Mobility is a key outcome in geriatric rehabilitation. The de Morton Mobility Index (DEMMI) is an internationally well-established, unidimensional measure of mobility with good psychometric properties. The aim of this study was to examine the reliability and construct validity of the German translation of the DEMMI in geriatric inpatients.This cross-sectional study included patients admitted to a sub-acute inpatient geriatric rehabilitation hospital (reliability sample: N = 33; validity sample: N = 107). Reliability, validity, and unidimensionality were investigated.Inter-rater reliability between two graduate physiotherapists was excellent, with intra-class correlation coefficient of 0.94 (95% confidence interval: 0.88-0.97). The minimal detectable change with 90% confidence was 9 points. Construct validity for the DEMMI was evidenced by significant moderate to strong correlations with other measures of mobility and related constructs (Performance Oriented Mobility Assessment: rho = 0.89; Functional Ambulation Categories: rho = 0.70; six-minute walk test: rho = 0.73; gait speed: rho = 0.67; Falls Efficacy Scale International: rho = -0.68). Known-groups validity was indicated by significant DEMMI mean group differences between independent versus dependent walkers and walking aid users versus non-users. Unidimensionality of the German DEMMI translation was confirmed by Rasch analysis.The German translation of the DEMMI is a unidimensional instrument producing valid and reproducible measurement of mobility in an inpatient geriatric rehabilitation setting.
This study describes the refinement and validation of the 17-item DEMMI in an independent sample of older acute medical patients. Instrument refinement was based on Rasch analysis and input from clinicians and researchers. The refined DEMMI was tested on 106 older general medical patients and a total of 312 mobility assessments were conducted. Based on the results of this study a further 2 items were removed and the 15 item DEMMI was adopted. The Rasch measurement properties of the DEMMI were consistent with estimates obtained from the instrument development sample. No differential item functioning was identified and an interval level scoring system was established. The DEMMI is the first mobility instrument for older people to be developed, refined and validated using the Rasch model. This study confirms that the DEMMI provides clinicians and researchers with a unidimensional instrument for measuring and monitoring changes in mobility of hospitalised older acute medical patients.
Internationally, COVID-19 has forced educational reform and disrupted already strained social work field education systems. This inquiry began pre-pandemic, responding to placement scarcity, which was only exacerbated by the pandemic as agencies migrated to online service delivery and universities responded to sudden placement cancellations. Educators found themselves navigating two interlinked global trends: 1) workplace learning that was changing radically; and 2) the immediate need to identify and develop placement opportunities. This article presents themes from a co-operative inquiry that interrogated four innovative international placement scenarios from Australia, Canada, Ireland, and New Zealand, highlighting enablers, markers, and aspects of quality learning. The four exemplars evidence the pedagogical challenges and opportunities presented by placement innovation and online learning. These placements reveal how tensions regarding placement scarcity, rapid placement innovation, and the concurrent need to mitigate risk while preserving placement quality were managed. The authors propose that creativity and innovation guided by well-articulated educational principles, learning outcomes, and pedagogical practices, promote the construction of quality placements that transcend potential risks. The challenge moving forward is upholding contemporary approaches to placement teaching and learning that ensure social work students' acquisition of professional knowledge, values and skills that are necessary for practice.
Aim: To validate the de Morton Mobility Index (DEMMI) in community‐dwelling older adults who require informal care. Methods: Thirty‐five consecutively recruited older adults (>65 years) living in the community who required informal care were included from Melbourne and regional Victoria, Australia. Participants were assessed using a battery of questionnaires, the Falls Risk for Older People (Community version), modified Barthel Index, Geriatric Depression Scale, the Medical Outcomes Survey Short Form 36, the Assessment of Quality of Life and the DEMMI. The DEMMI consists of 15 mobility items that are administered by therapist observation of physical performance. Each participant was assessed in their home. Results: The DEMMI is without floor or ceiling effects for community‐dwelling older adults who require informal care, and evidence of convergent, discriminant and known groups validity was obtained for the DEMMI. DEMMI data fitted the Rasch model and the minimal clinically important difference was 11 points. Conclusions: The DEMMI has suitable clinimetric properties for application in community‐dwelling older adults who require informal care.
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