Development and initial psychometric evaluation of the participation measure for post-acute care (PM-PAC).
OBJECTIVE
To evaluate a patient-reported participation measure constructed within the framework of the International Classification of Functioning, Disability, and Health.


METHODS
The Participation Measure for Post-Acute Care (PM-PAC) contains 51 items that assess participation in nine domains: mobility; role functioning; community, social, and civic life; domestic life/self-care; economic life; interpersonal relationships; communication; work; and education. Self-reported data were collected by interview with 395 noninstitutionalized rehabilitation patients. Psychometric analyses were conducted to test assumptions underlying the scaling and scoring of PM-PAC scales and to evaluate reliability and validity.


RESULTS
In general, analyses supported assignment of items to hypothesized scales. However, the community, social, and civic life, interpersonal relationships, and communication domains were highly correlated. Item response theory models indicated that items were directed primarily at people with worse than average limitations in participation than the average patient in this rehabilitation sample. Test and retest scale scores did not differ significantly (intraclass correlation coefficient range, 0.61-0.86). Groups with more severe conditions scored worse on PM-PAC scales, as hypothesized.


CONCLUSIONS
PM-PAC is a promising new measure of patient-reported participation as defined by the International Classification of Functioning, Disability, and Health. Information about PM-PAC items from this study will be useful in developing a computerized, adaptive measure of participation.
Gandek
Barbara
B
All correspondence and requests for reprints should be addressed to Barbara Gandek, MS, Health Assessment Lab, 275 Wyman Street, Suite 120, Waltham, MA 02451, USA.
Sinclair
Samuel J
SJ
Jette
Alan M
AM
Ware
John E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009422:Nervous System Diseases / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life; D012647:Self-Assessment; D018434:Sickness Impact Profile; D019467:Subacute Care; D011795:Surveys and Questionnaires; D013997:Time Factors