Abstract

PurposeTo develop two item content-matched, precise, score-level targeted inpatient physical function (PF) short form (SF) measures: one clinician-reported, one patient-reported. Items were derived from PROMIS PF bank content; scores are reported on the PROMIS PF T-score metric.MethodsThe PROMIS PF item bank was reviewed for content measuring lower-level PF status (T-scores 10–50) with high item set score-level reliability (≥ 0.90). Selected patient-reported (PR) items were also edited to function as clinician-reported (CR) items. Items were reviewed by clinicians and field tested; responses were assessed for meeting PROMIS measure development standards. New CR and PR items were calibrated using patient responses to the original PROMIS PF items as anchoring data. SFs were constructed, based on content and precision.ResultsNine PROMIS PF items were candidates for CR and PR inpatient PF assessment; three new items were written to extend content coverage. An inpatient sample (N = 515; 55.1% female; mean age = 66.2 years) completed 12 PR items and was assessed by physical therapists (using 12 CR items). Analyses indicated item sets met expected measure development standards. Twelve new CR and three new PR items were linked to the PROMIS PF metric (raw score r = 0.73 and 0.90, respectively). A 5-item CR SF measure was constructed; score-level reliabilities were ≥ 0.90 for T-scores 13–45. A 5-item PR SF measure was assembled, mirroring CR SF content.ConclusionsTwo item content-matched SFs have been developed for clinician and patient reporting and are an effective, efficient means of assessing inpatient PF and offer complementary perspectives.

Highlights

  • Physical function (PF) is a critical component of overall health [1, 2]

  • We tested our items with a hospital inpatient sample (N = 515; 55.1% female; mean age = 66.2 years), and our analyses indicated that these new item sets met good, established measure development standards

  • We summarized results via model fit index criteria: confirmatory fit index (CFI) and Tucker–Lewis Index (TLI) ≥ 0.95, root mean square error of approximation (RMSEA) < 0.10, standardized root mean residual (SRMR) < 0.08 [20, 21]

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Summary

Introduction

Physical function (PF) is a critical component of overall health [1, 2]. In the context of acute illness, PF is often poorly measured and tracked [3]. Many patients experience new, significant disability in the course of hospitalization [4–6]. Patients of all ages face recovery from the acute cause of their hospitalization and the trauma of hospitalization itself; many never return to their prior level of functioning [3, 7–9]. While numerous instruments measuring PF exist, few have been developed that can readily be deployed to track patients’ functional trajectory before, during, and after hospitalization [10]. In the absence of such instruments embedded across the care continuum, healthcare providers, patients, and caregivers miss an opportunity to understand and communicate about the occurrence of important PF changes

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