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APHA Scientific Session and Event Listing

Recorded presentation

Renan Castillo, MS¹, Ellen MacKenzie, PhD¹, and Stephen Wegener, PhD². (1) Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, 410-614-4024, rcastill@jhsph.edu, (2) Department of Physical Medicine and Rehabilitation, The Johns Hopkins University, 600 N Wolfe Street, Phipps, Room 174, Baltimore, MD 21239

Objectives: The International Classification of Functioning (ICF) specifies disability as occurring at three levels: body functions and structures (impairments), activity (limitations), and participation (restrictions). The goal of this analysis is to confirm the existence of separate activity limitation and participation restrictions domains within the Sickness Impact Profile (SIP), a widely used as a measure of function. Methods: Patients (N=1,045) from two longitudinal studies of severe leg trauma were followed at 6, 12, and 24 months post-injury. Exploratory factor analysis techniques were used to identify domains within the 136 items of the SIP. Reliability of factors was assessed using alpha coefficients. External normological validity was assessed using a multitrait-multimethod matrix incorporating a panel of accepted measures of functional independence, psychologic distress, quality of life, and return to usual major activities. Results: Four factors accounted for 52-55 % of the variance and labeled “Role Participation”, “Physical Activity Limitations”, “Psychosocial Activity Limitations” and “Cognitive Dysfunction”. All four domains had alpha coefficients in the range of 0.75-0.92, in line with alpha coefficients in the original domains of the SIP. A multitrait-multimethod matrix analysis showed high correlation (r2>0.4) between the “Role Participation” domain and return to usual major activity, the “Physical Activity Limitations” domain and several measures of functional independence, and “Psychosocial Activity Limitations” and measures of psychologic distress. Conclusions: The results confirm the existence of separate activity limitation and participation domains in the SIP, as suggested by the ICF framework of disability. The newly constructed domains exhibit high reliability and external normological validity.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the framework for the measurement of disability in the International Classification of Function.
• Recognize the importance of developing stronger measures of activity limitations and participation.
• Apply the results to obtain separate activity limitation and participation domains from the Sickness Impact Profile.

Keywords: Disability, Outcome Measures

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation