The Hopkins Rehabilitation Engagement Rating Scale: development and psychometric properties

OBJECTIVE: To conduct an initial investigation of the psychometric properties of the Hopkins Rehabilitation Engagement Rating Scale (HRERS), a 5-item, clinician-rated measure developed to quantify engagement in acute rehabilitation services. DESIGN: We used a cross-sectional design to conduct correlational and multivariate analyses to establish the measure's internal consistency, interrater reliability, construct validity, and criterion validity. SETTING: Acute inpatient rehabilitation in 3 metropolitan hospitals. PARTICIPANTS: A total of 206 subjects with spinal cord injury, ischemic or hemorrhagic stroke, amputation, or hip or knee replacement. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The HRERS, Positive and Negative Affect Schedule, Brief Symptom Inventory, Levine's Denial of Illness Scale, Craig Handicap Assessment and Reporting Technique, and FIM instrument. RESULTS: The HRERS has good internal consistency (alpha=.91) and interrater reliability (intraclass correlation coefficient, .73) and represents a unidimensional construct. It correlated negatively with symptoms of depression (r=-.24, P<.01), higher ratings of denial of illness (r=-.30, P<.001), and self-rated negative affect (r=-.23, P<.01), and correlated positively with self-rated positive affect (r=.36, P<.001) and level of functioning 3 months postdischarge (r=.22, P<.01). CONCLUSIONS: The HRERS is a valid and reliable measure of rehabilitation engagement that relates to intermediate-term functional outcomes.