Comparison of the Utrecht Scale for Evaluation of Rehabilitation-Participation with the ICF Measure of Participation and Activities Screener and the WHO Disability Assessment Schedule II in persons with spinal cord injury.
OBJECTIVE
To validate the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) in persons with spinal cord injury (SCI) using 2 International Classification of Functioning, Disability and Health (ICF)-based instruments: the ICF Measure of Participation and Activities-Screener (IMPACT-S) and the World Health Organization Disability Assessment Schedule II (WHODAS II).


DESIGN
Validation study. Score distributions, internal consistency, and concurrent and discriminant validity were evaluated.


SETTING
The community.


PARTICIPANTS
Convenience sample of persons (N=157) with long-term SCI living in The Netherlands.


INTERVENTIONS
Not applicable.


MAIN OUTCOME MEASURES
USER-Participation, IMPACT-S, and WHODAS II.


RESULTS
No instruments showed floor effects, and 3 out of 6 WHODAS II domains showed ceiling effects. Most scores showed adequate internal consistency (α≥.70), except for the USER-Participation frequency scale (.51) and 2 WHODAS II domains (.58-.60). Spearman correlation coefficients between the segregate USER-Participation scales were <.60 (range, .39-.46), showing that they cover separate aspects of participation. Concurrent validity of the USER-Participation was shown because >75% (83.3%) of the 24 hypotheses (Spearman correlation coefficients above or below .60) with the other measurement instruments were confirmed. Concurrent validity between the IMPACT-S and WHODAS II was not shown (53.8% of 13 hypotheses confirmed). All scores except 4 WHODAS II domains showed significant differences in participation between persons with paraplegia and tetraplegia.


CONCLUSIONS
The USER-Participation showed generally satisfactory psychometric properties in Dutch persons with long-term SCI living in the community. The IMPACT-S showed the best psychometric properties, and the WHODAS II showed less favorable results. Future research on the USER-Participation should focus on validation in other languages and different diagnostic groups.
['van der Zee|Carlijn H|CH|', 'Post|Marcel W|MW|', 'Brinkhof|Martin W|MW|', 'Wagenaar|Robert C|RC|']
D000328:Adult D004185:Disability Evaluation D005260:Female D006801:Humans D064702:International Classification of Functioning, Disability and Health D008297:Male D008875:Middle Aged D009426:Netherlands D026741:Physical Therapy Modalities D011594:Psychometrics D015203:Reproducibility of Results D058992:Social Participation D013119:Spinal Cord Injuries D014944:World Health Organization
Utrecht Scale for Evaluation of Rehabilitation-Participation ICF ICF Measure of Participation and Activities Screener Spinal cord injuries Spinal cord injuries USER-Participation SCI International Classification of Functioning, Disability and Health IMPACT-S World Health Organization Disability Assessment Schedule II WHODAS II Outcome assessment (health care) Rehabilitation Social participation Validation studies as topic spinal cord injury