| 제목 |
Psychometric validation of the Korean version of Rehabilitation Complexity Scale version 1 |
| 소속 |
National Traffic Injury Rehabilitation Hospital, TBI rehabilitation center1, The Catholic University of Korea Seoul St. Mary`s Hospital , Department of Rehabilitation Medicine2, The Catholic University of Korea St. Vincent`s Hospital , Department of Rehabilitation Medicine3, Seoul National University Hospital, Department of Rehabilitation Medicine4, Inje University Ilsan Paik Hospital, Department of Rehabilitation Medicine5, The Catholic University of Korea Bucheon St. Mary`s Hospital , Department of Rehabilitation Medicine6, St. Paul Hospital, The Catholic University of Korea, Department of Rehabilitation Medicine7, Bobath Memorial Hospital, Department of Rehabilitation Medicine8, National Traffic Injury Rehabilitation Hospital, Department of Nursing9, National Traffic Injury Rehabilitation Hospital, Traffic Injury Rehabilitation Research Institute10 |
| 저자 |
Tae-Woo Kim 1,2†, Hoo Young Lee1,2*, Seong Hoon Lim3, Hyung-Ik Shin4, Jeehyun Yoo5, Sun Im6, Myung Eun Chung7, Soon Yong Kwon8, Hyun-Mi Oh1,2, Jihye Park7, Hyo Eun Kim9, Da Ban Lim10, Si Young Park10, Ji-Yeon Lee10 |
Background and aim
To establish a rehabilitation medical delivery system according to the circumstances in Korea, existing Korean Rehabilitation Patient Group Version 1.1 (KRPG v1.1) alone is insufficient to embrace complex rehabilitation needs because it solely depends on the diagnosis, age, and physical and mental function. Therefore, it is necessary to complement the KRPG v1.1 and develop the comprehensive and feasible rehabilitation patient classification system that assess the complexity of rehabilitation needs. The aim of this study was to translate and cross-culturally adapt the RCS-E (13th version) to provide Korean version of the RCS(K-RCS), to report on the key clinimetric properties of the K-RCS, and to investigate its performance in a sample of patients in the subacute post-injury phase with highly complex rehabilitation needs. We also explored its dimensionality and relationship with the other functional outcome measures in order to evaluate its potential as a measure of caseload complexity in complex neurological rehabilitation settings. Furthermore, we quantified the predictive validity of the K-RCS on length of stay(LOS) and allocation of rehabilitation resources by R squared and compared with KRPGv1.1.
Methods
We translated, cross-culturally adaptd the RCS-E (13th version) to provide K-RCS and explored content and face validity. KRPGv1.1 and K-RCS data were collected for a total of 430 patients (234 males and 196 females) with complex neurological or musculoskeletal disabilities, mainly following acquired brain injury, from six designated rehabilitation institutions during a 8-month period from 1 January to 31 August 2018. K-RCS ratings of the level of medical(M), nursing(N), care(C), therapy (Ti for intensity and Td for disciplines), and equipment(E) were examined for dimensionality, repeatability, reliability, validity, responsiveness, explained variance and compared with the KRPGv1.1.
Results
Content Validity Index was >0.8. The test-retest reliability confirmed the RCS to be repeatable (spearman’s rho 0.69 to 0.86). Cronbach-α was 0.63. Item-total correlations were >0.50 for M, N, C, Ti with moderate to high loadings on the first principal component. Factor analysis revealed two clear factors (‘M/N,’ and ‘C/Td/Ti/E’). Comparative fit index was 0.871. MMSE-KC, MBI, MMT correlated well with N, C, and total score (Spearman rho 0.368~0.495). K-RCS was superior to KRPGv1.1 in predictive validity. R-squared measures were 13.6%, 20.3%, 13%, 38% for total, medical, rehabilitative therapy costs, and LOS, respectively, and were higher than each R-squared measure of KRPGv1.1.
Conclusion
The K-RCS provides a sensitive and reliable tool that appears to be suitable for measuring clinical complexity in Korean rehabilitation hospitals. Its psychometric validation may have an important impact on guiding the patient’s assignment to the rehabilitation setting that best suit their specific needs. |
|
the Korean version of Rehabilitation Complexity Scale version 1
R-squared measures for explained variance of K-RCS and KRPGv1.1
Multiple regression analysis of K-RCS on rehabilitation resource and length of stay
|
