Article

AIM: To increase research rigour and create a plausible way to assess clinical
effectiveness, it is necessary to measure the degree to which interventions are
delivered as intended (fidelity). Generic fidelity measures enable evaluation of
more than one intervention through observation of unique and general
characteristics relevant across interventions. This study describes the first
generic fidelity measure in paediatrics. METHOD: Items were constructed from
multiple sources to create a general attributes domain and two paediatric
cerebral palsy (CP) intervention-specific domains. After a pre-testing procedure,
raters were trained and videos of clinical interventions were rated to test the
measure's psychometric properties. RESULTS: The Paediatric Rehabilitation
Observational measure of Fidelity (PROF) consisted of 30 items. Six raters were
trained on the PROF and rated 25 videos. Internal consistency (alpha) and
interrater reliability (IRR) for the frequency scale showed the following
results: context therapy: alpha=0.71, IRR=0.75; child therapy: alpha=0.85,
IRR=0.87; and general attributes; alpha=0.78, IRR=0.82. Quality scale scores
across domains demonstrated internal consistency greater than 0.80 and interrater
reliability of less than 0.40. Pearson's correlations (r=-0.71, p<0.001) and
analyses of variance (p=0.01) validated that each intervention domain was an
independent construct. INTERPRETATION: The PROF is reliable and valid for
evaluating interventions used for children with CP. Future studies may use the
measure's framework, general attributes domain, and procedures to test the
psychometric properties of other interventions.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2013 Mac Keith
Press.

Langue : ANGLAIS