Development of the Participation Measure--3 Domains, 4 Dimensions (PM-3D4D): A New Outcome Measure for Rehabilitation

Publication date: Available online 1 September 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Feng-Hang Chang, Tsan-Hon Liou, Pengsheng Ni, Kwang-Hwa Chang, Chien-Hung Lai
ObjectiveTo describe the development of a participation measure that assesses three domains (productivity, social, and community) and four dimensions (frequency, diversity, desire for change, and perceived difficulty) of participation and to evaluate the initial psychometric properties in rehabilitation outpatients.DesignA mixed-method approach included a literature review, item selection, expert reviews, cognitive interviews and field testing with rehabilitation outpatients. A confirmatory factor analysis (CFA) and Rasch analysis were used to validate the construct validity of the difficulty dimension of the instrument.SettingOutpatient rehabilitation programs in Taiwan.ParticipantsAn expert panel consisting of 12 rehabilitation and measurement experts contributed to measurement development; 20 rehabilitation outpatients participated in cognitive interviews; and 556 rehabilitation outpatients (with an average age of 61.36±23.62 years, among whom 53% were male) participated in field testing.Main outcome measureThe Participation Measure--3 Domains, 4 Dimensions (PM-3D4D).ResultsA scoring method for each dimension of the PM-3D4D was established. The instrument displayed good overall model fit in the CFA and unidimensionality across three domains after removing and collapsing locally dependent items identified from a principal component analysis (PCA). However, considering the poor personal reliability of the social subscale and its high correlation with the community subscale, we decided to merge the two subscales into one. The combined subscale showed improved reliability and good construct validity by demonstrating a good model fit (CFI =0.985, TLI =0.982, RMSEA =0.061) and item fit.ConclusionsThe PM-3D4D is a newly developed participation measure designed to assess multiple domains and dimensions of participation by rehabilitation patients. The psychometric analysis results supported the construct of the instrument and helped item revision. Further examination of the validity and reliability of the PM-3D4D will be conducted.



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