Activity and participation in haemophiliacs: Item response modelling based on international classification of functioning, disability and health

Background and objectivesThere is scant research investigating the user-friendly functional assessment tool conceptualized by the International Classification of Functioning, Disability and Health (ICF) among persons with haemophilia (PWH). This study aims to accomplish two goals: (1) quantifying comprehensive functioning measures of haemophilia through Item Response Theory (IRT); (2) discussing patient-centred care based on the Wright map of personal ability and item difficulty. MethodsA cross-sectional study was carried out in 70 PWH (mean age, 33.09 +/- 11.04) via convenience sampling. All patients completed the 45 ICF categories of haemophilic-specific activity and participation. Psychometric properties of the categories were examined using Mokken scale analysis and parametric item response modelling. ResultsWe extracted a unidimensional scale with 31 categories, and constructed a Rasch model with good fitness. The Cronbach's alpha of the scale was .9713, with the Guttman's lambda(2) = .9730, Molenaar Sijtsma rho = .9802, and latent class reliability coefficient = .9769, indicating great internal reliability. The estimated individual social competence by the Rasch model was highly related to the index score of the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L) (p , r = .62), and had a moderate correlation (p , r = .54) with the score of Haemophilia Activities List (HAL). ConclusionsThe ICF scale of haemophilic activity and participation with 31 categories (HAPPY-ICF) has good construct validity and internal consistency. The person-item threshold distribution map might be helpful in research and clinical practices for patient-oriented care.