Assessing disability : the reliability and validity of the multiple sclerosis disability profile

Abstract

The assessment of people with disabilities is complex. The priorities adopted and issues addressed vary. The Multiple Sclerosis Disability Profile was developed and is currently used to assess people with MS in Australia. However, little is known about its psychometric properties and people with MS have not had a previous opportunity to comment on its relevance to them. Therefore the reliability and validity of the Disability Profile was assessed using widely used assessment methods and the views of people with MS. Standard methods for assessing the characteristics of assessment scales were used and one hundred and three people with MS were asked to nominate important issues that need discussing when assessing the person with MS. Support people and health professionals provided additional views. The research was conducted from a theoretical perspective that considers the relationship between disability and citizenship. The internal consistency of the Disability Profile was found to be excellent (Cronbach's Alpha= 0.9656). Furthermore it was found that the inter-rater reliability of the Multiple Sclerosis Disability Profile can be improved with clearer operational definitions, increased training for health professionals in the use of the instrument and reduced number of responses per item. Moreover the assessment of disability needs to be improved to achieve more sensitivity and to incorporate the handicap score devised in the course of this study. These amendments will enable improved discrimination when assessing handicap. However further research is required to assess the reliability and validity of the amended instrument. As the Disability Profile is a starting point for assessment, therapy and support for the person with MS, the revisions proposed here offer health professionals a holistic assessment instrument with acceptable reliability and viability