A Rasch analysis of the self-administered Foot Health Assessment Instrument (S-FHAI)

Minna Stolt,Riitta Suhonen,Anders Kottorp

doi:10.1186/s12912-021-00625-z

Minna Stolt, Riitta Suhonen + Show 1 more

Open Access

https://doi.org/10.1186/s12912-021-00625-z

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Abstract

BackgroundReliable and valid measurement is the foundation of evidence-based practice. The self-administered Foot Health Assessment Instrument (S-FHAI) was recently developed to measure patients’ evaluations of their own foot health. Evidence regarding the psychometric properties of the S-FHAI is limited. The aim of this study was to investigate those properties by using a Rasch analysis.MethodsThis methodological study analysed secondary data that was collected from nurses (n = 411) in 2015. The psychometric properties of the S-FHAI were evaluated using the Rasch model. Unidimensionality was analysed first, followed by item functioning, person misfit and differential item functioning (DIF).ResultsThe S-FHAI demonstrated evidence of unidimensionality, with an acceptable item fit according to the Rasch model. Person fit and person separation were low, however, indicating restricted separation among different respondents. Item separation was high, demonstrating clear discrimination between the items. No DIF was detected in relation to gender, but significant DIF was demonstrated in relation to age for 6 of the 25 items.ConclusionsThe S-FHAI has potential for use in investigating self-reported foot health. The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although some issues should be addressed to improve the scale. In future, it may be beneficial to analyse the sensitivity of the items and to test the S-FHAI in more diverse patient populations.

Highlights

Reliable and valid measurement is the foundation of evidence-based practice
This study evaluated the psychometrics of the S-Foot Health Assessment Instrument (FHAI) from the perspective of item response theory by using a Rasch analysis on responses from a sample of nurses
The findings suggest that the sensitivity of the self-administered Foot Health Assessment Instrument (S-FHAI) may be limited when used in more generic and healthy samples, its sensitivity among people whose foot health is poor is still unknown

Summary

Introduction

The self-administered Foot Health Assessment Instrument (S-FHAI) was recently developed to measure patients’ evaluations of their own foot health. Evidence regarding the psychometric properties of the S-FHAI is limited. Healthy feet help make pain-free activity possible for people in every age group. This is especially important in occupations that involve long periods of standing or walking, such as nursing. The prevalence of foot problems among nurses is high [1, 2]. Nurses may experience foot problems that stem from long-term disease (e.g. diabetes, rheumatoid arthritis) or a limited ability in foot self-care, and these issues can affect their ability to work [1,2,3,4].

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