Supervision rating scale: a measure of functional outcome from brain injury.
OBJECTIVE
To introduce a new outcome rating scale, the Supervision Rating Scale (SRS), which measures the level of supervision that a patient receives from caregivers. The SRS rates level of supervision on a 13-point ordinal scale that can optionally be grouped into five ranked categories (Independent, Overnight Supervision, Part-Time Supervision, Full-Time Indirect Supervision, and Full-Time Direct Supervision).


METHODS
Descriptive correlational study of the scale's interrater reliability and criterion-related validity.


METHODS
Brain injury program of a freestanding rehabilitation hospital.


METHODS
Referred case series of 114 patients with moderate to severe traumatic brain injury (mean time postinjury = 3.8 years) who resided in the community or a nonhospital facility.


METHODS
None.


METHODS
Functional outcome as measured by the Disability Rating Scale (DRS), Glasgow Outcome Scale (GOS), type of living arrangement and independence in selfcare and instrumental activities of daily living (ADL).


RESULTS
SRS ratings showed consistent relationships with type of living arrangement and with independence in self-care and instrumental ADL. SRS ratings were also strongly associated with ratings on the DRS and GOS. Interrater reliability of the SRS was evaluated in a subsample of 19 patients and found to be satisfactory (intraclass correlation = .86, weighted kappa = .64).


CONCLUSIONS
The results suggest that the SRS should have sufficient reliability and validity to serve as a measure of functional outcome from brain injury. Because SRS ratings are based on observed behaviors, the SRS may have a smaller subjective component as compared to the DRS and GOS.
Boake
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Department of Physical Medicine and Rehabilitation, University of Texas Houston Medical School, USA.
D000203:Activities of Daily Living; D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D015600:Glasgow Coma Scale; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D016896:Treatment Outcome