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Volume 45 Number 9, 2008
   Pages 1385 — 1400

Abstract - Rasch analysis of Minimum Data Set mandated in skilled nursing facilities

Ying-Chih Wang, PhD;1* Katherine L. Byers, PhD;2 Craig A. Velozo, PhD, OTR/L3

1Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL; 2Department of Clinical Administration and Rehabilitation Counseling, Texas Tech University Health Science Center, Lubbock, TX; 3Department of Veterans Affairs Health Services Research and Development and Rehabilitation Research and Development Services, Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, and Department of Occupational Therapy, University of Florida, Gainesville, FL

Abstract — This study examined the construct validity of the physical functioning and cognition scales of the federally mandated Minimum Data Set (MDS) via Rasch analysis. We performed a secondary analysis of retrospective MDS data collected by the Department of Veteran Affairs Austin Automation Center. Items demonstrated unidimensionality and represented two separate constructs: physical functioning and cognition. The physical functioning items showed good psychometric properties and covered a wide range of residents' physical functioning, with the spread of items efficiently discriminating residents' performance into different physical functioning strata. In contrast, the psychometric properties of the cognition items were less sound, had severe ceiling effects, and did not efficiently discriminate residents' performance into different cognition strata. The constructed validity of the physical functioning and cognition scales of the MDS, in general, was supported. Future investigations into the function of the rating scale and the necessity of adding challenging items are recommended.

Key words: activities of daily living, assessment, cognition, construct validity, MDS, patient outcomes, physical functioning, Rasch analysis, rehabilitation, skilled nursing facilities.

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