A key component in assessing the performance of rehabilitation services is the client's perspective. The purpose of this paper is to report on the development of a publicly available measure of client-centred rehabilitation (CCRQ) that can be used for discriminative and evaluative purposes.
Mixed qualitative and quantitative methods were used. Phase 1: Identification of seven domains of client-centred rehabilitation based on a literature review, focus groups with clients, and review by content experts. Phase 2: Item generation for the seven conceptually derived subscales and cognitive interviews with inpatient rehabilitation patients. Phase 3: Psychometric testing for internal reliability, test-retest reliability and discriminative construct validity using data from a mailed, self-administered survey to 1,568 patients discharged from two large inpatient rehabilitation facilities.
The seven conceptually derived subscales all have strong internal (0.72 - 0.87) and test-retest reliability (0.74 - 0.85). Discriminative construct validity is demonstrated by the ability of subscales to identify significant differences between programs within two rehabilitation facilities.
The results for the reliability and validity of this measure support its value for use in clinical and quality improvement work as well as research.
Table 1 lists the seven domains of client-centred rehabilitation that were identified as important from the client’s perspective in the qualitative phase of this research project.
Table 3 shows the internal (Cronbach’s alpha) and test-retest (intraclass correlation) reliability coefficients of the subscales based on the remaining 30 items. The internal consistency reliability coefficients ranged from 0.72 for the 3-item education subscale to 0.87 for the six-item scale on client participation in decision-making. The test-retest reliabilities ranged from 0.74 for the education subscale to 0.85 for the continuity/coordination subscale. The test-retest reliability of individual items was also acceptable, with intraclass correlation coefficients ranging from 0.55 – 0.81 (mean 0.67) over all 30 retained items.
No supplementary information is available for this paper.