Disability Measurement for Korean Community-Dwelling Adults With Stroke: Item-Level Psychometric Analysis of the Korean Longitudinal Study of Ageing.
10.5535/arm.2018.42.2.336
- Author:
Ickpyo HONG
1
;
Young Joo KIM
;
Mandi L SONNENFELD
;
Emily GRATTAN
;
Timothy A REISTETTER
Author Information
1. Department of Occupational Therapy, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA. ichong@utmb.edu
- Publication Type:Original Article
- Keywords:
Stroke;
Aging;
Community survey;
Reliability and validity;
Outcome assessment
- MeSH:
Activities of Daily Living;
Adult*;
Aging;
Dataset;
Humans;
Longitudinal Studies*;
Outcome Assessment (Health Care);
Psychometrics*;
Reproducibility of Results;
Retrospective Studies;
Stroke*;
Surveys and Questionnaires
- From:Annals of Rehabilitation Medicine
2018;42(2):336-345
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the psychometric properties of the activities of daily living (ADL) instrument used in the analysis of Korean Longitudinal Study of Ageing (KLoSA) dataset. METHODS: A retrospective study was carried out involving 2006 KLoSA records of community-dwelling adults diagnosed with stroke. The ADL instrument used for the analysis of KLoSA included 17 items, which were analyzed using Rasch modeling to develop a robust outcome measure. The unidimensionality of the ADL instrument was examined based on confirmatory factor analysis with a one-factor model. Item-level psychometric analysis of the ADL instrument included fit statistics, internal consistency, precision, and the item difficulty hierarchy. RESULTS: The study sample included a total of 201 community-dwelling adults (1.5% of the Korean population with an age over 45 years; mean age=70.0 years, SD=9.7) having a history of stroke. The ADL instrument demonstrated unidimensional construct. Two misfit items, money management (mean square [MnSq]=1.56, standardized Z-statistics [ZSTD]=2.3) and phone use (MnSq=1.78, ZSTD=2.3) were removed from the analysis. The remaining 15 items demonstrated good item fit, high internal consistency (person reliability=0.91), and good precision (person strata=3.48). The instrument precisely estimated person measures within a wide range of theta (−4.75 logits <θ< 3.97 logits) and a reliability of 0.9, with a conceptual hierarchy of item difficulty. CONCLUSION: The findings indicate that the 15 ADL items met Rasch expectations of unidimensionality and demonstrated good psychometric properties. It is proposed that the validated ADL instrument can be used as a primary outcome measure for assessing longitudinal disability trajectories in the Korean adult population and can be employed for comparative analysis of international disability across national aging studies.
