| dc.contributor.author | Doble, Susan Elizabeth. | en_US |
| dc.date.accessioned | 2014-10-21T12:35:08Z | |
| dc.date.available | 2000 | |
| dc.date.issued | 2000 | en_US |
| dc.identifier.other | AAINQ57362 | en_US |
| dc.identifier.uri | http://hdl.handle.net/10222/55712 | |
| dc.description | Other than the Assessment of Motor and Process Skills (AMPS) (Fisher, 1999), ADL assessments are not grounded in a clear conceptualization of occupation. The AMPS, an observational assessment, evaluates the quality of individuals' ADL motor and ADL process skills when they perform meaningful and relevant ADL tasks, and generates unbiased and stable measures of individuals' ADL ability. Despite these strengths, the AMPS has not been widely adopted in dementia-focused clinical and research settings. | en_US |
| dc.description | In this study, the AMPS proxy-report (AMPS-PR) was developed and its potential utility was evaluated. The AMPS ADL ability measures for 60 subjects with AD were compared with the AMPS-PR ADL ability measures generated by their family informants. When item response validity was examined, 75% of the 16 ADL motor skill items and 70% of the 20 ADL process skill items demonstrated acceptable goodness-of-fit with the measurement model. The low infit and outfit MnSq values of the items that failed to demonstrate acceptable goodness-of-fit with the measurement model suggest that these items were redundant. The person-response validity of the AMPS-PR was low; many proxy ratings were invariable. The reliability of many subjects' ADL ability measures was compromised by high standard errors. Nevertheless there was no significant difference between 62.5% of the observed and proxy-report ADL motor ability measures, and 56.5 of the observed and proxy-report ADL process ability measures. Although most observed and proxy-report ADL measures were comparable, overestimation by proxies was very common. In contrast to the AMPS, rater bias cannot be accounted for when generating AMPS-PR ADL ability measures. Therefore, a model comprised of five psychosocial factors (i.e., informants' depressive symptomatology and time-dependence caregiver burden; and perceptions of social support, reciprocity, and conflict within their relationships with the subjects) was examined to determine if these factors systematically biased proxies' ratings. The model, however, accounted for only a small proportion of the discrepancy between observed and proxy-report ADL process ability measures. A brief educational intervention, designed to enhance family informants' ability to make complex judgements about family members' ADL abilities, had no significant effect in reducing the discrepancies between the observed and proxy-report ADL motor ability measures, or the observed and proxy-report ADL process ability measures. | en_US |
| dc.description | The findings illustrate the complexity inherent in rating AD subjects' ADL abilities Although family informants can make good observations, their abilities to make complex judgements and assign ratings that accurately reflect the AD subjects' ADL abilities is questionable. Since proxy-report measures cannot account for proxies' biases, and factors that systematically bias their ratings are difficult to determine, it may be more feasible for trained AMPS examiners, whose biases can be accounted for, to complete ratings based on proxies' observations. Despite its current limitations, the AMPS-PR has potential use in clinical practice settings to identify family informants' perceptions of AD subjects' ADL motor and ADL process skill competencies, and to develop insights into the effects that family informants may have on their relatives' ADL task performances. | en_US |
| dc.description | Thesis (Ph.D.)--Dalhousie University (Canada), 2000. | en_US |
| dc.language | eng | en_US |
| dc.publisher | Dalhousie University | en_US |
| dc.publisher | | en_US |
| dc.subject | Biology, Biostatistics. | en_US |
| dc.subject | Health Sciences, Mental Health. | en_US |
| dc.subject | Psychology, Psychometrics. | en_US |
| dc.subject | Health Sciences, Health Care Management. | en_US |
| dc.title | Measuring competence in the performance of activities of daily living: The forgotten half of Alzheimer's disease. | en_US |
| dc.type | text | en_US |
| dc.contributor.degree | Ph.D. | en_US |
