accounted for 3.6%, and personal factors accounted for 16%. Most items used to measure functioning and disability in LBP patient treated with manual medicine focus on body functions, and activities and participation. The lack of measures that address environmental factors warrants further investigation. KW - Low back pain , International Classification of Functioning , Disability and Health , Musculoskeletal Manipulations , Disability Evaluation Y1 - 2020 UR - https://doi.org/10.1097/PHM.0000000000001636 VL - Online ahead of print. ER - TY - JOUR A1 - Prodinger, Birgit A1 - Coenen, M A1 - Hammond, A A1 - Küçükdeveci, AA A1 - Tennant, A T1 - Scale-Banking for Patient Reported Outcome Measures (PROMs) Measuring Functioning in Rheumatoid Arthritis: A Daily Activities Metric JF - Arthritis Care & Research N2 - Objective: Functioning is an important outcome for rheumatoid arthritis (RA) management. Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability. Methods: Common Item Non-Equivalent Groups Design (NEAT) with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (incl. UK, Turkey and Germany) to establish a common metric. Other PROMs included are the Physical Function items of the Multidimensional Health Assessment Questionnaire (MDHAQ), Disabilities of Arm, Shoulder and Hand (DASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0), and four short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System (PROMIS). As the HAQ includes mobility, self-care and domestic life items, this study focuses on these three domains. PROMs were described using Standard Error of Measurement (SEM) and Smallest Detectable Difference (SDD). Rasch Measurement model was used to create the common metric. Results: Range of SEM is 0.2 (MDHAQ) to 7.4 (SF36-PF). SDD revealed a range from 9.7 % (WOMAC-RAT) to 33.5 % (WHODAS-PF). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROMs scores. Discussion: Scores between the Daily Activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help determine choice of PROM in clinical practice and research. Keywords: Common metric; DASH; Disability and Health; HAQ; International Classification of Functioning; Multidimensional HAQ; PROMIS-SF; Rasch measurement model; Scale banking; WHODAS 2.0; WOMAC. KW - Common metric; DASH; Disability and Health; HAQ; International Classification of Functioning; Multidimensional HAQ; PROMIS-SF; Rasch measurement model; Scale banking; WHODAS 2.0; WOMAC. Y1 - 2020 UR - https://doi.org/10.1002/acr.24503 VL - Online ahead of print ER - TY - JOUR A1 - Stanley, Mandy A1 - Rogers, Sandra A1 - Forwell, Sue A1 - Hocking, Clare A1 - Nayar, Shoba A1 - Laliberte Rudman, Debbie A1 - Prodinger, Birgit A1 - Farias Vera, Lisette A1 - Townsend, Elizabeth A1 - Magalhães, Lilian A1 - Simaan, Juman A1 - Reid, Heleen A1 - Pols, Vee T1 - A Pledge to Mobilize Against Racism JF - Journal of Occupational Science KW - against racism Y1 - 2020 N1 - Position statement VL - 27 IS - s1 SP - 294 EP - 295 ER - TY - JOUR A1 - Maritz, Roxanne A1 - Tennant, Alan A1 - Fellinghauer, Carolina A1 - Stucki, Gerold A1 - Prodinger, Birgit T1 - Creating a common metric based on existing activities of daily living tools to enable standardized reporting of functioning outcomes achieved during rehabilitation JF - Journal of Rehabilitation Medicine N2 - Objective: Many different assessment tools are used to assess functioning in rehabilitation; this limits the comparability and aggregation of respective data. The aim of this study was to outline the development of an International Classification of Functioning, Disability and Health (ICF)-based interval-scaled common metric for 2 assessment tools assessing activities of daily living: the Functional Independence Measure (FIMTM) and the Extended Barthel Index (EBI), used in Swiss national rehabilitation quality reports. Methods: The conceptual equivalence of the 2 tools was assessed through their linking to the ICF. The Rasch measurement model was then applied to create a common metric including FIMTM and EBI. Subjects: Secondary analysis of a sample of 265 neurological patients from 5 Swiss clinics. Results: ICF linking found conceptual coherency of the tools. An interval-scaled common metric, including FIMTM and EBI, could be established, given fit to the Rasch model in the related analyses. Conclusion: The ICF-based and interval-scaled common metric enables comparison of patients and clinics functioning outcomes when different activities of daily living tools are used. The common metric can be included in a Standardized Assessment and Reporting System for functioning information in order to enable data aggregation and comparability. Keywords: Barthel Index; Functional Independence Measure; Rasch Measurement Model; activities of daily living; outcome assessment (healthcare); psychometrics; quality in healthcare; rehabilitation. KW - Barthel Index; Functional Independence Measure; Rasch Measurement Model; activities of daily living; outcome assessment (healthcare); psychometrics; quality in healthcare; rehabilitation. Y1 - 2020 UR - https://doi.org/10.2340/16501977-2711 VL - 52 IS - 7 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Küçükdeveci, AA A1 - Kutlay, S A1 - Elhan, AH A1 - Kreiner, S A1 - Tennant, A T1 - Cross-diagnostic scale-banking using Rasch analysis: Developing a common reference metric for generic and health condition-specific scales in people with rheumatoid arthritis and stroke. JF - Journal of Rehabilitation Medicine N2 - Abstract Objectives: To develop a common reference metric of functioning, incorporating generic and health condition-specific disability instruments, and to test whether this reference metric is invariant across 2 health conditions. Design: Psychometric study using secondary data analysis. Firstly, the International Classification of Functioning, Disability and Health (ICF) Linking Rules were used to examine the concept equivalence between the World Health Organization Disability Assessment Schedule (WHODAS 2.0), Health Assessment Questionnaire (HAQ), and Functional Independence Measure (FIMTM). Secondly, a scale-bank was developed using a reference metric approach to test-equating, based on the Rasch measurement model. Participants: Secondary analysis was performed on data from 487 people; 61.4% with rheumatoid arthritis and 38.6% with stroke. Results: Three sub-domains of the WHODAS 2.0 and all items of the HAQ and FIMTM motor mapped on to the ICF chapters d4 Mobility, d5 Self-care and d6 Domestic life. Test-equating of these scales resulted in good model fit, indicating that a scale bank and associated reference metric across these 3 instruments could be created. Conclusion: This study provides a transformation table to enable direct comparisons among instruments measuring physical functioning commonly used in rheumatoid arthritis (HAQ) and stroke (FIMTM motor scale), as well as in people with disability in general (WHODAS 2.0). Keywords: FIM; Functional Independence Measure; HAQ; Health Assessment Questionnaire; WHODAS 2.0; World Health Organization Disability Assessment Schedule; outcome assessment; rheumatoid arthritis; stroke; psychometrics. KW - FIM; Functional Independence Measure; HAQ; Health Assessment Questionnaire; WHODAS 2.0; World Health Organization Disability Assessment Schedule; outcome assessment; rheumatoid arthritis; stroke; psychometrics. Y1 - 2020 UR - https://doi.org/10.2340/16501977-2736 ER - TY - JOUR A1 - Peter, C. A1 - Schulenberg, S. E. A1 - Buchanan, E. M. A1 - Prodinger, Birgit A1 - Geyh, S. T1 - Rasch analysis of measurement instruments capturing psychological personal factors in persons with spinal cord injury JF - Journal of Rehabilitation Medicine N2 - Objective: To evaluate the metric properties of distinct measures of psychological personal factors comprising feelings, beliefs, motives, and patterns of experience and behaviour assessed in the Swiss Spinal Cord Injury Cohort Study (SwiSCI), using Rasch methodology. Methods: SwiSCI Pathway 2 is a community-based, nationwide, cross-sectional survey for persons with spinal cord injury (SCI) (n = 511). The Rasch partial credit model was used for each subscale of the Positive Affect Negative Affect Scale (PANAS), Appraisal of Life Events Scale (ALE), Purpose in Life test – Short Form (PIL-SF), and the Big Five Inventory-K (BFI-K). Results: The measures were unidimensional, with the exception of the positive affect items of the PANAS, where pairwise t-tests resulted in 10% significant cases, indicating multidimensionality. The BFI-K subscale agreeableness revealed low reliability (0.53). Other reliability estimates ranged between 0.61 and 0.89. Ceiling and floor effects were found for most measures. SCI-related differential item functioning (DIF) was rarely found. Language DIF was identified for several items of the BFI-K, PANAS and the ALE, but not for the PIL-SF. Conclusion: A majority of the measures satisfy the assumptions of the Rasch model, including unidimensionality. Invariance across language versions still represents a major challenge. KW - psychological factors KW - personality KW - affect KW - spinal cord injury KW - validity KW - reliability KW - psychometrics Y1 - 2016 UR - http://dx.doi.org/10.2340/16501977-2028 VL - 48 IS - 2 SP - 175 EP - 188 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Cieza, A. A1 - Williams, D.A. A1 - Mease, P. A1 - Boonen, A. A1 - Kerschan-Schindl, K. A1 - Fialka-Moser, V. A1 - Smolen, J. A1 - Stucki, G. A1 - Machold, K. A1 - Stamm, T. T1 - Measuring health in patients with fibromyalgia: Content comparison of questionnaires based on the International Classification of Functioning, Disability and Health (ICF) JF - Arthritis Care & Research N2 - Objective To analyze the content of outcome measures commonly used to assess health in patients with fibromyalgia (FM) by linking the items of the instruments with the International Classification of Functioning, Disability and Health (ICF) in order to evaluate the adequacy of currently used measures. Methods Questionnaires used in FM were identified in a structured literature search. All concepts included in the items of the questionnaires were linked to ICF categories, according to previously published linking rules, by 2 independent health professionals. The percentages of linked ICF categories addressing the different ICF components were calculated. Results Generic and symptom‐specific instruments were included. From the 296 items contained in all 16 instruments, 447 concepts were extracted and then linked to 52 ICF categories of the component body functions, 1 category of the component body structure, 40 categories of the component activities and participation, and 9 categories of the component environmental factors. More than half of the concepts identified were linked to body function, fewer were linked to activities and participation, and only concepts of 4 instruments were linked to the ICF component environmental factors. Conclusion Many concepts were linked to the categories in the ICF component body functions. While linking to the broad category, purportedly similar instruments often covered widely varying areas of function at more fine‐grained levels of detail. Some categories, such as environmental factors, were barely covered by any of the instruments and might constitute an important aspect of health deserving better coverage and future development. KW - fibromyalgia Y1 - 2008 UR - https://doi.org/10.1002/art.23559 VL - 59 IS - 5 SP - 650 EP - 658 ER - TY - JOUR A1 - Krieger, B. A1 - Kinébanian, A. A1 - Prodinger, Birgit A1 - Heigl, F. T1 - Becoming a member of the work force - Perceptions of adults with Asperger Syndrome JF - WORK N2 - Objective: Research has shown that comparatively few adults with Asperger Syndrome (AS) participate in the competitive work force. The purpose of this study was to gain in-depth knowledge about contextual factors, which contribute to successful labor market participation in some adults with AS. Participants: This study was conducted by indepth-interviewing six adults with AS working in the competitive job market in Switzerland. Methods: A developmental and hermeneutic narrative approach was used for data collection and analysis. Two in-depth narrative interviews were conducted with each participant. A narrative analysis according to the theories of Paul Ricoeur was performed. Results: Results showed that participants received pre-vocational requisites during their childhood through parents and friends that provided a feeling of security in social contexts. For participants, a supportive school setting resulted in academic achievements. The narratives reveal participants' capacities for understanding and adapting to social norms. Participants' understanding of their own needs was essential to the successful labor market participation. However, disclosure is rare and social stigma is still present. Conclusions: This study showed that successful labor participation of adults with AS can be enhanced through adequate social support already in the early stages of an individual's lifetime. KW - Pervasive developmental disorder KW - competitive work KW - biographic narrative KW - pre-vocational requisites KW - occupational therapy Y1 - 2012 UR - https://doi.org/10.3233/WOR-2012-1392 VL - 43 IS - 2 SP - 141 EP - 157 ER - TY - JOUR A1 - Dür, M. A1 - Binder, A. A1 - Sadloňová, M. A1 - Haider, S. A1 - Stoffer, M. A1 - Smolen, J. A1 - Dejaco, C. A1 - Kautzky-Willer, A. A1 - Prodinger, Birgit A1 - Fialka-Moser, V. A1 - Lovelock, L. A1 - Stamm, T.A. T1 - UPDATE: Life stories and laboratory parameters - the FWF funded GOBI study JF - Wiener Medizinische Wochenschrift KW - GOBI study Y1 - 2012 IS - 12 SP - 10 EP - 13 ER - TY - JOUR A1 - Carrier, A. A1 - Prodinger, Birgit T1 - Visions of possibility: Using institutional ethnography as a theory and method for understanding contexts and their ruling relations JF - Occupational Therapy Now KW - Occupational Therapy KW - institutional ethnography Y1 - 2014 VL - 16 IS - 2 SP - 18 EP - 21 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Shaw, L. A1 - Stamm, T. A1 - Rudman, D. L. T1 - Enacting occupation-based practice: Exploring the disjuncture between everyday life of mothers with rheumatoid arthritis (RA) and institutional processes JF - British Journal of Occupational Therapy N2 - Introduction: Occupation-based approaches are a hallmark of excellence in occupational therapy practice. This article focuses on the disjuncture between how women with rheumatoid arthritis go about their daily lives, that is to say their occupations, and what is addressed during routine visits at a specialized rheumatology outpatient clinic. Method: Institutional ethnography was employed as a method of inquiry to identify the occupations and related issues that were or were not accounted for in health records and addressed within institutional processes. Interviews and participant observations were conducted with seven women with rheumatoid arthritis who were mothers. Hospital records were analysed as texts mediating between the women's daily lives and the rheumatology outpatient clinic. Findings: The analysis revealed that despite the diversity in the ways that the women managed their daily lives, the things that they did were viewed, understood, and addressed only within the boundaries of the standardizing relations that ruled practice in this clinical setting. Institutional processes grounded in biomedical concepts such as functional status or disease activity, as well as clinical assessments that depict these concepts, both shape and limit opportunities for occupational therapists to advance and enact occupation-based practice. Conclusion: In this setting, the complexity of the participants' daily lives and the occupations they engage in remain unaddressed. KW - Rheumatoid arthritis KW - assessment KW - occupation Y1 - 2014 UR - https://doi.org/10.4276/030802214X14122630932359 VL - 77 IS - 10 SP - 491 EP - 498 ER - TY - JOUR A1 - Maritz, R. A1 - Baptiste, S. A1 - Darzins, S. W. A1 - Magasi, S. A1 - Weleschuk, C. A1 - Prodinger, Birgit T1 - Linking occupational therapy models and assessments to the ICF to enable standardized documentation of functioning JF - Canadian Journal of Occupational Therapy N2 - Background The International Classification of Functioning, Disability and Health (ICF) can serve as reference for standardized documentation of health in clinical practice. Purpose This study aims to bridge the gap between the ICF and occupational therapy specific concepts, represented by occupational therapy models and their derived assessments. Method Occupational therapy assessments in relation to their models were systematically linked to the ICF, and a compatibility analysis was conducted. To strengthen reliability of the linkings, feedback from the respective assessment hosts was obtained. Findings Linking tables were developed for the Assessment of Motor and Process Skills, the Canadian Occupational Performance Measure, and the Model of Human Occupation Screening Tool. Similarities and differences between the ICF and the three assessments and their associated models show how they differ from and complement each other. Implications The findings of this study lay the foundation for standardized documentation in occupational therapy and enhance the practicability of the ICF. KW - Assessment KW - Documentation KW - International Classification of Functioning, Disability and Health KW - Standardization KW - Theory Classification internationale du fonctionnement, handicap et santé KW - Documentation KW - Évaluation KW - Standardisation KW - Théorie Y1 - 2018 UR - https://doi.org/10.1177/0008417418797146 VL - 85 IS - 4 SP - 330 EP - 341 ER - TY - JOUR A1 - Hopfe, M. A1 - Prodinger, Birgit A1 - Bickenbach, J. E. A1 - Stucki, G. T1 - Optimizing health systems response to patient’s needs: An argument for the importance of functioning information JF - Disability and Rehabilitation N2 - Background: Current health systems are increasingly challenged to meet the needs of a growing number of patients living with chronic and often multiple health conditions. The primary outcome of care, it is argued, is not merely curing disease but also optimizing functioning over a person’s life span. According to the World Health Organization, functioning can serve as foundation for a comprehensive picture of health and augment the biomedical perspective with a broader and more comprehensive picture of health as it plays out in people’s lives. The crucial importance of information about patient’s functioning for a well-performing health system, however, has yet to be sufficiently appreciated. Methods: This paper argues that functioning information is fundamental in all components of health systems and enhances the capacity of health systems to optimize patients’ health and health-related needs. Results and conclusion: Beyond making sense of biomedical disease patterns, health systems can profit from using functioning information to improve interprofessional collaboration and achieve cross-cutting disease treatment outcomes. - Implications for rehabilitation - Functioning is a key health outcome for rehabilitation within health systems. - Information on restoring, maintaining, and optimizing human functioning can strengthen health system response to patients’ health and rehabilitative needs. - Functioning information guides health systems to achieve cross-cutting health outcomes that respond to the needs of the growing number of individuals living with chronic and multiple health conditions. - Accounting for individuals functioning helps to overcome fragmentation of care and to improve interprofessional collaboration across settings KW - Health systems KW - health service delivery KW - rehabilitation services KW - functioning information KW - patient’s needs KW - fragmentation of care Y1 - 2018 UR - https://doi.org/10.1080/09638288.2017.1334234 VL - 40 IS - 19 SP - 2325 EP - 2330 ER - TY - JOUR A1 - Liu, S. A1 - Reinhardt, J. D. A1 - Zhang, X. A1 - Ehrmann, C. A1 - Cai, W. A1 - Prodinger, Birgit A1 - Liu, S. A1 - Li, J. T1 - System-wide Clinical Assessment of Functioning Based on the International Classification of Functioning, Disability and Health in China: Interrater Reliability, Convergent, Known Group, and Predictive Validity of the ICF Generic-6 JF - Archives of Physical Medicine and Rehabilitation N2 - Objective To validate the International Classification of Functioning, Disability and Health (ICF) Generic-6 in daily routine clinical practice in Mainland China. Specific objectives were to analyze (1) interrater reliability, (2) convergent validity, (3) known group validity, and (4) predictive validity of the ICF Generic-6. Design Multicenter prospective cohort study. Setting Fifty hospitals from 20 provinces of Mainland China. Participants A total of 4510 patients from departments of rehabilitation, orthopedics, neurology, cardiology, pneumology, and cerebral surgery of the participating hospitals with different health conditions were included in this study. Intervention Not applicable. Main Outcome Measures The assessment was undertaken by nurses with ICF Generic-6 in combination with a numeric rating scale. Interrater reliability was evaluated with intraclass correlation coefficients (ICC). Convergent validity was evaluated with Spearman correlation coefficients between ICF Generic-6 and Medical Outcomes Short Form (SF)-12 items. Known group validity was examined by comparing discharge scores between different discharge destinations. Predictive validity was determined by using ICF Generic-6 baseline scores for estimating length of hospital stay with a loglogistic survival model with gamma shared frailty and cost of in-hospital treatment with a mixed effects generalized linear regression model of the gamma family. Results The interrater reliability of items and score of ICF Generic-6 was good with ICCs ranging from 0.67-0.87. ICF Generic-6 items were further correlated with respective SF-12 items. Discharge scores of patients differed significantly by discharge destination. The ICF Generic-6 admission score was a significant predictor of length of stay and treatment cost. Conclusions The ICF Generic-6 administered in combination with a 0-10 numeric rating scale is a reliable and valid tool for the collection of minimal information on functioning across various clinical settings. KW - International Classification of Functioning KW - Disability and Health KW - Rehabilitation KW - Reproducibility of results Y1 - 2019 UR - https://doi.org/10.1016/j.apmr.2018.11.014 VL - 100 IS - 8 SP - 1450 EP - 1457 ER - TY - JOUR A1 - Ehrmann, C. A1 - Prodinger, Birgit A1 - Stucki, G. A1 - Cai, W. A1 - Zhang, X. A1 - Liu, S. A1 - Liu, S. A1 - Li, J. A1 - Reinhardt, J. D. T1 - ICF Generic Set as new standard for the system wide assessment of functioning in China: a multicentre prospective study on metric properties and responsiveness applying item response theory JF - BMJ Open N2 - Objectives: To examine metric properties and responsiveness of the International Classification of Functioning, Disability and Health (ICF) Generic Set when used in routine clinical practice to assess functioning. Design: Prospective multicentre study. Setting: 50 hospitals from 20 provinces of Mainland China. Participants: 4510 adult inpatients admitted to the departments of Pulmonology, Cardiology, Neurology, Orthopaedics, Cerebral Surgery or Rehabilitation Medicine. Main outcome measures: The ICF Generic Set (ICF Generic 6 Set) applied with an 11-point numeric rating scale (0-no problem to 10-complete problem) was fit to the Partial Credit Model (PCM) to create an interval score of functioning. Results: PCM assumptions were found to be fulfilled after accounting for Differential Item Functioning. With an average improvement by 7.86 points of the metric ICF Generic 6 score (95% CI 7.53 to 8.19), the ICF Generic 6 Set proved sensitive to change (Cohen’s f2=0.41). Ceiling and floor effects on detecting change in functioning were cancelled or reduced by using the metric score. Conclusion: The ICF Generic 6 Set can be used for the assessment of functioning in routine clinical practice and an interval score can be derived which is sensitive to change. KW - International Classification of Functioning, Disability and Health (ICF) Y1 - 2018 UR - https://doi.org/10.1136/bmjopen-2018-021696 VL - 8 IS - 12 SP - e021696 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stucki, G. A1 - Coenen, M. A1 - Tennant, A. T1 - The measurement of functioning using the International Classification of Functioning, Disability and Health: comparing qualifier ratings with existing health status instruments JF - Disability and Rehabilitation N2 - Background: The International Classification of Functioning, Disability and Health is the international standard for describing and monitoring functioning. While the categories, the units of the classification, were not designed with measurement in mind, the hierarchical structure of the classification lends itself to the possibility of summating categories into some higher order domain. Focusing on the chapters of d4 Mobility, d5 Self-Care and d6 Domestic Life, this study seeks to ascertain if qualifiers rating of categories (0-No problem to 4-Complete problem) within those chapters can be summated, and whether such derived measurement is consistent with estimates obtained from well-known instruments which purport to measure the same constructs. Methods: The current study applies secondary analysis to data previously collected in the context of validating Core Sets for stroke, rheumatoid arthritis, and osteoarthritis. Data included qualifier-based ratings of the categories in the Core Sets, and the physical functioning sub-scale of the Short-Form 36, and the World Health Organization Disability Assessment Schedule 2.0. To examine qualifier-comparator scale item agreement Kappa statistics were used. To identify whether appropriate gradients of the comparator scales were observed across qualifier levels, an Independent Sample Median Test of the ordinal scores was deployed. To investigate the internal validity of the summated ICF categories, the Rasch model was applied. Results: Data from 2,927 subjects from Europe, Australasia, Middle East and South America were available for analysis; 36.3% had experienced a stroke, 35.8% osteoarthritis, and 27.9% had rheumatoid arthritis. The items from the Short-Form 36 could not match directly the qualifier categories as the former had only 3 response options. The Kappa between World Health Organization Disability Assessment Schedule 2.0 items and categories was low. For all qualifiers, a significant (<0.001) overall gradient was observed across the comparator scales. Only in few of the World Health Organization Disability Assessment Schedule 2.0 items could no discrete level be detected. The aggregation of the qualifiers at the Chapter and higher order levels mostly revealed fit to the Rasch model. Almost all ICF qualifiers showed ordered thresholds suggesting that the current structure and response options of the qualifiers worked as intended. Conclusions: The findings of this study provide supporting evidence for the use of the professionally rated categories and associated qualifiers to measure functioning. Implication for Rehabilitation - This study provides evidence that functioning data can be collected directly with the International Classification of Functioning, Disability and Health (ICF) by using the ICF categories as items and the ICF qualifiers as rating scale. - The findings of this study show the aggregated ratings of ICF categories from the chapters d4 Mobility, d5 Self-care, and d6 Domestic life capture a broader spectrum of the construct than the corresponding summated items from the SF36-Physical Function sub-scale and the corresponding items of the World Health Organization Disability Assessment Schedule 2.0. - This study illustrates the potential of building quantitative measurement by aggregating ICF categories and their qualifier ratings into meaningful domains. KW - ICF KW - health status KW - Rasch model KW - outcome measure KW - WHODAS 2.0 KW - SF-36 Y1 - 2019 UR - https://doi.org/10.1080/09638288.2017.1381186 VL - 41 IS - 5 SP - 541 EP - 548 ER - TY - JOUR A1 - Dorjbal, D. A1 - Prodinger, Birgit A1 - Zanini, C. A1 - Avirmed, B. A1 - Stucki, G. A1 - Rubinelli, S. T1 - Living with spinal cord injury in Mongolia: A qualitative study on perceived environmental barriers JF - Journal of Spinal Cord Medicine N2 - Context: Environmental factors play a key role in the lives of individuals with a spinal cord injury (SCI). This study identifies environmental barriers and their impacts on daily lives as perceived by individuals living with SCI in Mongolia. Design: A qualitative study with semi-structured interviews was conducted. A topic guide for the interviews was structured around the components of the International Classification of Functioning, Disability, and Health. Setting: Urban and rural areas of Mongolia. Participants: A purposive sample of 16 persons with traumatic SCI. Interventions: Not applicable. Outcome Measures: Not applicable. Results: Seven categories of environmental barriers were mentioned, such as poor access to the physical environment, absence of wheelchair-friendly transportation, negative societal attitudes, inadequate health and rehabilitation services, lack of access to assistive devices and medicines, limited financial resources for healthcare, and inaccurate categorization of disabilities in laws. These barriers were claimed to have an impact on physical and psychological health, limit activities, and restrict participation in almost all areas of life. Conclusion: This study contributes to the identification of targets for interventions aimed at improving the lived experience of persons with SCI in a low-resource context. The findings reveal that while the Mongolian government already has laws and policies in place to improve access to the physical environment, transportation, assistive devices and employment, much more has to be done in terms of enforcement. Specialized SCI care and rehabilitation services are highly demanded in Mongolia. KW - Lived experience KW - Developing country KW - International Classification of Functioning, Disability, and Health KW - Semi-structured interviews KW - Person-centeredness KW - Rehabilitation services Y1 - 2020 UR - https://doi.org/10.1080/10790268.2019.1565707 VL - 43 IS - 4 SP - 518 EP - 531 ER - TY - JOUR A1 - Maritz, R. A1 - Tennant, A. A1 - Fellinghauer, C. A1 - Stucki, G. A1 - Prodinger, Birgit T1 - The Functional Independence Measure 18-item version can be reported as a unidimensional interval-scaled metric: Internal construct validity revisited JF - Journal of Rehabilitation Medicine N2 - Abstract Objective: Since the 1990s the Functional Independence Measure (FIM™) was believed to measure 2 different constructs, represented by its motor and cognitive subscales. The practice of reporting FIM™ total scores, together with recent developments in the understanding of the influence of locally dependent items on fit to the Rasch model, raises the question of whether the FIM™ 18-item version can be reported as a unidimensional interval-scaled metric. Design: Rasch analysis of the FIM™ using testlet approaches to accommodate local response dependency. Patients: A calibration sample containing 946 cases of data from 11,103 patients undergoing neurological or musculoskeletal rehabilitation in Switzerland in 2016. Results: Baseline analysis and the traditional testlet approach showed no fit with the Rasch model. When items were grouped into 2 testlets, fit to the Rasch model was achieved, indicating unidimensionality across all 18 items. A transformation table to convert FIM™ raw ordinal scores to the corresponding Rasch interval scaled values was created. Conclusion: This study provides evidence that FIM™ total scores represent a unidimensional set of items, supporting their use in clinical practice and outcome reporting when applying the respective transformation table. This provides a basis for standardized reporting of functioning. Lay Abstract The aim of this study was to look in detail at the FIM™, an assessment tool often used for patients undergoing rehabilitation. Some users report the FIM™ as 2 scores: one related to motor tasks, the other to cognitive tasks; others recommend reporting it as a single score including both motor and cognitive tasks. This study explored whether it is statistically meaningful to sum all the points into a single FIM™ total score. The results support the current practice of summing the points into a single total score for patients undergoing musculo-skeletal and neurological rehabilitation. The results also allowed an interval scale to be derived from the FIM™, enabling a broad range of calculations to be made using the FIM™ score, such as calculating the change in FIM™ outcomes from the time a patient is admitted to a rehabilitation clinic until their discharge. KW - Functional Independence Measure Y1 - 2019 UR - https://doi.org/10.2340/16501977-2525 VL - 51 IS - 3 SP - 193 EP - 200 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Hammond, A. A1 - Tennant, A. A1 - Prior, Y. A1 - Tyson, S. T1 - Revisiting the disabilities of the arm, shoulder and hand (DASH) and QuickDASH in rheumatoid arthritis JF - BMC Musculoskeletal Disorder N2 - Background Limitations in upper limb functioning are common in Musculoskeletal disorders and the Disabilities of the Arm, Shoulder and Hand scale (DASH) has gained widespread use in this context. However, various concerns have been raised about its construct validity and so this study seeks to examine this and other psychometric aspects of both the DASH and QuickDASH from a modern test theory perspective. Methods Participants in the study were eligible if they had a confirmed diagnosis of Rheumatoid Arthritis (RA). They were mailed a questionnaire booklet which included the DASH. Construct validity was examined by fit to the Rasch measurement model. The degree of precision of both the DASH and QuickDASH were considered through their Standard Error of Measurement (SEM). Results Three hundred and thirty-seven subjects with confirmed RA took part, with a mean age of 62.0 years (SD12.1); 73.6% (n = 252) were female. The median standardized score on the DASH was 33 (IQR 17.5–55.0). Significant misfit of the DASH and QuickDASH was observed but, after accommodating local dependency among items in a two-testlet solution, satisfactory fit was obtained, supporting the unidimensionality of the total sets and the sufficiency of the raw (ordinal or standardized) scores. Conclusion Having accommodated local response dependency in the DASH and QuickDASH item sets, their total scores are shown to be valid, given they satisfy the Rasch model assumptions. The Rasch transformation should be used whenever all items are used to calculate a change score, or to apply parametric statistics within an RA population. Significance and innovations Most previous modern psychometric analyses of both the DASH and QuickDASH have failed to fully address the effect of a breach of the local independence assumption upon construct validity. Accommodating this problem by creating ‘super items’ or testlets, removes this effect and shows that both versions of the scale are valid and unidimensional, as applied with a bi-factor equivalent solution to an RA population. The Standard Error of Measurement of a scale can be biased by failing to take into account the local dependency in the data which inflates reliability and thus making the SEM appear better (i.e. smaller) than the true value without bias. KW - disabilities of the arm, shoulder and hand Y1 - 2019 UR - https://doi.org/10.1186/s12891-019-2414-6 VL - 20 IS - 1 SP - 41 ER - TY - JOUR A1 - Maritz, R. A1 - Tennant, A. A1 - Fellinghauer, C. A1 - Stucki, G. A1 - Prodinger, Birgit T1 - The Extended Barthel Index (EBI) can Be Reported as a Unidimensional Interval-Scaled Metric – A Psychometric Study JF - Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin N2 - Background: The Extended Barthel Index (EBI), consisting of the original Barthel Index plus 6 cognitive items, provides a tool to monitor patients’ outcomes in rehabilitation. Whether the EBI provides a unidimensional metric, thus can be reported as a valid sum-score, remains to be examined. Objective: To examine whether the EBI can be reported as unidimensional interval-scaled metric for neurological and musculoskeletal rehabilitation. Methods: Rasch analysis of a calibration sample of 800 cases from neurological or musculoskeletal rehabilitation in 2016 in Switzerland. Results: In the baseline analysis no fit to the Rasch Model was achieved. When accommodating local dependencies with a testlet approach satisfactory fit to the Rasch Model was achieved, and an interval scale transformation table was created. Conclusion: The results support the reporting of adapted EBI total scores for both rehabilitation groups by applying the interval scaled transformation table presented in this study. N2 - Hintergrund: Der Erweiterte Barthel Index (EBI), der den Barthel Index um 6 kognitive Items ergänzt, ist ein Assessmentinstrument für die Rehabilitation. Ob der EBI eine eindimensionale Metrik liefert und somit als valider Gesamtscore berichtet werden kann, ist unklar. Ziel: Untersuchung ob der EBI für die neurologische und muskuloskelettale Rehabilitation als eindimensionale intervallskalierte Metrik berichtet werden kann. Methode: Rasch-Analyse einer Stichprobe von 800 neurologischen und muskuloskelettalen Rehapatienten aus der Schweiz. Ergebnisse: In der Basisanalyse wurde keine Übereinstimmung mit den Annahmen des Rasch-Modells erreicht. Nachdem lokale Item-Abhängigkeiten mit 2 Testlets angepasst wurden, wurde die Übereinstimmung erreicht und eine intervallskalierte Transformationstabelle erstellt. Konklusion: Die Ergebnisse unterstützen die Verwendung eines angepassten EBI Gesamtscores für beide Rehabilitationsgruppen unter Anwendung der intervallskalierten Transformationstabelle. KW - activities of daily living KW - assessment instruments KW - outcome assessment KW - rehabilitation KW - Rasch model KW - quality management Y1 - 2019 UR - https://doi.org/10.1055/a-0820-4642 VL - 29 IS - 04 SP - 224 EP - 232 ER - TY - JOUR A1 - Maritz, R. A1 - Pongpipatpaiboon, K. A1 - Melvin, J.L. A1 - Graves, D.E. A1 - Prodinger, Birgit T1 - Content comparison of the Spinal Cord Injury Model System Database to the ICF Generic Sets and Core Sets for spinal cord injury JF - Spinal Cord N2 - Study design Mapping of the National Spinal Cord Injury Model System (SCIMS) Database (NSCID) to the International Classification of Functioning, Disability and Health (ICF). Objectives To link the content of the latest two versions of the NSCID to the ICF; more specifically (1) to compare the content of the current NSCID 2016–2021 version to its predecessor (NSCID 2011–2016) using the ICF as a neutral reference framework, and (2) to compare the content contained in the NSCID 2016–2021 version with relevant ICF Sets. Setting The forms of the NSCID 2016–2021 and 2011–2016 versions were linked to the ICF and contrasted. Comparability of the current version of the NSCID with the ICF Core Set for Spinal Cord Injury (SCI) in the post-acute and long-term context and the two generic ICF sets— ICF Generic-7 and ICF Generic-30 was then examined. Methods ICF Linking Rules and descriptive statistics. Results The current NSCID 2016–2021 version covers functioning as classified in the ICF with 8 ICF categories more comprehensively than its predecessor does. More than 50% of ICF categories contained in the two ICF Generic Sets were covered. The coverage of the brief ICF Core Sets for SCI by the NSCID 2016–2021 was more than 50%, but the coverage of the comprehensive core sets was low. Results showed the best coverage in the ICF component Activities and Participation. Conclusions This study emphasizes how the ICF and its Sets can serve as a reference framework to foster comparability of existing data sets from both clinical practice and research. KW - Rehabilitation KW - Spinal cord injury Y1 - 2019 UR - https://doi.org/10.1038/s41393-019-0326-9 VL - 57 IS - 12 SP - 1023 EP - 1030 ER - TY - JOUR A1 - Mukaino, M. A1 - Prodinger, Birgit A1 - Okouchi, Y. A1 - Mizutani, K. A1 - Senju, Y. A1 - Suzuki, M. A1 - Saitoh, E. T1 - Development and assessment of a home environment checklist to evaluate mismatch between patients' ability and home environment JF - Annals of Physical and Rehabilitation Medicine N2 - 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. KW - ICF KW - Environmental factors KW - Activities of daily living Y1 - 2020 UR - https://doi.org/10.1016/j.rehab.2019.09.004 VL - 63 IS - 4 SP - 288 EP - 295 ER - TY - JOUR A1 - Devi, N. A1 - Prodinger, Birgit A1 - Pennycott, A. A1 - Sooben, R. A1 - Bickenbach, J. T1 - Investigating Supported Decision‐Making for Persons With Mild to Moderate Intellectual Disability Using Institutional Ethnography JF - Journal of Policy and Practice in Intellectual Disabilities N2 - Making one's own choices is an important part of leading a fulfilling life within society. However, people with IDs often face significant obstacles when making their own decisions. Article 12 (Equal recognition before the law) of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) aims to ensure firstly that people with IDs and others with compromised capacity are nonetheless recognized as legal individuals, and secondly that assistance is provided in the form of supported decision‐making in order to exercise this resulting legal capacity. It is unclear whether current national legislation in any country satisfies these requirements in practice. This study utilizes institutional ethnography to reveal how decision‐making is coordinated in practice for people with mild to moderate IDs living in supported residential environments in England, and to determine whether these processes are compliant with Article 12 of the CRPD. Data collection was based on observations, semi‐structured interviews, and documentary analysis, involving 29 participants including people with mild to moderate IDs. The results point to the complexity of supported decision‐making and identify three main categories of decision‐making: spontaneous decisions, mid‐term decisions, and strategic decisions. The data also show that people with mild to moderate IDs are able to exercise their legal capacity through support decision‐making in their everyday life. Immediate and informal supported decision‐making exists in daily practice for people with mild to moderate IDs living in supported residential environments. Although there are structures in place for implementing supported decision‐making, various barriers persist that limit the overall efficacy and consistency of the realization of supported decision‐making, for example, multiple use of mental capacity assessments. Such practices move away from the supported decision‐making model toward substituted decision‐making. KW - Institutional Ethnography KW - Intellectual Disability Y1 - 2020 UR - https://doi.org/10.1111/jppi.12314 VL - 17 IS - 2 SP - 143 EP - 156 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Tennant, A. A1 - Stucki, G. T1 - Standardized reporting of functioning information on ICF-based common metrics JF - European Journal of Physical and Rehabilitation Medicine N2 - BACKGROUND: In clinical practice and research a variety of clinical data collection tools are used to collect information on people’s functioning for clinical practice and research and national health information systems. Reporting on ICF-based common metrics enables standardized documentation of functioning information in national health information systems. The objective of this methodological note on applying the ICF in rehabilitation is to demonstrate how to report functioning information collected with a data collection tool on ICF-based common metrics. We first specify the requirements for the standardized reporting of functioning information. Secondly, we introduce the methods needed for transforming functioning data to ICF-based common metrics. Finally, we provide an example. METHODS: The requirements for standardized reporting are as follows: 1) having a common conceptual framework to enable content comparability between any health information; and 2) a measurement framework so that scores between two or more clinical data collection tools can be directly compared. The methods needed to achieve these requirements are the ICF Linking Rules and the Rasch measurement model. Using data collected incorporating the 36-item Short Form Health Survey (SF-36), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and the Stroke Impact Scale 3.0 (SIS 3.0), the application of the standardized reporting based on common metrics is demonstrated. RESULTS: A subset of items from the three tools linked to common chapters of the ICF (d4 Mobility, d5 Self-care and d6 Domestic life), were entered as “super items” into the Rasch model. Good fit was achieved with no residual local dependency and a unidimensional metric. A transformation table allows for comparison between scales, and between a scale and the reporting common metric. CONCLUSIONS: Being able to report functioning information collected with commonly used clinical data collection tools with ICF-based common metrics enables clinicians and researchers to continue using their tools while still being able to compare and aggregate the information within and across tools. KW - International Classification of Functioning, Disability and Health KW - Rehabilitation KW - Delivery of health care Y1 - 2018 UR - https://doi.org/10.23736/S1973-9087.17.04784-0 VL - 54 IS - 1 SP - 110 EP - 117 ER - TY - JOUR A1 - Mukaino, M. A1 - Prodinger, Birgit A1 - Yamada, S. A1 - Senju, Y. A1 - Izumi, S. I. A1 - Sonoda, S. A1 - Selb, M. A1 - Saitoh, E. A1 - Stucki, G. T1 - Supporting the clinical use of the ICF in Japan - development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 set, its operationalization through a rating reference guide, and interrater reliability study JF - BMC Health Services Research N2 - Background The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) in 2001 and has been in the process of implementing it in clinics since then. Current international efforts to implement ICF in rehabilitation clinics include the implementation of ICF Core Sets and the development of simple, intuitive descriptions for the ICF Generic-30 Set (also called Rehabilitation Set). The present study was designed to operationalize these ICF tools for clinical practice in Japan. This work included 1) the development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set, 2) the development of a rating reference guide for Activity and Participation categories, and 3) the examination of the interrater reliability of rating Activity and Participation categories. Methods The Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set was developed following the process employed to develop the Chinese and Italian versions. For further operationalization of this ICF Set in practice, a rating reference guide was developed. The development of the rating reference guide involved the following steps: 1) a trial of rating patients by several raters, 2) cognitive interviewing of the raters to analyse the thinking process involved in rating, 3) drafting of the rating reference guide, and 4) review by ICF specialists to confirm consistency with the original ICF concepts. After the rating reference guide was developed, interrater reliability of the rating with the reference guide was determined. Interrater reliability was examined using weighted kappa statistics with linear weight. Results Through the pre-defined process, the Japanese version of the simple, intuitive descriptions for 30 categories of the ICF Generic-30 Set and the rating reference guides for 21 Activity and Participation categories were successfully developed. The weighted kappa statistics ranged from 0.61 to 0.85, showing substantial to excellent agreement of the ratings between raters. Conclusions The present study demonstrates that ICF categories can be translated into clinical practice. Collaboration between clinicians and researchers would further enhance the implementation of the ICF in Japan. KW - ICF KW - ICF rehabilitation set KW - Simple, intuitive descriptions KW - Interrater reliability Y1 - 2020 UR - https://doi.org/10.1186/s12913-020-4911-6 VL - 20 IS - 1 SP - 66 ER - TY - JOUR A1 - Ehrmann, C. A1 - Mahmoudi, S. M. A1 - Prodinger, Birgit A1 - Kiekens, C. A1 - Ertzgaard, P. T1 - Impact of spasticity on functioning in spinal cord injury: an application of graphical modelling JF - Journal of Rehabilitation Medicine N2 - Abstract Objective: To identify the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury. Design: Secondary analysis of cross-sectional survey data using graphical modelling. Subjects: Individuals (n = 1,436) with spinal cord injury aged over 16 years with reported spasticity problems. Methods: Spasticity and 13 other impairments in body functions were assessed using the spinal cord injury Secondary Conditions Scale. Impairments in mental functions were assessed using the Mental Health subscale of the 36-item Short Form (SF-36). Independence in activities was measured with the Spinal Cord Injury Independence Measure Self-Report. Restrictions in participation were measured with the Utrecht Scale for Evaluation Rehabilitation – Participation. Results: Fifty-one percent of participants reported moderate-to-severe spasticity. Graphical modelling showed that Chronic pain, Contractures, Tiredness, Doing housework, and Respiratory functions were associated with spasticity and were the top 5 potential targets for interventions to improve the experience of spasticity. The associations and intervention targets were dependent on the level and completeness of the lesion. Conclusion: This is the first application of graphical modelling in studying spasticity in people living with spinal cord injury. The results can be used as a basis for studies aiming to optimize rehabilitation interventions in people with moderate-to-severe spasticity. Lay Abstract Spasticity is one of the most common complications of spinal cord injury. It influences limitations in functioning. Comprehensive evidence on the impact of spasticity on all domains of functioning may be beneficial to optimize rehabilitation interventions aimed at reducing the effects of spasticity. This is the first application of graphical modelling to study and visualize the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury. The results show that chronic pain, contractures, tiredness, doing housework, and respiratory functions were the functioning domains associated with spasticity. These are therefore the top 5 potential targets for interventions to improve the experience of spasticity. In addition, the level and completeness of lesions should be considered when studying spasticity in relation to all domains of functioning. These results should be used as a basis for studies aiming to optimize rehabilitation interventions in people with moderate-to-severe spasticity. KW - spinal cord injury Y1 - 2020 UR - https://doi.org/10.2340/16501977-2657 VL - 52 IS - 3 ER - TY - JOUR A1 - Maritz, R. A1 - Ehrmann, C. A1 - Prodinger, Birgit A1 - Tennant, A. A1 - Stucki, G. T1 - The influence and added value of a Standardized Assessment and Reporting System for functioning outcomes upon national rehabilitation quality reports JF - International Journal for Quality in Health Care N2 - Objective To demonstrate the influence and added value of a Standardized Assessment and Reporting System (StARS) upon the reporting of functioning outcomes for national rehabilitation quality reports. A StARS builds upon an ICF-based (International Classification of Functioning, Disability and Health) and interval-scaled common metric. Design Comparison of current ordinal-scaled Swiss national rehabilitation outcome reports including an expert-consensus-based transformation scale with StARS-based reports through descriptive statistical methods and content exploration of further development areas of the reports with relevant ICF Core Sets. Setting Swiss national public rehabilitation outcome quality reports on the clinic level. Participants A total of 29 Swiss rehabilitation clinics provided their quality report datasets including 18 047 patients. Interventions Neurological or musculoskeletal rehabilitation. Main outcome measures Functional Independence Measure™ or Extended Barthel Index. Results Outcomes reported with a StARS tended to be smaller but more precise than in the current ordinal-scaled reports, indicating an overestimation of achieved outcomes in the latter. The comparison of the common metric’s content with ICF Core Sets suggests to include ‘energy and drive functions’ or ‘maintaining a basic body position’ to enhance the content of functioning as an indicator. Conclusions A StARS supports the comparison of outcomes assessed with different measures on the same interval-scaled ICF-based common metric. Careful consideration is needed whether an ordinal-scaled or interval-scaled reporting system is applied as the magnitude and precision of reported outcomes is influenced. The StARS’ ICF basis brings an added value by informing further development of functioning as a relevant indicator for national outcome quality reports in rehabilitation. KW - quality of health care KW - public reporting of healthcare data KW - outcome assessment (health care) KW - rehabilitation KW - international classification of functioning, disability and health KW - psychometrics Y1 - 2020 UR - https://doi.org/10.1093/intqhc/mzaa058 VL - 32 IS - 6 SP - 379 EP - 387 PB - Oxford University Press CY - Oxford ER - TY - JOUR A1 - Pongpipatpaiboon, K A1 - Selb, M A1 - Kovindha, A A1 - Prodinger, Birgit T1 - Toward a framework for developing an ICF-based documentation system in spinal cord injury-specific rehabilitation based on routine clinical practice: a case study approach JF - Spinal Cord Series and Cases N2 - Study design Case study. Objective To present a framework for developing an International Classification of Functioning, Disability and Health (ICF)-based documentation system in spinal cord injury (SCI)-specific rehabilitation. Setting Data collection took place at Maharaj Hospital, Thailand. The preparatory studies and analysis were performed at Swiss Paraplegic Research, Switzerland. Methods Data collected from interviews and health records of four SCI cases across the continuum of care (acute, post-acute, early and late long term) were linked to ICF categories using established ICF linking rules. The resulting categories were compared with selected ICF sets (ICF Generic-30, ICF core sets for SCI and multiple sclerosis) to determine the extent of coverage. Furthermore, the context of applicable services was described systematically. Results Less than half of the ICF categories in the defined ICF sets were covered by clinical assessment tools. Low correspondence was found predominantly in acute and late long-term phase. Least well covered were categories of activities and participations and environmental factors. The correspondence of categories increased when considering the additional ICF categories identified from patient interviews. The description of rehabilitation services provided in each case classified according to the dimensions of service provider, funding, and service delivery. Conclusions There is a need to promote the systematic and standardized assessment of functioning among health professionals working in the field of SCI in developing countries. This study describes basic steps toward developing a standardized ICF-based system for assessing and reporting functioning outcomes in SCI rehabilitation and across the continuum of care. KW - ICF KW - rehabilitation KW - documentation KW - case study Y1 - 2020 UR - https://doi.org/10.1038/s41394-020-0283-8 VL - 6 IS - 33 ER - TY - JOUR A1 - Lampart, Patricia A1 - Gemperli, Armin A1 - Baumberger, Michael A1 - Bersch, Ines A1 - Prodinger, Birgit A1 - Schmitt, Klaus A1 - Scheel-Sailer, Anke T1 - Administration of assessment instruments during the first rehabilitation of patients with spinal cord injury: a retrospective chart analysis. JF - Spinal Cord N2 - Objectives To examine which professionals administered which assessment instruments in which patient in clinical practice during first rehabilitation after newly acquired spinal cord injury (SCI) and the differences in the frequencies of different assessments between patient groups. Setting Specialized SCI acute care and rehabilitation clinic. Methods Patients after SCI, aged 18 years and above, admitted for first rehabilitation between December 2014 and December 2015 were analyzed. Descriptive statistics of 54 selected assessments. p values based on the χ 2 test were calculated for assessments used in both paraplegic and tetraplegic patients. Results One hundred and nineteen patients were screened. Forty-one assessments were administered, of which 10 on average more than once per patient. The most frequently used assessments were Spinal Cord Independence Measure III (7.7 times per patient), Skin Assessment (3.6 times), and Manual Muscle Test (3.2 times for Lower Extremities; 2.5 times for Upper Extremities). The American Spinal Injury Association Impairment Scale was administered on average 1.9 times per patient. More variation in the number of assessments per patient was observed in patients with complete and incomplete lesions compared to patients with paraplegia and tetraplegia. Conclusion Assessments covering neurological functioning, mobility, and self-care are used in clinical practice during first rehabilitation of patients with SCI, while others covering autonomic functioning, pain, participation, or quality of life are still missing. Based on these observations and national and international requirements, a meaningful standard for an assessment toolkit, applicable in general and in specific subgroups, needs to be defined and implemented. KW - spinal cord injury (SCI) KW - rehabilitation KW - assessment instruments Y1 - 2018 UR - https://doi.org/10.1038/s41393-017-0039-x VL - 56 IS - 4 SP - 322 EP - 331 PB - Springer Nature ER - TY - JOUR A1 - Fellinghauer, Carolina Saskia A1 - Prodinger, Birgit A1 - Tennant, Alan T1 - The Impact of Missing Values and Single Imputation upon Rasch Analysis Outcomes: A Simulation Study JF - Journal of Applied Measurement N2 - Imputation becomes common practice through availability of easy-to-use algorithms and software. This study aims to determine if different imputation strategies are robust to the extent and type of missingness, local item dependencies (LID), differential item functioning (DIF), and misfit when doing a Rasch analysis. Four samples were simulated and represented a sample with good metric properties, a sample with LID, a sample with DIF, and a sample with LID and DIF. Missing values were generated with increasing proportion and were either missing at random or completely at random. Four imputation techniques were applied before Rasch analysis and deviation of the results and the quality of fit compared. Imputation strategies showed good performance with less than 15% of missingness. The analysis with missing values performed best in recovering statistical estimates. The best strategy, when doing a Rasch analysis, is the analysis with missing values. If for some reason imputation is necessary, we recommend using the expectation-maximization algorithm. KW - Local item dependencies (LID) KW - Differential item functioning (DIF) KW - Imputation techniques KW - Rasch analysis Y1 - 2018 VL - 19 IS - 1 SP - 1 EP - 25 PB - JAM Press ER - TY - JOUR A1 - Ehrmann, Cristina A1 - Prodinger, Birgit A1 - Gmünder, Hans Peter A1 - Hug, Kerstin A1 - Bickenbach, Jerome E. A1 - Stucki, Gerold T1 - Describing Functioning in People Living With Spinal Cord Injury in Switzerland: A Graphical Modeling Approach JF - Archives of Physical Medicine and Rehabilitation N2 - Objective: To describe functioning in people living with spinal cord injuries (SCI) in Switzerland. Design: Secondary analysis of cross-sectional survey data. Setting Community, Switzerland. Participants: Individuals (N=1549) 16 years of age or older with a history of traumatic or nontraumatic SCI and permanently residing in Switzerland. Interventions: Not applicable. Main Outcome Measures: Functioning was operationalized through 4 domains: (1) impairments in body functions; (2) impairments in mental functions; (3) independence in performing activities; and (4) performance problems in participation. Results: Univariate analysis indicated a high prevalence of problems in 5 areas: (1) housework; (2) climbing stairs; (3) tiredness; (4) spasticity; and (5) chronic pain. Graphical modeling showed a strong association among the four domains of functioning. Moreover, we found that the differences in the dependence structures were significant between the paraplegia SCI population and the tetraplegia SCI population. Conclusions: This study is a first study in the epidemiology of functioning of people living with SCI in Switzerland. Using univariate and graphical modeling approaches, we proposed an empirical foundation for developing hypotheses on functioning in each domain and category that could inform health systems on people’s health needs. KW - DAG (directed acrylic graph) KW - ICF KW - SCI (Spinal cord injuries) Y1 - 2018 UR - https://doi.org/10.1016/j.apmr.2018.04.015 VL - 99 IS - 10 SP - 1965 EP - 1981 PB - Elsevier ER - TY - JOUR A1 - Prodinger, Birgit A1 - Taylor, Paul T1 - Improving quality of care through patient-reported outcome measures (PROMs): expert interviews using the NHS PROMs Programme and the Swedish quality registers for knee and hip arthroplasty as examples JF - BMC Health Services Research N2 - Background: Patient reported outcome measures (PROMs) have been integrated in national quality registries or specific national monitoring initiatives to inform the improvement of quality of care on a national scale. However there are many unanswered questions, such as: how these systems are set up, whether they lead to improved quality of care, which stakeholders use the information once it is available. The aim of this study was to examine supporting and hindering factors relevant to integrating patient-reported outcome measures (PROMs) in selected health information systems (HIS) tailored toward improving quality of care across the entire health system. Methods: First, a systematic search and review was conducted to outline previously identified factors relevant to the integration of PROMs in the selected HIS. A social network analysis was performed to identify networks of experts in these systems. Second, expert interviews were conducted to discuss and elaborate on the identified factors. Directive content analysis was applied using a HIS Evaluation Framework as the frame of reference. This framework is structured into four components: Organization, Human, Technology, and Net benefits. Results: The literature review revealed 37 papers for the NHS PROMs Programme and 26 papers for the SHPR and SKAR: Five networks of researchers were identified for the NHS PROMs Programme and 1 for the SHPR and SKAR. Seven experts related to the NHS PROMs Programme and 3 experts related to the SKAR and SHPR participated in the study. The main themes which revealed in relation to Organization were Governance and Capacity building; to Human: Reporting and Stakeholder Engagement; to Technology: the Selection and Collection of PROMs and Data linkage. In relation to Net benefits, system-specific considerations are presented. Conclusion: Both examples succeeded in integrating PROMs into HIS on a national scale. The lack of an established standard on what change PROMs should be achieved by an intervention limits their usefulness for monitoring quality of care. Whether the PROMs data collected within these systems can be used in routine clinical practice is considered a challenge in both countries. KW - Health information system evaluation KW - Quality registry KW - Oxford hip score KW - Oxford knee score KW - EQ-5D Y1 - 2018 UR - https://doi.org/10.1186/s12913-018-2898-z VL - 18 SP - 87 PB - Springer Nature ER - TY - JOUR A1 - Adroher, Núria Duran A1 - Prodinger, Birgit A1 - Fellinghauer, Carolina Saskia A1 - Tennant, Alan ED - Public Library of Science, T1 - All metrics are equal, but some metrics are more equal than others: A systematic search and review on the use of the term 'metric' JF - PLoS One N2 - Objective: To examine the use of the term ‘metric’ in health and social sciences’ literature, focusing on the interval scale implication of the term in Modern Test Theory (MTT). Materials and methods: A systematic search and review on MTT studies including ‘metric’ or ‘interval scale’ was performed in the health and social sciences literature. The search was restricted to 2001–2005 and 2011–2015. A Text Mining algorithm was employed to operationalize the eligibility criteria and to explore the uses of ‘metric’. The paradigm of each included article (Rasch Measurement Theory (RMT), Item Response Theory (IRT) or both), as well as its type (Theoretical, Methodological, Teaching, Application, Miscellaneous) were determined. An inductive thematic analysis on the first three types was performed. Results: 70.6% of the 1337 included articles were allocated to RMT, and 68.4% were application papers. Among the number of uses of ‘metric’, it was predominantly a synonym of ‘scale’; as adjective, it referred to measurement or quantification. Three incompatible themes ‘only RMT/all MTT/no MTT models can provide interval measures’ were identified, but ‘interval scale’ was considerably more mentioned in RMT than in IRT. Conclusion: ‘Metric’ is used in many different ways, and there is no consensus on which MTT metric has interval scale properties. Nevertheless, when using the term ‘metric’, the authors should specify the level of the metric being used (ordinal, ordered, interval, ratio), and justify why according to them the metric is at that level. KW - Metrics KW - MTT assay KW - Database Searching KW - Psychometrics Y1 - 2018 UR - https://doi.org/10.1371/journal.pone.0193861 VL - 13 IS - 3 SP - e0193861 ER - TY - JOUR A1 - Gimigliano, Francesca A1 - De Sire, Alessandro A1 - Gestaldo, Marco A1 - Maghini, Irene A1 - Paoletta, Marco A1 - Pasquini, Andrea A1 - Baldrini, Paolo A1 - Selb, Melissa A1 - Prodinger, Birgit A1 - SIMFER Residents Section Group, ED - Minerva Medica, T1 - Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project JF - European Journal of Physical and Rehabilitation Medicine N2 - The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice.1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool.Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM.Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS).Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6%) and the most common altered ICF categories were b280 (76.3%) and b710 (72.9%).This multicenter cross-sectional study shown that the ICF Generic-30 Set is a valuable instrument for reporting and assessing functioning and disability in clinical populations with different health conditions and along the continuum of care and that SID facilitate the understanding of the ICF categories and therefore their use in clinical practice. This National survey, improving the knowledge of ICF among Italian PRM residents, represents an important step towards the system-wide implementation of ICF in the healthcare system. KW - Disability and health Y1 - 2019 UR - https://doi.org/10.23736/S1973-9087.18.05324-8 VL - 55 IS - 2 SP - 258 EP - 264 ER - TY - JOUR A1 - Maritz, Roxanne A1 - Scheel-Sailer, Anke A1 - Schmitt, Klaus A1 - Prodinger, Birgit ED - Oxford Jounals, T1 - Overview of quality management models for inpatient healthcare settings: A scoping review JF - International Journal of Quality in Health Care N2 - This scoping review aimed to generate an overview of existing quality management (QM) models for inpatient healthcare published in peer-reviewed literature. Data sources Peer-reviewed publications published until June 2016 were retrieved from the databases Medline, PubMed, CINAHL and Cochrane Library using search terms related to QM and models. Study selection Publications mentioning a QM model for general application in healthcare or inpatient care in their title or abstract were included. Languages considered were: English, French, German, Italian and Spanish. Data extraction was 3-fold. First, publication characteristics were summarized. Second, the frequency of each identified model was documented and the publications were divided into conceptual and implementation publications. Third, relevant QM models were identified and information regarding the model, including content and relationship with other models, was extracted. Of 925 retrieved publications, 213 were included. The included publications reported on 64 different QM models that were suitable for or used in inpatient care. Seventeen models were identified as being relevant. The 17 models were then categorized into three different levels: conceptual quality improvement models, concrete application models and country specific adaptations. This scoping review provides an overview of 17 existing QM models for inpatient care and their relationships with each other. Various types of models with differing aspects and components exist. In searching for QM models, many different concepts like QM system, accreditation or methodologies appeared. For future investigation, concepts of interest should be clarified. KW - Quality improvement KW - Total quality management KW - Models KW - Inpatient care Y1 - 2019 UR - https://doi.org/10.1093/intqhc/mzy180 VL - 31 IS - 6 SP - 404 EP - 410 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Rastall, Paul A1 - Kalra, Dipak A1 - Wooldridge, Darren A1 - Carpenter, Iain ED - Thieme E-Journals, T1 - Documenting Routinely What Matters to People: Standardized Headings for Health Records of Patients with Chronic Health Conditions JF - Applied Clinical Informatics N2 - Objective Specifying the content in electronic health records (EHRs) through standardized headings based on international reference classifications will facilitate their semantic interoperability. The objective of this study was to specify potential chapter headings for EHRs aligned with the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF) based on the perspectives of people living with chronic health conditions, carers, and professionals. Methods A multistage process was established including (1) a patient workshop, (2) an online survey of both patients and carers, and (3) an online consultation with patient and professional bodies. The ICF served as a starting point. Based on the first stage, a first draft of the headings was developed and further refined based on the feedback at each stage. We examined in a fourth step whether items from existing assessment tools support the operationalization of the identified headings. Therefore, we used the WHO Disability Assessment Schedule 2.0 (WHODAS2.0), a patient-reported instrument, and interRAI, a clinician-administered instrument. Results The first workshop was attended by eight people, the survey was completed by 250 persons, and the online consultation received detailed feedback by 18 professional bodies. This study resulted in 16 potential chapter headings for EHRs which capture aspects related to the body, such as emotions, motivation, sleep, and memory or thoughts, to being involved in social life, such as mobility, social activities, and finances, as well as to the care process, such as understanding of health issues and treatment or care priorities and goals. When using the WHODAS2.0 and interRAI together, they capture all except one of the proposed headings. Conclusion The identified headings provide a high level structure for the standardized recording, use, and sharing of information. Once implemented, these headings have the potential to facilitate the delivery of personalized care planning for patients with long-term health problems. KW - Patient's perspective KW - electronic health records KW - international classification of functioning KW - disability and health Y1 - 2018 UR - https://doi.org/10.1055/s-0038-1649488 VL - 9 IS - 2 SP - 348 EP - 365 ER - TY - JOUR A1 - Hopfe, Maren A1 - Stucki, Gerold A1 - Bickenbach, Jerome E. A1 - Prodinger, Birgit T1 - Accounting for what matters to patients in the G-DRG System: A stakeholder’s perspective on integrating functioning information JF - Health Services Insights N2 - Functioning information constitutes a relevant component for determining patients’ service needs and respective resource use. Diagnosis-Related Group (DRG) systems can be optimized by integrating functioning information. First steps toward accounting for functioning information in the German DRG (G-DRG) system have been made; yet, there is no systematic integration of functioning information. The G-DRG system is part of the health system; it is embedded in and as such dependent on various stakeholders and vested interests. This study explores the stakeholder’s perspective on integrating functioning information in the G-DRG system. A qualitative interview study was conducted with national stakeholders in 4 groups of the G-DRG system (health policy, administration, development, and consultations). Interviews were analyzed using inductive thematic analysis. In total, 14 interviews were conducted (4 administration and 10 consultation group). Three main themes were identified: (1) functioning information in the G-DRG system: opportunities and obstacles, (2) general aspects concerning optimizing G-DRG systems by integrating additional information, and (3) ideas and requirements on how to proceed. The study offers insights into the opportunities and obstacles of integrating functioning information in the G-DRG system. The relevance of functioning information was evident. However, the value of functioning information for the G-DRG system was seen critically. Integrating functioning information alone does not seem to be sufficient and a systems approach is needed. KW - G-DRG System KW - Functioning information KW - Stakeholder interviews Y1 - 2018 UR - https://doi.org/10.1177%2F1178632918796776 IS - 11 SP - 1 EP - 10 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A. T1 - The emergence of Occupational Science in Austria: An insider perspective JF - Journal of Occupational Science N2 - Occupational science has been discussed in terms of its relation to occupational therapy, its philosophical and theoretical foundations, and its international and interdisciplinary character over the past years. The disciplinary identity of occupational science in non-English speaking countries has not yet been debated in the literature. The aim of this article is to discuss occupational science as an emergent discipline in Austria, a German-speaking country. The discussion is divided into two parts. In the first part we engage in critical reflexivity to explicate the current development of occupational science in Austria by reviewing the disciplinary and historical context of occupational science and the related profession of occupational therapy, the educational and institutional influences as well as the influence of language. In the second part, we illustrate that occupational science is an emerging discipline in Austria by drawing on an ongoing research project: the Gender, Occupational Balance, and Immunology Study. By making explicit how occupational science has emerged, from our insider perspective, we aim to contribute to the further development of the disciplinary identity of occupational science nationally and internationally. KW - Critical reflexivity KW - Knowledge generation KW - Occupational balance KW - Occupational science Y1 - 2012 UR - https://doi.org/10.1080/14427591.2011.582833 VL - 19 IS - 2 SP - 127 EP - 137 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A. T1 - Self-reflection as a means for personal transformation: An analysis of women's life stories living with a chronic disease JF - Forum Qualitative Sozialforschung / Forum: Qualitative Social Research N2 - The aim of this secondary analysis is to explicate taken-for-granted practices in the health care system in which the life stories of six women with rheumatoid arthritis (RA) are embedded. A secondary analysis of life stories of six women with RA, which were assigned to a typology named "rheumatoid arthritis as a source for new challenges" (STAMM et al., 2008) in the primary narrative study, was conducted. The theoretical framework applied for the analysis was informed by feminist standpoint theory and feminist philosophy. In the present analysis, each of the women challenged established health care practices and the cognitive authority of medicine at a certain point in their life story reflections. Becoming more conscious about health care practices enabled the women to acknowledge their own knowledge and to make choices about their health. The findings challenge health care providers to engage in critical reflexivity to become conscious about and to transform taken-for-granted practices as embedded in larger systems and to create health care environments that enable dialogue between clients and health care providers. KW - Secondary analysis KW - Narratives KW - Feminist critiques on health care KW - Standpoint theory KW - Gender KW - Rheumatiod arthritis Y1 - 2010 UR - http://dx.doi.org/10.17169/fqs-11.3.1379 VL - 11 IS - 4 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Weise, A. P. A1 - Shaw, L. A1 - Stamm, T. A. T1 - A Delphi study on Environmental Factors that impact work and social life participation of individuals with Multiple Sclerosis in Austria and Switzerland JF - Disability and Rehabilitation N2 - Purpose: This study aimed to gain knowledge about environmental factors (EFs) that impact work and social life participation of people with multiple sclerosis (MS) in Austria and Switzerland to extend the knowledge of participation and to identify key areas for measuring participation. Method: A three-round Delphi study was conducted defining patients as experts. In the 1st round, qualitative data was gathered through questionnaires, analyzed with content analysis, and factors were assigned to EFs as classified in the ICF. In the 2nd and 3rd round, experts judged EFs according to its relevance to obtain consensus (cut-off 75%). Categories were ranked on a scale from mostly important to important. Results: One hundred and twelve Austrian and 109 Swiss experts were recruited. The content analysis revealed 768 EFs. The study resulted in a list of 176 consensus factors for Austria and 177 Switzerland. Five categories revealed to be highly important, 12 moderately important, 6 fairly important, and 10 important. Conclusions: This study indicates that participation in work or social life is influenced by physical, social, attitudinal, and policy factors. Consensus factors afford insights into areas for consideration in the development of participation outcome measurements and support a comprehensive and inclusive rehabilitation approach. KW - Contextual factors KW - Patient perspective KW - Consensus method KW - ICF KW - Disability and health Y1 - 2010 UR - https://doi.org/10.3109/09638280903071883 VL - 32 IS - 3 SP - 183 EP - 195 ER -