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Original Article
 
The development of a community reintegration outcome measure to assess people with stroke living in low socioeconomic areas
Maleka Douglas Morake1, Stewart Aimee Vivienne2, Hale Leigh Ann3,
1PhD PT, Associate Professor, HOD Physiotherapy Department Sefako Makgatho Health Sciences University, Molotegi Street, Ga-Rankuwa Gauteng.
2PhD PT, Associate Professor, Physiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannes burg, Gauteng Province, South Africa.
3PhD PT, Professor and Dean, School of Physiotherapy, University of Otago, Dunedin, New Zealand.

Article ID: 100026D05MM2017
doi:10.5348/D05-2017-26-OA-2

Address correspondence to:
Stewart Aimee Vivienne
Stewart Aimee Vivienne PhD PT, Associate Professor, Physiotherapy Department
School of Therapeutic Sciences University of the Witwatersrand,
Johannes burg, Gauteng Province,
South Africa

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How to cite this article:
Morake MD, Stewart AV, Hale LA. The development of a community reintegration outcome measure to assess people with stroke living in low socioeconomic areas. Edorium J Disabil Rehabil 2017;3:11–24.


Abstract
Introduction: Aims: The aim of this study was to develop and psychometrically evaluate an interview–administered questionnaire to assess community reintegration for black people with stroke in low socioeconomic rural and urban South African communities.
Methods: A sequential mixed methods design was used. A qualitative approach using semi–structured interviews with adults with stroke and/or their caregivers was undertaken to conceptualize and generate community reintegration interview items. Thereafter quantitative methods including the Delphi technique, nominal groups, factor analysis and internal consistency statistics were used to test the validity and reliability of the outcome measure.
Results: Thirty–two interviews (13 urban, 19 rural) generated 67 items. These were reduced to 44 categorized under eight domains during three rounds of the Delphi technique and two nominal group meetings. Factor analysis (FA) and internal consistency statistics on the remaining items, resulted in a two part outcome measure, one for a rural and the other an urban community. The internal consistency of both measures was good (alpha coefficient = 0.95). The new outcome measure, the Maleka Stroke Community Reintegration Measure (M–SCRIM) was compared to the Subjective Index of Physical and Social Outcomes to establish construct validity (urban r = 0.88, p<0.001; rural r = 0.95, p < 0.001). Conclusion: The M–SCRIM is a valid, reliable interview–administered measure to assess community reintegration following stroke for people living in low socioeconomic communities in South Africa. With further refinement it could be validated for use in other developing countries with similar cultures.

Keywords: Community reintegration, Low socioeconomic areas, Outcome measure development, Stroke


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Author Contributions:
Maleka Douglas Morake ; Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Stewart Aimee Vivienne ; Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Hale Leigh Ann ; Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of submission.
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© 2017 Maleka Douglas Morake et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.