Validating Three Common Occupational Therapy Assessments in Participants With Schizophrenia
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Observational

Summary: 
      To improve activities of daily living (ADL) and social functions is the important treatment
      plans and goals in participants with schizophrenia. Precise and effective measures of ADL and
      social functions are critical for clinicians to set up appropriate treatments plans, follow
      up participants' changes, and understand participants' progress. Three common measures of ADL
      and social functions used in participants with schizophrenia were the Comprehensive
      Occupational Therapy Evaluation Scale (COTES), the Activities of Daily Living Rating Scale
      third ed. (ADLRS-3), and the Social Functioning Scale. To investigators' knowledge,
      psychometric properties of these assessments have not been examined in participants with
      schizophrenia. Therefore, the purpose of the study is to (1) examine internal consistency and
      construct validity of these 3 assessments (the COTES, the ADLRS-3, and the Social Functioning
      Scale); and (2) calculate missing rate of self-report assessment (the ADLRS-3 and the Social
      Functioning Scale). Investigators expect that these results of internal consistency,
      construct validity and/or missing rate will provide empirical evidence for using these three
      measures in both clinical and research setting.
    

Detailed description: 
      Social dysfunction is one of the main characteristics of participants with schizophrenia and
      influences participants' daily functions and quality of life. The Social Functioning
      Scale-Taiwan short form (SFST) is commonly used to measure social function in participants
      with schizophrenia. However, no study has examined psychometric properties of the SFST in
      participants with schizophrenia exclusively. Therefore, the study aimed to examine missing
      rate, ceiling effect/floor effect, internal consistency, and convergent validity of the SFST
      in participants with schizophrenia. Investigators obtained schizophrenic self-report data
      (the SFST and the ADLRS-3) from occupational therapy records. The Chinese version of the
      Activities of Daily Living Rating Scale (ADLRS-3), which has 10 domains, is commonly used for
      assessing activities of daily living (ADL) in participants with schizophrenia. However,
      construct validity (i.e., unidimensionality) for each domain of the ADLRS-3 is unknown,
      limiting the explanations of the test results. From occupational therapy records,
      investigators obtained self-report data of the ADLRS-3. Confirmatory factor analysis (CFA)
      was conducted to examine the 10 one-factor structures. If a domain showed an insufficient
      model fit, exploratory factor analysis (EFA) was performed to investigate the factor
      structure and choose one factor representing the original construct. Internal consistency was
      examined using Cronbach's alpha. Ceiling and floor effects were determined by the percentage
      of participants with the maximum and minimum scores in each domain, respectively. To evaluate
      construct validity (i.e., unidimensionality and convergent validity) and Rasch reliability of
      the Comprehensive Occupational Therapy Evaluation Scale (COTES) in participants with
      schizophrenia. From occupational therapy records, investigators collected COTES data of
      participants with schizophrenia. The 20-item COTES contains three subscales. For construct
      validity, investigators first examined the unidimensionality of each subscale using Rasch
      analysis. After unidimensionality was supported, investigators examined convergent validity
      using Pearson's r and Rasch reliability of the individual subscales in unidimensional and
      multidimensional approaches.
    

Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        A retrospective study was conducted and the data were obtained from occupational therapy
        records at community rehabilitation centers in Taiwan.