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Paediatric Rehabilitation Ingredients Measure: a new tool for identifying paediatric neurorehabilitation content
Rob Forsyth1,2, David Young3, Gemma Kelly4
1Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Insights
The Paediatric Rehabilitation Ingredients Measure (PRISM) quantifies interdisciplinary neurorehabilitation content. This tool aids research into treatment effects on outcomes for children with acquired brain injury (ABI).
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pediatrics
Background:
- Quantifying rehabilitation 'dose' and 'content' is crucial for understanding its contribution to outcomes in acquired brain injury (ABI).
- Previous methods may have overemphasized individual therapy sessions, necessitating a more holistic approach to assessing rehabilitation interventions.
- The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding disability and functioning in rehabilitation.
Purpose of the Study:
- To develop the Paediatric Rehabilitation Ingredients Measure (PRISM) for quantitative estimation of interdisciplinary neurorehabilitation content.
- To enable studies examining the relationship between delivered rehabilitation treatment and severity-adjusted outcomes in pediatric acquired brain injury (ABI).
Main Methods:
- Developed using an ingredients-mediators-outcomes model, literature review, and rehabilitation treatment taxonomy initiatives.
- Item co-development occurred in workshops with rehabilitation professionals.
- Interrater reliability was assessed in inpatient and residential pediatric rehabilitation settings.
Main Results:
- PRISM demonstrated excellent acceptability among professionals, despite an initially unfamiliar perspective.
- Internal consistency improved with practice; interrater reliability (Kendall's W) was good.
- Modifications enhanced the tool's internal consistency and its value in facilitating interdisciplinary communication.
Conclusions:
- PRISM effectively identifies the 'active ingredients' of interdisciplinary rehabilitation packages.
- The tool enhances interdisciplinary communication and collaboration.
- PRISM holds significant potential as a research instrument for pediatric ABI studies linking rehabilitation to outcomes.
Aim:
To develop an instrument (Paediatric Rehabilitation Ingredients Measure [PRISM]) for quantitative estimation of contents of interdisciplinary neurorehabilitation for use in studies of relationships between rehabilitation treatment delivered and severity-adjusted outcomes after acquired brain injury (ABI).
Method:
The measure was developed using an ingredients-mediators-outcomes model consistent with the International Classification of Functioning, Disability and Health, a literature review, and other current initiatives in the development of rehabilitation treatment taxonomies, with item codevelopment in workshops with rehabilitation professionals. Interrater reliability was assessed in inpatient and residential paediatric rehabilitation settings.
Results:
Although sometimes an initially unfamiliar perspective on rehabilitation practice, PRISM's acceptability amongst professionals was excellent. Internal consistency of scores was sometimes an issue for users unfamiliar with the tool; however, this improved with practice and interrater reliability (assessed by Kendall's W) was good. The tool was felt to have particular value in facilitating interdisciplinary communication and working. Modifications to the design of the tool have improved internal consistency.
Interpretation:
PRISM supports identification of the 'active ingredients' of an interdisciplinary rehabilitation package and facilitates interdisciplinary communication. It also has potential as a research tool examining relationships between rehabilitation delivered and severity-adjusted outcomes observed after paediatric ABI.
What This Paper Adds:
Identifying contribution of rehabilitation to outcomes after acquired brain injury requires quantification of rehabilitation 'dose' and 'content'. Previous approaches to 'parsing' of rehabilitation dose and content may have overemphasized one-to-one sessions with therapists. We present a novel, holistic tool for identification of ingredients of an interdisciplinary rehabilitation package. It supports interdisciplinary communication and has potential as a research tool.
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