Reliability and Validity of a New Transfer Assessment Form for Stroke Patients

INTRODUCTION: Transferring is a basic skill that is essential for mobility independence and indispensable for expanding activities of daily living of stroke patients using a wheelchair. Therefore, transfer independence is an important issue that greatly affects daily life in the hospital and at home. To offer an effective intervention to acquire a skill, developing an assessment for individual subtasks that comprise transferring would assist the identification of specific tasks that prevent independence in patients and facilitate interventions to improve transferring independence. OBJECTIVE: To examine the reliability and validity of a newly developed transfer assessment form, the Bed‐wheelchair transfer Tasks Assessment Form (BTAF), for stroke patients to evaluate subtasks required for transferring. DESIGN: Validation and test‐retest studies. SETTING: Subacute rehabilitation wards in Japan. PARTICIPANTS: A total of 82 therapists for verifying content validity; 30 patients for validation and test‐retest study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The content validity was initially assessed based on a questionnaire. Subsequently, four occupational therapists used the form to evaluate the video‐recorded transferring performances of stroke participants. Two assessors evaluated each performance once and then 2 weeks later. The inter‐rater reliability, intra‐rater reliability, internal consistency, and concurrent validity were examined. RESULTS: Fleiss's κ coefficient for inter‐rater reliability for each item of the form was 0.66 or more. Cohen's κ coefficient for intra‐rater reliability for each item was 0.73 or more. Cronbach's coefficient alpha ranged from 0.90 to 0.93. Spearman's rank correlation coefficients between the mean scores of our form and scores of the functional independence measure item “transfer to bed/chair/wheelchair” ranged from 0.53 to 0.78 (P < .01). CONCLUSIONS: The form demonstrated good reliability and validity. Its usefulness and efficacy should be further investigated in stroke patients to facilitate rehabilitation.