Development of a tool to guide referral of patients with neuromuscular disorders to allied health services. Part two

• Published in: Disability and rehabilitation 2008, Vol.30 (11), p.863-870
• Main Authors: Pieterse, Allan J., Cup, Edith H. C., Knuijt, Simone, Akkermans, Reinier, Hendricks, Henk T., van Engelen, Baziel G. M., van der Wilt, Gert-Jan, Oostendorp, Rob A. B.
• Format: Article
• Language: English
• Subjects: Chi-Square Distribution; Consultation; Disability Evaluation; Factor Analysis, Statistical; Humans; Muscular diseases; Needs Assessment; Nervous system disorders; Neuromuscular diseases; Neuromuscular Diseases - rehabilitation; Occupational Therapy - utilization; Physical Therapy Modalities - utilization; questionnaire; Referral and Consultation; Referrals; Reproducibility of Results; Selfreport; Speech Therapy - statistics & numerical data; Statistics, Nonparametric; Surveys and Questionnaires
• ISSN: 0963-8288; 1464-5165
• DOI: 10.1080/09638280701403460

Purpose. The Perceived Limitations and Needs Questionnaire (PLAN-Q) was developed to guide referral for a one-off consultation by occupational therapy (OT), physical therapy (PT), and speech therapy (ST) consultation, to provide a tailor-made advice on allied health interventions. This article reports on the testing of validity and reliability of the PLAN-Q. Methods. In the validation study, 208 patients with a broad spectrum of neuromuscular disorders completed the PLAN-Q, Medical Outcome Study short-form 36-item version (SF-36), and the Impact of Participation on Autonomy (IPA) questionnaires. A subsection of 51 patients, whose physical condition was stable, participated in the evaluation of the intra-rater reliability of the questionnaire. The theoretical construct was tested with factorial analysis, subscales were constructed and reliability and validity of the PLAN-Q subscales were assessed. Results. Factorial analysis resulted in an 18-item self-report questionnaire. Items were grouped into four subscales ('physical capacity', 'transferring', 'oropharyngeal capacity', and 'hand-use'), each with two dimensions ('capacity' and 'need for help'). The internal consistency of all subscales was good (Cronbach's α: 0.77 - 0.94) as well as the intra-rater reliability of the subscales 'physical capacity' and 'transferring' in the 'capacity' dimension (Kappa: 0.70 - 0.75). The 'need' dimension showed poor intra-rater reliability suggesting that 'need for help' is a variable phenomenon that changes between two points of measurement. The construct validity of the subscales against the SF-36 and the IPA was satisfactory. Conclusion. The PLAN-Q is a valid self-report instrument that measures patients' perception of capacity and needs in domains relevant to referral for a one-off OT, PT, or ST consultation.