Content and Item Validity for the Self Care Inventory for Children with Cerebral Palsy living resourced constrained contexts

Abstract

Introduction

Many children with cerebral palsy (CP) struggle to participate with activities of daily living (ADLs), especially self-care. Occupational therapists need to be able to assess contextually and culturally appropriate engagement in self-care for intervention to be clinically applicable. There is little documentation regarding culturally appropriate assessment tools for South African children with CP living in under resource contexts. The purpose of this study was to determine item criteria and content validity for a new assessment, the Self Care Inventory for Children with Cerebral Palsy (SCICP) to be used in resource constrained contexts against which dysfunction in selfcare in the CP population can be determined.

This paper reports the initial development of the items and the two methods of content validity used in the development of the SCICP namely, a content validity index determined by subject matter experts and consensus determined by caregivers of children living a rural low resourced environment in South Africa.

Methods

Using an instrument design methodology, the domains the International Classification of Function, Disability and Health (ICF) were used to map items from existing assessments of self-care for children. These items were categorised into sections in the first draft of the SCICP. Subject matter experts critically reviewed this draft to establish whether the sections and items selected accurately represented self-care and functionally mobility applicable to children within resource-constrained areas of South Africa using a content validity index (CVI). The SCICP was translated into isiZulu and the items were further evaluated by caregivers of children in Nquthu in KwaZulu Natal to ensure cultural relevance and age of independence in items by typical children living in this context.

Results

Of the 197 items 88 were discarded and 16 were edited. Items were excluded mainly due to ambiguity, and some were reworded to be contextually relevant reducing the items on the SCICP to 109. Adequate CVI values ranging from 1.00 to 0.82 were achieved for the six sections on the SCICP with limited consensus on the age of independence for self-care tasks.

Conclusion

This study presents the first step in the development of the SCICP. The assessment requires further testing for validity and reliability to confirm its suitability for use in the South African context.

Implications for practice

This study focused on the first stage of the development of the Self Care Inventory for Children with Cerebral Palsy (SCICP), which has the potential to become a standardised, usable assessment tool for use within resource-constrained areas of South Africa.

A pilot study to confirm the other psychometric properties of the SCICP as a contextually relevant assessment for use in South Africa is required before the assessment can be used clinically.