Abstract
Many performance-based tools to assess hand function fall short of providing assessment in an occupation-based fashion. Here we report the interrater reliability of a standardized upper extremity (UE) assessment, the Suitcase Packing Activity (SPA), in individuals who sustained hand burns. We included adults with deep partial thickness or full thickness burns of one or both hands. Unstable orthopedic UE injuries, amputation of the thumb or UE, and/or mild cognitive deficits were excluded. SPA performance was independently rated by 2-3 assessors. Thirty participants, mean age 40.5 (SD = 14.7) years, 66.7% male were included. Interclass Correlation Coefficients Model 3, single rater, absolute agreement (ICC3,1) was used to assess interrater reliability. The ICC3,1 was 1.000 for total time, > 0.923 for accuracy score, and 1.000 for efficiency score. The SPA demonstrates good to excellent interrater reliability and suggests the validity of the SPA assess hand function after burn injury in an occupation-based manner.
Plain Language Summary
Examining the interrater reliability of the Suitcase Packing Activity (SPA) in adults with upper extremity burns Many of the performance-based outcome measures that have been cited in the literature to assess hand function fall short of providing assessment in an occupation-based fashion, let alone have been tested for use in individuals who have sustained burn injury. This is the first study to assess the interrater reliability of the Suitcase Packing Activity (SPA) in a population of clients who have sustained upper extremity injury (i.e., hand burns). The SPA is a standardized physical performance assessment that requires an individual to complete a 20-step process to pack a suitcase. It is used to assess hand and upper extremity function in an occupation-based manner. The researchers tested whether the SPA would yield the same results from different therapists assessing the performance of an individual completing the assessment (inter-rater reliability). Inter-rater reliability was assessed by giving the SPA to 30 individuals who had sustained burns to their hands and each of their performances were rated by two to three different occupational therapists or certified occupational therapy assistants. The therapists were not allowed to discuss their scores with each other. The study found that the SPA has good to excellent inter-rater reliability. This means that a client completing the SPA can be scored by different therapists and yield the same or very similar scores. This is crucial in therapy outcome assessments because it ensures accuracy and consistency of scores across different assessors. It is also essential when using outcome assessments in research studies as it improves the trustworthiness and validity of research findings. The relationship between these occupation-based assessment results and health-related quality of life and influence of occupation-based care on the trajectory of recovery remains to be determined and warrants further study.
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