The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

THE INTER-TESTER RELIABILITY AMONG THE MEMBERS OF A MULTIDISCIPLINARY TEAM FOR AN ACTIVITY OF DAILY LIVING ASSESSMENT TOOL FOR PATIENTS WITH CHRONIC LUNG DISEASE

M. K. Hart1, E. Abmas1, C. Duncan1, L. Aguirre-Kelley1, A. Lotshaw1, M. Millard1

Background: Traditionally activity of daily living (ADL) skills are assessed in pulmonary rehabilitation (PR) through self-report quality of life tools which measure perception rather than actual performance. Objectively measuring ADLs may assist in the tailoring of treatment programs to address these important issues. Our ADL tool was previously developed to assess these skills in PR. The purpose of this study was to determine the inter-rater reliability among a multidisciplinary team of occupational, physical and respiratory therapist (OT, PT, RT) observers.

Methods: The ADL tool was performed for patient initial evaluations and discharges for the PR program over 3 months in 2006. All testers and observers received the same training by the investigating OT on the evaluation tool prior to testing, utilizing the standardized instructions and procedures. Therapists who were available during the evaluation times participated in the observation of the ADL tool and their results were blinded to the other raters and investigators. Inter-tester reliability was analyzed using Cronbach’s alpha (r = 0.80 was considered reliable) on the 4 measurement scales used on the ADL tool which includes: Borg, pain, dyspnea, and functional measure for all nine tasks of the ADL tool.

Results:
The multidisciplinary team demonstrated excellent reliability (r = 0.876) on all scales of the ADL tool when analyzed as one group. Results of the specific measurement scales were Borg r = 0.900, Functional Measure r = 0.953, Dyspnea r = 0.867, and Pain r = 0.992. Further analysis showed that the inter-tester reliability between RT and OT was good (r = 0.738).

Conclusions:
The ADL tool developed at Baylor University Medical Center has been previously shown to have content validity in testing ADL skills. This tool has now been demonstrated to produce reliable results in a multidisciplinary team, as well as between OTs with expertise in ADLs and RTs who may be the primary staff members in PR as some programs operate without the support of an OT to perform ADL assessments. Therefore, we believe this tool is reliable and will be useful in assisting other pulmonary rehabilitation professionals including RTs assess ADL skills for patients in their PR programs.

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