Examining Interrater Reliability and Validity of a Paediatric Cardiopulmonary Physiotherapy Discharge Tool
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abstract
Purpose: To determine the interrater reliability (IRR) of the individual items in the Paediatric Cardiopulmonary Physiotherapy (CPT) Discharge Tool. This tool identifies six critical items that physiotherapists should consider when determining a paediatric patient's readiness for discharge from CPT after upper-abdominal, cardiac, or thoracic surgery: oxygen saturation, mobility, secretion retention, discharge planning, auscultation, and signs of respiratory distress. Methods: A total of 33 paediatric patients (ages 2 to <19 years) who received at least 1 day of CPT following cardiac, thoracic, or upper-abdominal surgery were independently assessed using the Paediatric CPT Discharge Tool by two designated assessors, who assessed each patient within 4 hours of each other. Results: Kappa analysis showed the following levels of interrater agreement for the six items of the Paediatric CPT Discharge Tool: Oxygen Saturation, excellent (κ=0.80); Mobility, substantial (κ=0.62); Secretion Clearance, moderate (κ=0.39); Discharge Planning, fair (κ=0.37); and Auscultation and Respiratory Distress, poor (κ=0.24 and κ=−0.08, respectively). Conclusion: Several of the items in the Paediatric CPT Discharge Tool demonstrate good IRR. The discharge tool is ready for further psychometric testing, specifically validity testing.
