Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
The need for diverse and culturally relevant assessment tools is the responsibility of all OTs when delivering client-centered care. Assessment tools for Arabic-speaking clients in the United States are close to none. The use of culturally less-relevant assessment tools sabotages the client-centered care approach (e.g., addressing self-care activities that are culturally or religiously mandated). This study reviews the adaptation and the psychometric properties of the A-PASS.
Primary Author and Speaker: Razan Hamed
Additional Authors and Speakers: Margo Holm
PURPOSE: There is a pressing need in OT practice for diverse and culturally-relevant assessment tools that reflect the functional needs of clients from different cultures. Finding such tools is the professional and ethical responsibility of all occupational therapists when delivering client-centered care (AOTA, 2013; Smith, 1992). Assessment tools for Arabic-speaking clients in the United States are close to none (Hamed, Tariah, Jarrar, & Holm, 2012). Occupational therapists treating clients from Arabic origins are forced to use assessment tools originally designed for western cultures due to the lack of tools designed for Arabic-speaking populations. The use of culturally-less relevant assessment tools sabotages the client-centered care approach (e.g., addressing self-care activities that are culturally or religiously mandated). This study reviews the adaptation and the psychometric properties of the Arabic Performance Assessment of Self-care Skills (A-PASS): the first and only performance-based assessment tools designed for clients with Arabic heritage. The A-PASS is an adaptation of the original tool PASS (Holm & Rogers, 2008) which is a valid and reliable performance-based assessment tool used by occupational therapists. The PASS is used to assess independence, adequacy, and safety of performance in daily activities for clients with physical and mental health diagnoses.
DESIGN: Quantitative, evaluation research.
METHODS: The PASS was translated to Arabic and was adapted to better assess functional performance in a way that reflects the culture of Arabic speaking populations.
PARTICIPANTS: A consecutive convenience sample of healthy adults and clients with physical dysfunction was recruited for this study.
RESULTS: A total of 68 participants participated in this study with 40 healthy participants, 12 patients with stroke, and 16 patients with knee osteoarthritis (OA). The mean age of the participants was 49.9 (+10.9) with the majority being males (n = 38; 55.9%), married (n = 59; 86.8%), living with a family (n = 64; 94.1%) and having school-level education (n = 47; 69.2%). The adapted tool had a total of 26 items reviewed for their cultural fitness and relevance. Five items in the original PASS were excluded from the Arabic version for cultural irrelevance. Five new self-care items were added to match religious practices (e.g., praying, ablution, wearing the scarf). The adapted tool was also translated into Arabic using the World Health Organization Forward/back translation guidelines. Discriminant and convergent validity were tested using a sample of 40 healthy adults, 12 patients with stroke, and 16 patients with knee osteoarthritis. The findings showed that the A-PASS has good discriminant (F = 25.0, p < .000) and convergent validity (r = -0.37; p < 0.002). The A-PASS also showed excellent internal consistency for all three performance criteria: independence (α = 0.94), adequacy (α = 0.94), and safety (α = 0.92).
CONCLUSION: A-PASS is the first valid and reliable performance-based assessment tool designed for Arabic-speaking clients. The tool can be used by occupational therapists working with clients of Arabic heritage or by those working in Arabic-speaking countries. This study can be used as a guide for therapists looking to adapt existing assessment tools for minorities and culturally different populations.
References
American Occupational Therapy Association (2013). How Can Occupational Therapy Strive Towards Culturally Sensitive Practices? https://www.aota.org/∼/media/Corporate/Files/Secure/Practice/Multicultural/FAQCulturalSensitivity.pdf
Hamed, R., Abu Tariah, H., Jarrar, M., & Holm, M.B. (2012). Development of the Arabic version of the Performance Assessment of Self-Care Skills, Jordan Medical Journal, 46: 221-228.
Holm MB, Rogers JC. Performance Assessment of Self-Care Skills (PASS) (2008). In: Hemphill-Pearson B ed. Assessments in Occupational Therapy Mental Health 2nd ed. NJ: SLACK,101-110.
Smith R (1992). The science of occupational therapy assessment. Occupational Therapy Journal of Research, 12, 1: 3-15. https://doi.org/10.1177/153944929201200101
