Linking Existing Instruments to Develop an Activity of Daily Living Item Bank

Eval Health Prof. 2018 Mar;41(1):25-43. doi: 10.1177/0163278716676873. Epub 2016 Nov 16.

Abstract

This study examined dimensionality and item-level psychometric properties of an item bank measuring activities of daily living (ADL) across inpatient rehabilitation facilities and community living centers. Common person equating method was used in the retrospective veterans data set. This study examined dimensionality, model fit, local independence, and monotonicity using factor analyses and fit statistics, principal component analysis (PCA), and differential item functioning (DIF) using Rasch analysis. Following the elimination of invalid data, 371 veterans who completed both the Functional Independence Measure (FIM) and minimum data set (MDS) within 6 days were retained. The FIM-MDS item bank demonstrated good internal consistency (Cronbach's α = .98) and met three rating scale diagnostic criteria and three of the four model fit statistics (comparative fit index/Tucker-Lewis index = 0.98, root mean square error of approximation = 0.14, and standardized root mean residual = 0.07). PCA of Rasch residuals showed the item bank explained 94.2% variance. The item bank covered the range of θ from -1.50 to 1.26 (item), -3.57 to 4.21 (person) with person strata of 6.3. The findings indicated the ADL physical function item bank constructed from FIM and MDS measured a single latent trait with overall acceptable item-level psychometric properties, suggesting that it is an appropriate source for developing efficient test forms such as short forms and computerized adaptive tests.

Keywords: activities of daily living; continuity of patient care; outcome assessment (health care); psychometrics; veterans.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Outcome Assessment, Health Care
  • Physical Therapy Modalities / standards*
  • Psychometrics
  • Reproducibility of Results
  • Retrospective Studies
  • Sex Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires / standards*
  • United States
  • United States Department of Veterans Affairs