Advanced Search

Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > European Journal of Physical and Rehabilitation Medicine 2012 September;48(3) > European Journal of Physical and Rehabilitation Medicine 2012 September;48(3):443-54

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

 

European Journal of Physical and Rehabilitation Medicine 2012 September;48(3):443-54

 ORIGINAL ARTICLES

Predicting the need for institutional care shortly after admission to rehabilitation: Rasch analysis and predictive validity of the BRASS Index

Panella L. 1, La Porta F. 2, Caselli S. 2, Marchisio S. 3, Tennant A. 4

1 Department of Rehabilitation Medicine, ASL Vercelli, Vercelli, Italy;
2 Rehabilitation Medicine Unit, AUSL Modena, Modena, Italy;
3 Quality Improvement Unit, ASL Vercelli, Vercelli, Italy;
4 Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK

BACKGROUND: Effective discharge planning is increasingly recognised as a critical component of hospital-based Rehabilitation. The BRASS index is a risk screening tool for identification, shortly after hospital admission, of patients who are at risk of post-discharge problems.
AIM: To evaluate the internal construct validity and reliability of the Blaylock Risk Assessment Screening Score (BRASS) within the rehabilitation setting.
DESIGN: Observational prospective study.
SETTING: Rehabilitation ward of an Italian district hospital.
POPULATION: One hundred and four consecutively admitted patients.
METHODS: Using classical psychometric methods and Rasch analysis (RA), the internal construct validity and reliability of the BRASS were examined. Also, external and predictive validity of the Rasch-modified BRASS (RMB) score were determined.
RESULTS: Reliability of the original BRASS was low (Cronbach’s alpha=0.595) and factor analyses showed that it was clearly multidimensional. A RA, based on a reduced 7-BRASS item set (RMB), satisfied model’s expectations. Reliability was 0.777. The RMB scores strongly correlated with the original BRASS (rho=0.952; P<0.000) and with FIM™ admission scores (rho=-0.853; P<0.000). A RMB score of 12 was associated with an increased risk of nursing home admission (RR=2.1, 95%CI=1.7-2.5), whereas a score of 17 was associated to a higher risk of length of stay >28 days (RR=7.6, 95%CI=1.8-31.9).
CONCLUSION: This study demonstrated that the original BRASS was multidimensional and unreliable. However, the RMB holds adequate internal construct validity and is sufficiently reliable as a predictor of discharge problems for group, but not individual use.
CLINICAL REHABILITATION IMPACT: The application of tools and methods (such as the BRASS Index) developed under the biomedical paradigm in a Physical and Rehabilitation Medicine setting may have limitations. Further research is needed to develop, within the rehabilitation setting, a valid measuring tool of risk of post-discharge problems at the individual level.

language: English


FULL TEXT  REPRINTS

top of page