Applying the ICF codes, flag model and C-OAR-SE in the development of return-to-work assessment scale for stroke survivors

Abstract

BACKGROUND: The Return-to-Work Assessment Scale (RAS) was developed in 2021 by Ibikunle et al. to assess return-to-work among post-stroke survivors. OBJECTIVE: The aim of this study was to describe how the conceptual (flag model and ICF) and theoretical framework (C-OAR-SE) were used in developing the RAS. METHOD: The development of the RAS consisted of three phases: (i) Initial item generation (ii) Face and content validity (iii) Psychometric testing. With each phase embracing the flag model, international classification of functioning, disability and health (ICF) and the C-OAR-SE an acronym for the six aspects of the theory: ‘C’ [construct definition], ‘OAR’ [object representation, attribute classification, and rater entity identification], and ‘SE’ [selection of item type and answer scale, as well as, enumeration]. RESULTS: A triangulated approach drawn on three separate theories and models. Phase one was developed by using the flag model which provided the semi-structured open ended questions that materialized into the draft instrument while phases two and three were developed using the ICF and the C-OAR-SE. The scale consists of two sections, A and B. Section A comprises general information about post-stroke survivors, which would not be scored, while section B includes three parts that are important to consider when deciding to return-to-work. CONCLUSION: An instrument called RAS was developed, an excellent, internally consistent, as well as reliable tool that has demonstrated good group and structural validity.