|Title:||Validation of ADL domains for patients with chronic obstructive pulmonary disease in Hong Kong|
|Subject:||Hong Kong Polytechnic University -- Dissertations|
Lungs -- Diseases, Obstructive -- Patients -- Rehabilitation -- China -- Hong Kong
|Department:||Department of Rehabilitation Sciences|
|Pages:||ix, 114 leaves : ill. ; 30 cm|
|Abstract:||Local occupational therapists always face the problems of lacking validated clinical tools to locate relevant activities of daily living (ADL) domains for assessing patients with chronic obstructive pulmonary disease (COPD). A local study has explored most of the domains for performance assessment for this disease group and has provided a basis for the present study. This study focused on developing a comprehensive ADL Inventory relevant to our local patients. Moreover, content. and construct validity were established in two phases. In phase I study, a 25-item ADL Inventory was initially constructed from the basis of the previous study with addition of items from other existing local ADL-related tools. An expert panel of 12 COPD patients in all diversities of the disease stage was interviewed individually for content validity evaluation. The result indicated that the overall representativeness of the inventory was exceedingly agreed (97% of agreement) by the panel members. Only 3 of the items had less than 50% of agreement (42% to 47%) on their relevancy as an ADL item being affected by their respiratory disease. However, they were retained for phase II analysis as still a proportion of panel members experienced difficulty in them. The recommendation of an additional ADL item resulted in a finalized 26-item ADL. inventory. In phase II study, another 120 COPD patients were recruited to rate on the perceived difficulty on each item. The underlying constructs were explored by exploratory factor analysis. The result suggested that there were six categories of components, accounting for a total of 78% variance. The factors were namely "physical stamina", "speech-related performance", "drastic change of posture", "arm and trunk movement", "coordinated dexterity" and "prolonged continuous exercise" which might have hindered the performance. The high Cronbach's alpha (a=0.708 to 0.948) of the components together with moderate inter-item coefficients (r =0.55 to 0.73) suggested high internal consistency of items within the components. The development of a complete spectrum of ADL items relevant to our local COPD patients offers an appropriate scope for therapists to work on. By understanding the underlying constructs influencing specific category of ADL items, therapists can establish their different strategies to deal with them. With an addition of a measuring scale, the inventory can be further developed into an ADL assessment tool for clinical and research measurement. In conclusion, this study has devised a comprehensive ADL Inventory with significant content and construct validity.|
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