Validation of Persian Version of Patient-Rated Wrist and Hand Evaluation: Confirmatory Factor Analysis and Rasch Analysis

Maryam Farzad; Joy C MacDermid; Ze Lu; Erfan Shafiee

doi:10.1016/j.arrct.2020.100076

Validation of Persian Version of Patient-Rated Wrist and Hand Evaluation: Confirmatory Factor Analysis and Rasch Analysis

Arch Rehabil Res Clin Transl. 2020 Aug 1;2(4):100076. doi: 10.1016/j.arrct.2020.100076. eCollection 2020 Dec.

Authors

Maryam Farzad^{1

2}, Joy C MacDermid^{3

4}, Ze Lu^{1

5}, Erfan Shafiee^{1

2}

Affiliations

¹ School of Physical Therapy, Western University, Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.
² Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
³ Physical Therapy and Surgery, Western University, London, ON, Canada.
⁴ Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada.
⁵ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

Abstract

Objectives: To determine the factor structure and test the clinometric properties of wrist and hand version of the Patient-Rated Wrist Evaluation.

Design: Cross-sectional study using Rasch analysis and factor analysis. Confirmatory factor analysis was conducted to assess the factor structure. Higher-order factor analysis was used to explore the hierarchical structure of the items. The Rasch model was used to assess the overall fit, reliability, validity, and construct unidimensionality. Rasch analysis and factor analysis were conducted using RUMM2030 and LISREL software, respectively.

Setting: Outpatient hand rehabilitation clinic.

Participants: A convenience sample of patients (N=206) with various hand injuries who completed the Persian version of the Patient-Rated Wrist and Hand Evaluation (PRWHE-P) at 2 months postinjury. The study included 66 men and 139 women, with a mean age of 40 years.

Intervention: Not applicable.

Main outcome measures: The PRWHE-P was used as a patient-reported measure of pain and disability in wrist and hand conditions.

Results: Factor analysis confirmed 3-factor models of the PRWHE-P. Items fit well to the Rasch model in 3 subscales. The PRWHE-P had a good item reliability (0.82) and good internal consistency (0.8). No differential item functioning was detected for age, sex, dominant hand, or injured hand.

Conclusions: The results of this study indicated that the PRWHE-P with 3 sub scales is a reliable and valid measurement tool and could be used in patients with different wrist and hand disabilities.

Keywords: CFA, confirmatory factor analysis; CFI, comparative fit index; DIF, differential item functioning; FA, factor analysis; Factor analysis; GFI, goodness of fit index; ICC, item characteristic curve; ICF, International Classification of Functioning, Disability and Health; PRWE, Patient-Rated Wrist Evaluation; PRWHE, Patient-Rated Wrist and Hand Evaluation; PRWHE-P, Persian version of the Patient-Rated Wrist and Hand Evaluation; PSI, person separation index; RMSEA, root means square error of approximation; Rehabilitation.