Validation of the Participation Measure-3 Domains, 4 Dimensions (PM-3D4D)

Objective: To examine the construct validity of the Participation Measure-3 Domains, 4 Dimensions (PM-3D4D), a multidimensional participation measure developed for use in rehabilitation practice. Design: Cross-sectional study. Setting: Outpatient rehabilitation programs. Participants: Rehabilitation patients (N=556; mean age, 61.4±23.6y; 47.1% women). Interventions: Not applicable. Main Outcome Measures: The PM-3D4D is a 19-item measure designed to evaluate participation in 3 domains-Productivity, Social, and Community-across 4 dimensions-Diversity, Frequency, Desire for change, and Difficulty. Intercorrelations among the 4 dimensions of the PM-3D4D and correlations between the PM-3D4D and 3 legacy instruments-Participation Assessment with Recombined Tools-Objective, Participation Measure for Post-Acute Care, and Satisfaction With Life Scale-were examined to establish the convergent and divergent validity of the PM-3D4D. Known-group validity was evaluated by comparing PM-3D4D scores across age groups and groups of people classified by functional level. Results: The Diversity scale of the PM-3D4D was strongly correlated with the Frequency scale (Spearman correlation coefficient, r s = 83-.96 across the 3 domains), and these 2 scales showed moderate to strong correlations with the Difficulty scale (r s = 42-.70) but weak (r s=-.4 to 0) and insignificant correlations with the Desire for change scale. The Frequency and Difficulty scales of the PM-3D4D showed moderate to strong correlations with the Participation Assessment with Recombined Tools-Objective and Participation Measure for Post-Acute Care (r s = 41-.82), respectively, and the Desire for change scale had weak correlations with the Satisfaction With Life Scale (r s=-.32 to -.18). Significant differences in PM-3D4D scores were found by age and functional level. Conclusions: Findings of this study support the construct validity of the PM-3D4D, providing evidence for using the PM-3D4D to assess rehabilitation patients' participation performance and helping practitioners identify intervention priorities to improve patients' participation outcomes.