Performance Assessment of Self-Care Skills

Overview

Author(s): Rogers, J.C., Holm, M.B., Chisholm, D

Year of Publication: 2016

Publisher: University of Pittsburgh, Department of Occupational Therapy

Type of Assessment: 

• Standardized Performance Measure

• Criterion-Based

• Observation-Based

• Occupation-Based

Cost: Free for Access; $ for materials

How to Access: https://www.shrs.pitt.edu/performance-assessment-self-care-skills-pass-materials 

Age: Adolescent - 13-17, Adult - 18-64, Elderly Adult - 65+

Diagnoses: Arthritis + Joint Conditions, Cardiac Dysfunction, Multiple Sclerosis, Parkinson's Disease & Movement Disorders, Pulmonary Disorders Spinal Cord Injury, Stroke Recovery, Bipolar Disorder, Dementia, Depression, Macular Degeneration, Osteoarthritis, CVA, & other Mental Health Conditions

Setting: Home health, Inpatient, Outpatient

Areas Assessed:

• Functional Mobility:

  • Bed Mobility, Stair Use, Toilet Mobility & Management, Bathtub & Shower Mobility, & Indoor Walking

• Basic ADLs:

  • Oral Hygiene, Trimming Toenails, Dressing

• IADLs-Physical:

  • Taking out Garbage & Key Use, Changing Bed Linens, Sweeping, Cleanup after Meal Preparation

• IADLs-Cognition:

  • Shopping, Bill Paying by Check, Checkbook Balancing, Mailing Bills, Telephone Use, Medication Management, Obtaining Critical Info from the Media (Auditory & Visual), Flashlight Repair, Home Safety, Playing Bingo, Oven Use, Stovetop Use, Use of Sharp Utensils

• Balance-Vestibular

• Cognition

• Coordination

• Dexterity

• Executive Functioning

• Functional Mobility

• Hearing

• Occupational Performance 

• Reading Comprehension

• Reasoning/Problem Solving

• Seating

• Strength

• Upper Extremity Function

• Vision & Perception 

Administration

Time: 1.5-3 hours

Group/Individual: Individual

Subtests: 26 tasks within 4 domains: Functional mobility (5), Basic ADLs (3), IADLs -physical (4) & cognitive (14)

• 163 criterion-referenced subtasks rated for independence, safety, & adequacy on a 4-pt scale

Instructions: For each task or area of function being tested, there are instructions on the set up, materials needed, and a script for directions

• E.g.: For Task C#1: FM - Bed Mobility: "I need to have you show me how you get into bed, move in bed, and get out of bed. I have placed a towel on the end of the bed, so don't worry about your shoes."

Materials: Paper, Pencil, and Varied Household Items

• Bed, pillows, shoes, Stairs, toilet, shorts, water, towels, toothbrush, toothpaste, dentures, shower, safety rails around bathtub, paper towels, garbage can, toenail scissor, toenail clipper, toenail nipper and file, bathroom, chair, clothes, socks and shoes (large in case client does not have their own), table, 8 unopened cans, envelope, 5 coupons, wallet, change purse, coins, bills, paper, pen, calculator, hand help magnifier, local utility bills with envelopes, tablet, calendar, checkbook, lights, scissors, tablet, stamps, room, keys, plastic garbage sack, telephone, local consumers yellow pages, 7 day medication sheet, one prescription type bottle with child proof lid, one prescription type bottle with non-child proof lid, wall clock, chains, audiotape recorder, newspaper article about hypothermia or heat stroke, 2 good batteries, 2 bad batteries, one burned out bulb, one good bulb, and clear plastic bag. Broom, dustpan. dry cereal, rugs, medium sized knife, cooking oil, bingo card, highlighter, audio tape reading BINGO numbers, kitchen essentials (saucepans, cutting board) and ingredients to make muffins. 

User Qualifications: Training including reading and review of an article/manual

Psychometrics

Reliability: 

• Test-Retest: High

  • Independence scale: r=0.92-0.96 

  • Safety scale: 90% agreement

• Interrater: High

  • Independence: 96% agreement

  • Safety: 97% agreement

Validity: 

• Content Validity

  • Based on established functional assessment questionnaires, including the OARS Multidimensional Functional Assessment Questionnaire and the Functional Assessment Questionnaire

• Construct Validity

  • Unidimensionality of Independence and Safety scales confirmed through exploratory factor analysis

Pros & Cons

Strengths:

• Standardized - task administration (placement of objects & verbal instructions)

  • Therapist can provide assistance when needed

• Clinic & Home version to increase accessibility that are nearly identical and account for use of client's materials

• Flexible - therapist can only administer relevant tasks & can use the test as a template to develop new items

• Free to access and materials are common household items

Weaknesses: 

• Length of time for administration

• No certificate

References

• Chisholm, D., Toto, P., Raina, K., Holm, M., & Rogers, J. (2014). Evaluating capacity to live independently and safely in the community: Performance assessment of self-care skills. British Journal of Occupational Therapy, 77(2), 59-63. https://doi.org/10.4276/030802214X13916969447038 

• Czohla, D., Gajudo, K., Manhinan, J., Ryemon, J., Stern, M., Renfro, M., & Petrovsky, J. (2019). Performance assessment of self-care skills (PASS). American Physical Therapy Association. https://www.apta.org/patient-care/evidence-based-practice-resources/test-measures/performance-assessment-of-self-care-skills-pass 

• Rogers, J.C., Holm, M.B., Chisholm, D. (2016). Performance assessment of self-care skills (PASS-Clinic)[Version 4.1]. University of Pittsburgh.

• Rogers, J.C., Holm, M.B., Chisholm, D. (2016). Performance assessment of self-care skills: Scoring guidelines [Version 4.1]. University of Pittsburgh.

• Shirley Ryan Ability Lab. (2024, January 9). Performance assessment of self-care skills. https://www.sralab.org/rehabilitation-measures/performance-assessment-self-care-skills