Validity and Reliability of the Portuguese-Performance Assessment of Self-Care Skills (P-Pass) for Individuals with Disabilities

Abstract Background: Due to the increasing need to measure health outcomes and to ensure a more independent life, it is essential to validate instruments capable of assessing the functionality of activities of daily living. The Performance Assessment of Self-Care Skills (PASS), based on three occupational performance constructs (independence, safety and adequacy), allows health professionals to delineate their interventions more effectively according to the needs of each patient. The purpose of this study was to create a Portuguese version of the PASS (P-PASS) and to measure the performance of people with disabilities. Methods. Linguistic validation was performed through the translation/back-translation procedure. Next, the scale to be completed by health professionals was submitted to a clinical review by a panel of experts. Subsequently, it was applied to 98 people with physical and/or cognitive disabilities. The data collected were then analyzed and the results evaluated in accordance with the three PASS constructs. The results were also analyzed in terms of age and gender. Results. To create the Portuguese version, one task was removed from the original PASS and seven tasks were combined or adapted. Task independence had the highest scores and adequacy the lowest. In terms of reliability, the P-PASS revealed almost perfect levels of agreement between observers, except for the adequacy construct of the ‘bed mobility’ task that showed moderate agreement. In general, the original structure of the PASS was replicated in the Portuguese version. Men presented greater independence than women in the tasks of ‘bill paying by ATM’ and ‘changing TV command batteries.’ Participants under 60 years of age had the highest scores overall. Conclusions. The combination or adaptation of some items to be more culturally relevant is a valid procedure that has been used by other authors during the validation of PASS items. The results obtained by P-PASS showed comparable scores with the original PASS and with other translated/adapted versions. The P-PASS is a valid and reliable scale for the Portuguese population, enabling more effective measurement of health outcomes.