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KMID : 1140920180420020336
Annals of Rehabilitation Medicine
2018 Volume.42 No. 2 p.336 ~ p.345
Disability Measurement for KoreanCommunity-Dwelling Adults With Stroke:Item-Level Psychometric Analysis of the KoreanLongitudinal Study of Ageing
Hong Ick-Pyo

Kim Young-Joo
Sonnenfeld Mandi L.
Grattan Emily
Reistetter Timothy A.
Abstract
Objective: To investigate the psychometric properties of the activities of daily living (ADL) instrument used in the analysis ofKorean Longitudinal Study of Ageing (KLoSA) dataset.

Methods: A retrospective study was carried out involving 2006 KLoSA records of community-dwelling adults diagnosed withstroke. The ADL instrument used for the analysis of KLoSA included 17 items, which were analyzed using Rasch modelingto develop a robust outcome measure. The unidimensionality of the ADL instrument was examined based on confirmatoryfactor analysis with a one-factor model. Item-level psychometric analysis of the ADL instrument included fit statistics, internalconsistency, precision, and the item difficulty hierarchy.

Results: The study sample included a total of 201 community-dwelling adults (1.5% of the Korean population with an age over 45years; mean age=70.0 years, SD=9.7) having a history of stroke. The ADL instrument demonstrated unidimensional construct. Twomisfit items, money management (mean square [MnSq]=1.56, standardized Z-statistics [ZSTD]=2.3) and phone use (MnSq=1.78,ZSTD=2.3) were removed from the analysis. The remaining 15 items demonstrated good item fit, high internal consistency (personreliability=0.91), and good precision (person strata=3.48). The instrument precisely estimated person measures within a widerange of theta (-4.75 logits < q < 3.97 logits) and a reliability of 0.9, with a conceptual hierarchy of item difficulty.

Conclusion: The findings indicate that the 15 ADL items met Rasch expectations of unidimensionality and demonstrated goodpsychometric properties. It is proposed that the validated ADL instrument can be used as a primary outcome measure forassessing longitudinal disability trajectories in the Korean adult population and can be employed for comparative analysis ofinternational disability across national aging studies.
KEYWORD
Stroke, Aging, Community survey, Reliability and validity, Outcome assessment
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