title: Development and preliminary reliability testing of an assessment of patient independence in performing a treatment program: standardized scenarios.
abstract: BACKGROUND
  Physical therapists often assess patient independence through observation; however, it is not known if therapists make these judgments reliably. We have developed a standardized method to assess a patient's ability to perform his or her treatment program independently.
  
  
  OBJECTIVE
  To develop a standardized assessment of patient independence in performance of a treatment program and examine the intra- and inter-rater reliability decisions made by two physical therapists.
  
  
  METHODS
  Test-retest.
  
  
  METHODS
  An assessment of patient independence in performance was developed. Standardized patient scenarios were used to assess the intra- and inter-tester reliability of two physical therapists. Percentage of agreement (%) and kappa's coefficient (k and k(w)) indexed rater reliability.
  
  
  RESULTS
  Intra-rater reliability of therapist 1 was as follows: knowledge: % = 95, k = 0.90; performance: % = 95, k(w) = 0.82. Intra-rater reliability of therapist 2 was as follows: knowledge: % = 85, k = 0.68; performance: % = 94, k(w) = 0.80. Inter-rater reliability for knowledge was % = 91 and k = 0.79 and for performance was % = 91 and k(w) = 0.72.
  
  
  CONCLUSIONS
  Trained therapists displayed substantial to excellent intra-rater reliability and substantial inter-rater reliability in assessing a patient's independence in a treatment program. :
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA. harrisma@wustl.edu
authors.forename: Marcie
authors.initials: M
authors.lastname: Harris-Hayes
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Holtzman
authors.forename: Jeanne A
authors.initials: JA
authors.lastname: Earley
authors.forename: Linda R
authors.initials: LR
authors.lastname: Van Dillen
mesh_terms: D000203:Activities of Daily Living; D023801:Directly Observed Therapy; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D015588:Observer Variation; D010146:Pain / Q000534:rehabilitation*; D010349:Patient Compliance; D011597:Psychomotor Performance; D015203:Reproducibility of Results; D016896:Treatment Outcome
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