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Item-level psychometrics of the ADL instrument of the Korean National Survey on persons with physical disabilities

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Abstract

Purpose

The aim of this study is to investigate the psychometrics of the 12 items of an instrument assessing activities of daily living (ADL) using an item response theory model.

Methods

A total of 648 adults with physical disabilities and having difficulties in ADLs were retrieved from the 2014 Korean National Survey on People with Disabilities. The psychometric testing included factor analysis, internal consistency, precision, and differential item functioning (DIF) across categories including sex, older age, marital status, and physical impairment area.

Results

The sample had a mean age of 69.7 years old (SD = 13.7). The majority of the sample had lower extremity impairments (62.0%) and had at least 2.1 chronic conditions. The instrument demonstrated unidimensional construct and good internal consistency (Cronbach’s alpha = 0.95). The instrument precisely estimated person measures within a wide range of theta values (−2.22 logits < θ < 0.27 logits) with a reliability of 0.9. Only the changing position item demonstrated misfit (χ2 = 36.6, df = 17, p = 0.0038), and the dressing item demonstrated DIF on the impairment type (upper extremity/others, McFadden’s Pseudo R 2 > 5.0%).

Conclusions

Our findings indicate that the dressing item would need to be modified to improve its psychometrics. Overall, the ADL instrument demonstrates good psychometrics, and thus, it may be used as a standardized instrument for measuring disability in rehabilitation contexts. However, the findings are limited to adults with physical disabilities. Future studies should replicate psychometric testing for survey respondents with other disorders and for children.

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Author information

Authors and Affiliations

  1. Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA

    Ickpyo Hong

  2. Department of Occupational Therapy, University of Florida, PO BOX 100164, Gainesville, FL, 32611, USA

    Mi Jung Lee

  3. Department of Occupational Therapy, College of Health Science, Yonsei University, Backun-kwan, 1 Yonseidae-gil, Wonju-si, Kangwon-do, 26493, South Korea

    Moon Young Kim & Hae Yean Park

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  1. Ickpyo Hong
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Correspondence to Hae Yean Park.

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Conflict of interest

Ickpyo Hong, Mi Jung Lee, Moon-Young Kim, and Hae Yean Park declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was exempted by the Institutional review boards (IRB) of Yonsei University because the research is a study of an existing dataset, the 2014 Korean National Survey on People with Disabilities which is publicly available. The study dataset is de-identified, such that subjects cannot be identified directly, or through identifiers linked to the subjects.

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Hong, I., Lee, M.J., Kim, M. et al. Item-level psychometrics of the ADL instrument of the Korean National Survey on persons with physical disabilities. Qual Life Res 26, 2867–2875 (2017). https://doi.org/10.1007/s11136-017-1637-y

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