Complex Patient
Conditions
Keywords
validation study, social participation, rehabilitation, occupational therapy
Brief summary
Since the post-acute phase, patients have occupational needs related to social reintegration, that improve the autonomy, social roles in family, at work and in the community. Unmet needs could lead to a lower level of social reintegration. Healthcare professionals should be able to recognize the level of social reintegration of complex patients discharged from the Physical Medicine Rehabilitation (PRM) unit with the aim to identify those who need intervention aimed at improving social reintegration. The preliminary Italian version of the RNL index (RNLI) will describe the social reintegration level of the target population, once its psychometric properties will be tested.
Detailed description
The investigators will recruit three groups of participants to test the psychometric properties of the Italian version of the RNLI: complex patients, caregivers and stakeholders. Phase\_1: to test the Content validity. The content validity will be tested on 10 complex patients and 10 stakeholders, who will assess the clarity and relevance of the RNLI items, respectively. In this phase, complex patients are hospitalized in the PMR unit. From this first phase, the investigators will obtain the preliminary Italian version of the RNLI to test its psychometric properties. Phase\_2: to test the Reliability, Construct validity and Responsiveness. During the hospitalization in the PMR unit, 138 patients and their caregivers will be recruited. During this phase, the investigators will detect the important occupational activities of complex patients enrolled through a semi-structured interview conducted in person. After discharge, the investigators will contact the patients and their caregivers by telephone at different times (T0, T1 and T2) to test the following psychometric properties through the administration of the Italian version of the RNLI and the Canadian Occupational Performance Measure (COPM). Caregiver will have to answer to the RNLI as a proxy for the patient. The contact times and the psychometric properties that will be tested are: T0\_ 2 weeks after discharge * internal consistency * inter-observer reliability * convergent construct validity T1\_ 10-14 days after T0 \- test-retest reliability T2\_ 6-8 weeks after T0 * discriminant construct validity * responsiveness
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
For patient: Inclusion Criteria: * hospitalized in the PMR unit of AUSL-IRCCS of Reggio Emilia * Rehabilitation Complexity Scale Extended ≥ 9 * Discharge at home
Exclusion criteria
* language barrier * comorbidities that limit communication and/or collaboration (eg aphasia, dementia, cognitive deficits, severe anxious-depressive syndromes pre-existent to hospitalization, etc.) * discharge in residential structures, retirement homes or long-term care or transferred to acute wards for complications. For caregiver: main caregivers of the patients enrolled For stakeholders: a rehabilitation healthcare professional with at least 3 years of clinical experience in rehabilitation and reintegration into the living environment of highly complex patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Phase_1: to test the Content validity of the Reintegration to Normal Living Index | 3 months | A group of complex patients and stakeholders will report the clarity and the relevance of the items of the Reintegration to Normal Living Index (RNLI), respectively. Thus, the content validity of the RNLI will be tested. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Phase_2: to test the Reliability, Construct validity and Responsivness of the Reintegration to Normal Living Index | 19 months | The Reintegration to Normal Living Index (RNLI) and the Canadian Occupational Performance Measure (COPM) will be administer to the complex patients and their caregiver in different times to test the psychometric properties of the RNLI. |
Countries
Italy
Contacts
AUSL of Reggio Emilia