Construct validity and reliability of the participation scale (P-scale) in individuals with spinal cord injury

Abstract

Objectives

To investigate the reliability and the construct validity of the Participation Scale (P-scale) in adults with Spinal Cord Injury (SCI).

Design

A cross-sectional study.

Setting

: SARAH Network of Rehabilitation Hospitals, Brazil.

Participants

: One hundred individuals with SCI.

Interventions

: Not applicable.

Outcome Measures

: Sociodemographic and clinical characteristics were investigated. To assess reliability the P-scale was applied twice with a one-week interval. To assess construct validity the Functional Independence Measure, the Beck Depression Inventory, and the Accessibility Perception Questionnaire were administered.

Results

The mean age of the participants was 38.9 ± 12.80 years. The majority were male (70%) and had traumatic injuries (74%). The P-scale showed significant correlations with the Functional Independence Measure motor domain (r_s = −0.280) and cognitive domain (r_s = −0.520); with the Beck Depression Inventory score (r_s= 0.610); with the Accessibility Perception Questionnaire displacement domain (r_s= −0.620) and psycho-affective domain (r_s= 0.530). Mean scores obtained on the P-scale differed significantly between the groups with and without depressive symptoms (P = 0.001), neuropathic pain (P = 0.033), and functional dependence (P = 0.001). There was no difference between the paraplegic and quadriplegic groups. The P-scale had adequate internal consistency (Cronbach’s alpha = 0.873), excellent test-retest reliability (ICC_2,1= 0.992; 95% CI = 0.987–0.994), and in the Bland–Altman plot analysis, only six values fell outside the limits of agreement.

Conclusion

Our results support the use of the P-scale to assess the participation of individuals with SCI in research and clinical practice.

Keywords:

• Spinal cord injury
• Social participation
• Functional status
• Depression
• Accessibility
• Rehabilitation