Development and Validation of the Occupational Therapy Engagement Scale for Patients with Stroke.
Tzu-Yi Wu, Bella Ya-Hui Lien, Anthony H Lequerica and 2 others
PMID 30962799WHAT IT FOUND
A 12-item scale allowed occupational therapists to rate engagement in hospitalized subacute stroke patients.
Higher scores meant more engagement, and scores were modestly related to daily-living performance two months after discharge.
Key findings
01After Rasch analysis, the final Occupational Therapy Engagement Scale has 12 items, and a higher score indicates higher engagement in occupational therapy.
02The 12-item scale had person reliability 0.88, above the study's 0.7 threshold for group comparisons and below its 0.9 threshold for individual comparisons.
03Engagement scores were associated with daily-living performance two months after discharge (r = 0.37).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was convenience and only hospitalized patients with stroke onset within 6 months, so it may not apply to outpatients or later after stroke. Patients with severe cognitive or communication deficits were not recruited, so the scale is not validated for people who cannot follow instructions or speak. 20.2% (51 patients) had the highest possible raw score of 36, so the scale may not distinguish very high engagement. 25.3% (64 patients) fell in one item-difficulty gap, meaning some engagement ranges were less well covered by the items. The predictive validity analysis used a simple correlation rather than regression controlling for motor or cognitive impairment, so engagement scores may reflect ability rather than causing better daily function.
The easy way to misread this
Do not read the 0.37 association between engagement scores and daily-living performance as proof that increasing engagement will improve recovery. The study validated a rating scale, not an intervention, and did not control for motor or cognitive impairment.