TY - JOUR
T1 - Construct validity, responsiveness, and interpretability of the Utrecht Scale for Evaluation of Rehabilitation (USER) in patients admitted to inpatient geriatric rehabilitation
AU - de Waal, Margot W. M.
AU - Jansen, Michael
AU - Bakker, Loes M.
AU - Doornebosch, Arno J.
AU - Wattel, Elizabeth M.
AU - Visser, Dennis
AU - Smit, Ewout B.
N1 - Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Verenso, the Dutch Association of Elderly Care Physicians (Verenso Grant 2017). Publisher Copyright: © The Author(s) 2023.
PY - 2024/1
Y1 - 2024/1
N2 - Objective: The Utrecht Scale for Evaluation of Rehabilitation is a multi-domain measurement with good content validity, structural validity and reliability for measuring physical functioning (mobility, selfcare) and cognitive functioning in geriatric rehabilitation. We aimed to determine the construct validity of both Utrecht Scale for Evaluation of Rehabilitation scales and the responsiveness and interpretability of the scale for physical functioning in geriatric rehabilitation. Design: Prospective follow-up study embedded in routine care. Setting: Four care organisations in The Netherlands. Subjects: Patients admitted for inpatient geriatric rehabilitation (2021–2022). Main measures: Data collection included the Utrecht Scale for Evaluation of Rehabilitation, Mini-Mental State Examination, Barthel index, and a global rating scale anchor on recovery. Hypothesis testing was used to determine construct validity and responsiveness. For interpretability, minimal important change and floor and ceiling effects were determined. Results: The mean age of participants (n = 211) was 77 (SD 10.4). Their mean length of stay was 38.6 days (SD 26.3), and 81% returned home. The Utrecht Scale for Evaluation of Rehabilitation showed adequate construct validity, as all three hypotheses were confirmed for both scales. The Utrecht Scale for Evaluation of Rehabilitation-physical function scale showed adequate responsiveness, with all five hypotheses confirmed. The mean change for physical function (scale range 0–70) was 15.5 points (SD 17.1). The minimal important change for Utrecht Scale for Evaluation of Rehabilitation-physical function was 14.5 points difference for improvement. This scale showed no floor (2%) and ceiling effects (14%) at admission and discharge. Conclusions: The Utrecht Scale for Evaluation of Rehabilitation showed to be effective for evaluating physical functioning during geriatric rehabilitation as well as screening cognitive functioning. In total, 14.5 points difference has been established as a minimal important change for physical functioning.
AB - Objective: The Utrecht Scale for Evaluation of Rehabilitation is a multi-domain measurement with good content validity, structural validity and reliability for measuring physical functioning (mobility, selfcare) and cognitive functioning in geriatric rehabilitation. We aimed to determine the construct validity of both Utrecht Scale for Evaluation of Rehabilitation scales and the responsiveness and interpretability of the scale for physical functioning in geriatric rehabilitation. Design: Prospective follow-up study embedded in routine care. Setting: Four care organisations in The Netherlands. Subjects: Patients admitted for inpatient geriatric rehabilitation (2021–2022). Main measures: Data collection included the Utrecht Scale for Evaluation of Rehabilitation, Mini-Mental State Examination, Barthel index, and a global rating scale anchor on recovery. Hypothesis testing was used to determine construct validity and responsiveness. For interpretability, minimal important change and floor and ceiling effects were determined. Results: The mean age of participants (n = 211) was 77 (SD 10.4). Their mean length of stay was 38.6 days (SD 26.3), and 81% returned home. The Utrecht Scale for Evaluation of Rehabilitation showed adequate construct validity, as all three hypotheses were confirmed for both scales. The Utrecht Scale for Evaluation of Rehabilitation-physical function scale showed adequate responsiveness, with all five hypotheses confirmed. The mean change for physical function (scale range 0–70) was 15.5 points (SD 17.1). The minimal important change for Utrecht Scale for Evaluation of Rehabilitation-physical function was 14.5 points difference for improvement. This scale showed no floor (2%) and ceiling effects (14%) at admission and discharge. Conclusions: The Utrecht Scale for Evaluation of Rehabilitation showed to be effective for evaluating physical functioning during geriatric rehabilitation as well as screening cognitive functioning. In total, 14.5 points difference has been established as a minimal important change for physical functioning.
KW - Geriatric rehabilitation
KW - clinimetrics
KW - cognitive functioning
KW - measurement properties
KW - physical functioning
KW - post-acute care
UR - http://www.scopus.com/inward/record.url?scp=85172168035&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/02692155231203095
DO - https://doi.org/10.1177/02692155231203095
M3 - Article
C2 - 37743801
SN - 0269-2155
VL - 38
SP - 98
EP - 108
JO - Clinical rehabilitation
JF - Clinical rehabilitation
IS - 1
ER -