Article

Objective: To examine the structure and content coverage of
an item pool of new items based on the Activity categories
from the International Classification of Functioning, Disability
and Health and items from existing instruments to measure the
applied cognition dimension of function.
Design: Prospective study.
Setting: Four postacute care rehabilitation settings (inpatient,
transitional care, home care, outpatient) in an urbansuburban
area of northeast United States.
Participants: Convenience sample of 477 patients (mean
age, 62.7y) receiving rehabilitation services for neurologic,
orthopedic, or complex medical conditions.
Interventions: Not applicable.
Main Outcome Measures: Participants were administered
applied cognition items from the new Activity Measure for
Post-Acute Care, the Medical Outcomes Study 8-Item Short-
Form Health Survey, and an additional setting-specific measure:
the FIM instrument (inpatient rehabilitation); the Minimum
Data Set (skilled nursing facility); the Minimum Data
Set­Post Acute Care (postacute settings); or the Outcome Assessment
and Information Set (home care). Rasch (partialcredit
model) analyses were conducted to examine item fit,
item coverage, scale unidimensionality, and category difficulty
estimates.
Results: The majority of items (46/59) could be located
along a single continuum. Relatively few people were performing
at the lower end of the difficulty scale, and about 25% were
at ceiling.
Conclusions: The proposed definition of applied cognition
dimension provides a useful guide for item development to
measure this dimension. Further work is needed to determine
how best to measure function in this domain for people at the
upper and lower ends of the continuum.

Langue : ANGLAIS