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Supervision rating scale: a measure of functional outcome from brain injury
1Department of Physical Medicine and Rehabilitation, University of Texas Houston Medical School, USA.
Objective:
To introduce a new outcome rating scale, the Supervision Rating Scale (SRS), which measures the level of supervision that a patient receives from caregivers. The SRS rates level of supervision on a 13-point ordinal scale that can optionally be grouped into five ranked categories (Independent, Overnight Supervision, Part-Time Supervision, Full-Time Indirect Supervision, and Full-Time Direct Supervision).
Design:
Descriptive correlational study of the scale's interrater reliability and criterion-related validity.
Setting:
Brain injury program of a freestanding rehabilitation hospital.
Patients:
Referred case series of 114 patients with moderate to severe traumatic brain injury (mean time postinjury = 3.8 years) who resided in the community or a nonhospital facility.
Intervention:
None.
Main Outcome Measures:
Functional outcome as measured by the Disability Rating Scale (DRS), Glasgow Outcome Scale (GOS), type of living arrangement and independence in selfcare and instrumental activities of daily living (ADL).
Results:
SRS ratings showed consistent relationships with type of living arrangement and with independence in self-care and instrumental ADL. SRS ratings were also strongly associated with ratings on the DRS and GOS. Interrater reliability of the SRS was evaluated in a subsample of 19 patients and found to be satisfactory (intraclass correlation = .86, weighted kappa = .64).
Conclusions:
The results suggest that the SRS should have sufficient reliability and validity to serve as a measure of functional outcome from brain injury. Because SRS ratings are based on observed behaviors, the SRS may have a smaller subjective component as compared to the DRS and GOS.