Development of a toileting performance assessment test for patients in the early stroke phase

Purpose: The study aimed to develop a toileting performance assessment test to measure the toileting performance ability of patients in the early phase after stroke. Methods: In this study, 214 stroke patients were enrolled. Cronbach’s α, Spearman’s rank correlations (ρ values) with the toileting-related items of the functional independence measure and Barthel Index, interrater reliability (weighted κ), and responsiveness (standardized response mean) were evaluated. Receiver operating characteristic and the area under the curves were utilized to determine the cutoff scores for the significance of the independence of toilet ability with the functional independence measure and Barthel Index. Results: Cronbach’s α was ≥0.90. The p values between toileting performance assessment test and Barthel Index and between toileting performance assessment test and functional independence measure were 0.88 and 0.86, respectively. The weighted κ for each item was ≥0.61. The standardized response means were 0.81 for the functional independence measure, 0.70 for the Barthel Index, and 0.93 for the toileting performance assessment test. Cutoff scores of the toileting performance assessment test were 18 points. Conclusions: The toileting performance assessment test has acceptable psychometric properties and proved useful in assessing toileting performance ability of patients in the early phase after stroke.Implications for rehabilitation Toileting performance assessment test demonstrated acceptable psychometric properties, and it can be useful for assessing the toileting ability of patients in the early phase after stroke. Toileting performance assessment test should provide information that leads to lowered risk of falls while toileting, and the information gathered can assist patients in achieving early toileting independence after stroke. As the development of toileting performance assessment test excluded patients with cognitive disabilities, the item for cognitive function should be developed as well.