Criterion validity of a home health aide's algorithm for recommending bathroom equipment

Background. Occupational therapists are experts at adapting bathroom environments. However, to increase access to services, the algorithm Prealables aux soins d'hygiene (French for Prerequisites for bathing care) has been developed to be used by trained home health aides to recommend bathroom equipment. Purpose. The purpose of this study was to assess the criterion validity of the algorithm by measuring the level of agreement between an occupational therapist's recommendations (gold standard) and those made by four home health aides using the algorithm. Methods. Community-living adults with bathing difficulties (n = 96) were visited by both types of evaluators. Findings. Home health aides correctly identified clinical situations in which they should feel confident about their ability (sensitivity: 96%, specificity: 69%) and, apart from type of bathing seat (k(w) = 0.63 [0.52; 0.75]), agreement between recommendations varied from substantial to almost perfect (Delta >= 0.72). Implications. Results increase confidence in the algorithm, but other studies are needed to ensure population safety and fulfil the occupational therapist's obligations.