Measurement properties of a modified Reintegration to Normal Living Index in a community-dwelling adult rehabilitation population

Abstract

Purpose. To examine the validity and reliability of a modified Reintegration to Normal Living Index (mRNL Index) with a sample of community-dwelling adults with mixed diagnoses.

Method. Forty-six adults (mean 55.2  ±  20.3 years) were recruited through convenience sampling from outpatient rehabilitation services. They completed the mRNL Index, Community Integration Measure (CIM) and Life Space Assessment (LSA) and were invited to complete them again 2 weeks later.

Results. Construct validity of the mRNL Index was confirmed by good fit to the Rasch measurement model. The mRNL Index demonstrated acceptable internal consistency (Cronbach's α  ==  0.80), as did the Daily Functioning subscale (Cronbach's α  ==  0.80) and Personal Integration subscale (Cronbach's α  ==  0.82). Test-retest reliability was also acceptable (intraclass correlation coefficient (3,1)  ==  0.83, p  ==  .0001). As hypothesised, the LSA did not correlate with the Personal Integration subscale (Spearman rho  ==  0.08) and moderately correlated to the Daily Functioning subscale (Spearman rho  ==  0.59). The CIM was moderately correlated with the Personal Integration subscales (Spearman rho  ==  0.54) and the Daily Functioning subscale (Spearman rho  ==  0.53), though higher correlation was expected with the latter.

Conclusion. Modifications to the phrasing, rating scale and subscales improved the validity of the original RNL Index for a mixed rehabilitation, community-dwelling population.

Keywords:

• Participation
• psychometrics
• rehabilitation
• patient discharge
• Reintegration to Normal Living Index (RNL)

Acknowledgements

The authors are grateful to all patients and therapists who took part in this study and to the Royal Rehabilitation Centre Sydney and Mt Wilga Private Hospital for their support in recruitment.