Funahashi R, Mukaino M, Otaka Y, Senju Y, Yoneda C, Ozeki Y, Shimizu Y, Koike T, Saito E. Feasibility of the International Classification of Functioning, Disability and Health Rehabilitation Set for inpatient rehabilitation: Selection and validity of a set of categories for inpatients in a convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2020; 11: 1-8.
Objective: To evaluate the feasibility of the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set for inpatients in a convalescent (Kaifukuki) rehabilitation ward.
Methods: Overall, 295 inpatients in convalescent rehabilitation wards were rated using the ICF Rehabilitation Set, and the proportion of missing values was investigated. Categories with missing values <10% were selected, and internal construct validity of the total score of the selected categories was examined using Rasch analysis.
Results: Missing values were detected in 25 items, of which seven had missing values of ≥10%. No ceiling or floor effects were noted. Rasch analysis of 23 categories with missing values <10% showed a good fit to the model after applying testlet solution and item splitting, which supported the internal construct validity of the ICF Rehabilitation Set.
Conclusion: This identified the set of categories of the ICF Rehabilitation Set that could be used for evaluating rehabilitation inpatients. These categories had good internal construct validity based on Rasch analysis.
Senju Y, Mukaino M, Ozeki M, Watanabe M, Okochi Y, Mizutani K, Saito E, Sonoda S. Interrater agreement between clinician ratings and patient self-assessments for body function categories of ICF Rehabilitation Set. Jpn J Compr Rehabil Sci 2020; 11: 9-16.
Objective: This study investigates interrater agreement between clinician ratings using the Rating reference guide developed in Japan for the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set and patient self-assessments for body function categories of the ICF Rehabilitation Set.
Methods: Eighty-eight inpatients and/or outpatients who received rehabilitation participated in this study. For the assessment of the nine body function categories of the ICF Rehabilitation Set, the patients were asked to complete the self-assessment questionnaires, and the clinicians rated the patients using the Rating reference guide. Interrater agreement between clinicians and patients was investigated using weighted kappa statistics and an intraclass correlation coefficient (ICC (2,1)) to determine interrater agreement of each category and the total score, respectively.
Results: The weighted kappa statistics ranged from 0.58 to 0.87. Eight out of nine categories presented with weighted kappa statistics greater than 0.61. The total score of all categories showed no significant difference between clinicians and patients and presented with an ICC (2,1) of 0.85.
Conclusion: No significant difference was observed between clinician ratings with the Rating reference guide for body function categories and patient self-assessments, showing feasibility of the Rating reference guide as a means of describing the status of patients' functioning.
Aoki K, Iguchi A, Watabe T. Evaluation of Functional Independence Measure item scores for predicting home discharge after acute stroke rehabilitation. Jpn J Compr Rehabil Sci 2020; 11: 17-20.
Objective: To determine whether certain Functional Independence Measure (FIM) items assessed early during acute-stage rehabilitation are predictive of home discharge for patients with stroke following intervention.
Methods: Medical record data were retrospectively compiled and analyzed for 103 patients with stroke admitted to our hospital between December 2016 and March 2017. Patients were either discharged to their own homes (n=41) or transferred to another facility (n=62) after acute-phase rehabilitation. Fisher's exact test was used to compare characteristics between the home and transfer groups. Stepwise multiple logistic regression analysis was also performed to identify FIM items predictive of patients' discharge destination.
Results: Significant differences between the home and transfer groups were observed for all FIM items, except for shower/tub transfer and stairs. Eating and social interaction were identified as significant predictors of the post-rehabilitation destination in multiple logistic regression analysis (p=0.001, odds ratio [OR]: 10.956, 95% confidence interval [CI]: 0.638-1.755; p=0.008, OR: 4.273, CI: 0.182-1.269, respectively).
Conclusion: In some cases, early assessment of FIM items, particularly eating and social interaction, after a stroke can help predict a patient's discharge destination after rehabilitation.