VITENSKAP A Rasch analysis of the Sunnaas ADL Index for stroke survivors Av Kristin S. Loxley & Ann-Kristin G. Elvrum Abstract Sunnaas ADL Index’s internal scale validity Kristin S. Loxley is an occupational thera- pist, MSc, working at Sunnaas Rehabilitation Hospital and affiliated with Department of In- terdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Norway. Email: kristin.loxley@ sunnaas.no Ann-Kristin G. Elvrum is an occupational th- erapist, ph.d., working at Clinic of Rehabi- litation, St. Olav’s Hospital, Trondheim University Hospital, Trondheim and De- partment of Neurom- edicine and Movement Science, Norwegian University of Scien- ce and Technology, Trondheim. Artikkelen ble mottatt 23.03.2023 og godkjent 22.07.2023. Det er ingen interessekonflikter. Background : The Sunnaas ADL Index (SADL) is a generic outcome measure that evaluates indepen- dence in activities of daily living (ADL). Acceptable reliability of SADL for patients with stroke has been confirmed, while information concerning construct validity is lacking. Aims/Objectives : The objective of our study was to evaluate SADL’s internal scale validity and aspe- cts of reliability for stroke survivors. Material and Methods : Data from 200 patients (136 men, mean age 58 years) admitted to the stro- ke unit at Sunnaas Rehabilitation Hospital (2012- 2017), was included in the Rasch measurement model analyses to evaluate internal scale validity and item and person reliability of SADL. Results : SADL was found to be unidimensional with an item fit of 91.8 percent and excellent person (0.91) and item reliability (0.99). Only one item, communication, showed misfit, but was retained, as removal did not improve fit statistics. The scoring categories functioned well, but mean person ability was higher than mean item difficulty with nine per- sons reaching maximum scores. Conclusion : The SADL is a valid measure of inde- pendence in daily activities for stroke survivors and seems most appropriate for those with moderate to severe disabilities. It should be considered to revise the scoring criteria for the item communication. Keywords : Outcome Measures; Model, Statistical; Psychometrics; Activities of Daily Living 32 Ergoterapeuten 5–2023
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