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Inter-rater reliability of a paediatric outcome measure in Nepal
Insights
A new tool effectively measures functional levels and caregiver attitudes for children with disabilities in Nepal. This instrument shows acceptable reliability for in-hospital and community programs.
Area of Science:
- Rehabilitation Medicine
- Disability Studies
- Health Program Evaluation
Background:
- The Hospital and Rehabilitation Centre for Disabled Children (HRDC) in Nepal requires evaluation of its programs.
- Existing instruments may not adequately capture functional levels or caregiver attitudes in this context.
Purpose of the Study:
- To develop and assess the inter-rater reliability of a new instrument for evaluating children's functional levels and caregiver attitudes.
- To support the assessment of HRDC's in-hospital and community programs.
Main Methods:
- An instrument was developed to assess functional status and caregiver attitudes.
- Inter-rater reliability was tested in three regions of Nepal with 49 children.
- Field workers assessed children in their homes, alternating roles as administrator and observer, with scores compared using weighted kappa.
Main Results:
- The instrument demonstrated acceptable inter-rater reliability, with weighted kappa coefficients ranging from 0.60 to 1.0.
- The measure proved reliable in a field setting across different regions.
Conclusions:
- The developed instrument shows promising inter-rater reliability for use in Nepal.
- Further research is recommended to establish validity and test-retest reliability in diverse cultural settings.
Abstract:
The Hospital and Rehabilitation Centre for Disabled Children (HRDC) in Nepal identified the need to evaluate their in-hospital and community programmes. An instrument was developed to provide information regarding the functional level of the children treated by the HRDC as well as to provide information regarding care-givers' attitudes towards disability. Inter-rater reliability of the measure was tested in three regions of Nepal with 49 children. Six HRDC field workers travelled in pairs to the childrens' homes and alternated in roles as test administrator and observer. Correlations between the scores documented by the administrator and observer were used to estimate inter-rater reliability. Inter-rater reliability coefficients, calculated using a weighted kappa statistic, varied from 0.60 to 1.0. We conclude that the instrument demonstrated an acceptable level of inter-rater reliability in the field setting. Future studies to measure construct and concurrent validity, test-retest reliability and responsiveness of the instrument are recommended as well as testing the instrument in different cultures.
