Development, Reliability, and Validity of the Measurable Assessment in Recreation for Resident-Centered Care (MARRCC)

This paper examines the Measurable Assessment in Recreation for Resident-Centered Care (MARRCC)-a of recent origin standardized computer-based assessment developed specifically for therapeutic recreation professionals working within drawn out Term Care (LTC). The conceptual background and exhibition of the MARRCC and its validation within a sample population of residents from 11 LTC facilities will be outlined. Inter-rater reliabilities from 97 to 99 and intra-rater reliabilities from 95 to 99 are reported. Validity correlation with the Multidimensional Observation Scale for somewhat advanced in life Subjects (MOSES) was statistically significant and supports the validity of the MARRCC. rises support the reliability and validity of the MARRCC as a clinical assessment for therapeutic recreation professionals working within LTC settings.

KEY WORDS: Therapeutic Recreation, Assessment, Reliability, Validity

In an era of increased accountability and demand for outcome-based programming, therapeutic recreation (TR) professionals working within drawn out Term Care (LTC) must have an empirically-tested clinical assessment (Dunn Sneegas, & Carruthers, 1991; Stumbo 2001; Witt, Connolly, & Compton, 1980) like an assessment must be based on a sound conceptual and theoretical foundation. It must go through rigorous testing for both reliability and validity, and include comprehensive manuals with clear directions for consistent implementation, scoring, analysis, and interpretation of assessment arises (Dunn, 1989; Peterson & Stumbo 2000; Stumbo 2002) Furthermore, it should be capable of assessing the general health status and the physical, cognitive, and psycho-social wants of residents as related to their ability to engage in optimally satisfying leisure interests and activities (Austin & Crawford, 1996; Howe, 1989; Peterson & Stumbo 2000; Sneegas, 1989; Stumbo 1996) Finally, it must be capable of establishing resident clinical direction as well as measuring change above time secondary to therapeutic intervention (Peterson & Stumbo 2000; Shank, Kinney, & Coyle 1993; Stumbo 1996) The Measurable Assessment in Recreation for Resident-Centered Care (MARRCC) was designed to suitable these needs.

The purpose of the MARRCC is to provide TR professionals with a standardized assessment of a resident's functional horizontal in each of the physical, cognitive, social, and emotional domains as related to recreation participation. The four domains are incorporated into the MARRCC for three reasons. First, the assessment of each of the four domains enables the TR professional to disentangle an objective, assessment-based understanding of the resident- single that includes both the resident's vigors and limitations. second, an assessment of a resident's functioning horizontal in each domain provides an indicator of that resident's ability to actively engage in leisure pursuits. Third, it enables the recreation professional to more accurately address the straits of the entire person rather than primarily focusing upon an illness or disabling condition, thereby maintaining the foundation that TR is a holistic approach to wellness (Howe-Murphy & Charboneau, 1987; Peterson & Gunn 1984; Peterson & Stumbo 2000) Thus, the MARRCC enables the TR professional to place residents into appropriate recreation programs or clusters based upon each resident's assessed functional horizontals needs, and interests.

Conceptualization

The underlying conceptual framework for the MARRCC may be ground within the leisure ability type (Peterson & Gunn, 1984; Peterson & Stumbo 2000) and the type of selective optimization and compensation (Baltes & Baltes, 1990) The leisure ability mould operationalizes the delivery of TR practice and consists of three program categories: Functional Intervention, Leisure Education, and Recreation Participation. Functional Intervention focuses upon enhancing a client/patient's ability to participate in leisure experiences through addressing conditions relative to that person's physical, cognitive, social, or emotional functional horizontals Leisure Education focuses on the disclosure and acquisition of skills, attitudes, and knowledge related to leisure participation and leisure lifestyle disclosure Recreation Participation services provide the opportunity for clients/patients to engage in structur assemblage recreation experiences for enjoyment or self-expression (Peterson & Gunn 1984; Peterson & Stumbo 2000) The three ultimate parts of the leisure ability type offer a continuum of care that individuals may access based upon assessed needs and anticipated outcomes

The protoplast of selective optimization and compensation (Baltes & Baltes, 1990) is a developmental theory of fortunate aging and adaptation. It is based upon the premise that successful aging is a proces that involves three interacting components: selection, optimization, and compensation. Selection commits to the restriction in the amount and variety of one's life pursuits to be paid to a decrease in functional abilities. This decrease in functioning is caused largely by dint of impairment of the individual's ability to adapt to environmental or intrinsic demands. The proces of selection implies that an individual will pick out to participate in life pursuits in which the environmental demands match personal motivations and remaining resources, skills, and abilities (Baltes & Baltes, 1990) Optimization directs to the propensity of an individual to capitalize upon remaining personal strengths and abilities as well as environmental resources while engaging in leisure and life pursuits. Thus, flat though the number, and perhaps variety, of life pursuits are decreased to be paid to the aging process, the potential for the individual to experience a faculty of perception of satisfaction and control while engaging in these pursuits is maintained at the highest horizontal possible (Baltes & Baltes, 1990) Compensation commits to the use of individual or any combination of psychological intimations social/environmental adaptation, and technological adaptive devices to compensate for those functional abilities and behavioral capacities that are not to be found due to the aging proces These adaptations enable the individual to continue to participate in chosen life pursuits with a horizontal of independence and mastery as similar as possible to that which was experienced prior to the first brunt of a decrease in functioning (Baltes & Baltes, 1990) The mould of selective optimization and compensation, therefore, describes a lifelong proces within which individuals go after their own well-being. This is accomplished end ongoing assessment of one's have abilities and limitations, maximization of one's have a title to abilities and resources, and the disclosure and utilization of creative strategies for adapting to changing personal, task, and resource challenges. This type is also consistent with established theories of aging including part theory (Atchley, 1977; Kaplan, 1979; Kelly 1983) continuity theory (Atchley, 1977; Kaplan, 1979; Neugarten, Havighurst, & Tobin, 1968) and activity theory (Havighurst & Albrecht, 1953; Havighurst, Neugarten, & Tobin, 1968; Lemon Bengston, & Peterson 1972; Longino & Kart, 1982; Neugarten, Havighurst, & Tobin, 1961)