title: Testing the validity, reliability and utility of the Self-Administration of Medication (SAM) tool in patients undergoing rehabilitation.
abstract: BACKGROUND
  Determination of patients' ability to self-administer medications in the hospital has largely been determined using the subjective judgment of health professionals.
  
  
  OBJECTIVE
  To examine the validity, reliability and utility of the Self-Administration of Medication (SAM) tool as an objective means to determine patients' ability to self-administer in a rehabilitation unit of a public teaching hospital in Melbourne, Australia.
  
  
  METHODS
  To assess validity of the SAM tool, associations were examined between the total SAM tool score and of the patients' competence to self-administer from the perceptions of the tool administrator, patients and nurses. Validity also was determined from a principal component analysis. Pearson correlations were calculated for how SAM scores related to scores obtained from the Functional Independence Measure (FIM) and Barthel Score Index (BSI). To assess the SAM tool's reliability, a Cronbach's alpha coefficient was calculated. Utility of the SAM tool was evidenced by documenting its administration time.
  
  
  RESULTS
  One hundred patients participated in this study. The SAM tool had a Cronbach's alpha coefficient of 0.75 and took a mean time of 5.36 min to complete. The capability to self-medicate section of the SAM tool had strong correlations with the FIM (r = 0.485) and BSI (r = 0.472) data, respectively, and the total SAM tool had moderate and strong correlations with the nurses' (r = 0.315) and tool administrator's (r = 0.632) perceptions of patients' ability to self-administer, respectively. Bland-Altman and ROC curve analyses showed poor agreement between the total SAM tool score and the nurses' perceptions.
  
  
  CONCLUSIONS
  The SAM tool demonstrated acceptable overall internal consistency. It only requires a short time to be completed and is more objective than seeking out health professionals' perceptions. Additional research is needed to further validate this approach to determining patients' ability to self-medicate.
authors.affiliation: Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia; Royal Melbourne Hospital Academic Centre, Parkville, Victoria 3010, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Anderson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
authors.forename: Snezana
authors.initials: S
authors.lastname: Kusljic
authors.forename: Sue
authors.initials: S
authors.lastname: Finch
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology; D025341:Principal Component Analysis; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function; D012046:Rehabilitation; D015203:Reproducibility of Results; D012646:Self Administration / Q000379:methods*; D011795:Surveys and Questionnaires; D014739:Victoria
keywords: Medication-taking competence; Self-Medication; Self-administration of medication