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The Planning in Life and Adapting to Novel Situations (PLANS): An Ecologically Valid Measure of Every-day Planning

Knutson, Evan (2019) The Planning in Life and Adapting to Novel Situations (PLANS): An Ecologically Valid Measure of Every-day Planning. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Individuals with brain injuries often experience impairment in executive functioning, including the ability to plan. Planning dysfunction limits the capacity to complete functional planning tasks required for effective independent living and community functioning and is a frequent target of community rehabilitation intervention. Current planning measurement tools have limitations in their ecological validity, and are not sensitive to every-day planning. Research has shown that naturalistic simulated instruments have higher degrees of ecological validity than traditional testing options, and are more predictive of executive functioning limitations observed in real-world contexts.
This dissertation project describes three research studies involved with the development and feasibility of a new naturalistic instrument: The Planning in Life and Adapting to Novel Situations (PLANS). The first study conducted a scoping literature review (n=22) and semi-structured interviews (n=8) with community rehabilitation clinicians to inform the context, tasks, and scoring of the PLANS. Second, an analysis of clinical data from the Community Multiple Errands Test (CoMET), by individuals with cognitive disabilities (n=55) was conducted to assess planning performance errors in community functioning. CoMET performance was significantly related to measures of logical reasoning, planning and verbal fluency, and demonstrated ecological validity but was limited for adaption to new environments. These findings informed the task demands, environments and scoring of the PLANS. A preliminary draft of the PLANS was constructed and surveys (n=4) were completed by content experts to establish PLANS content validity. The validated PLANS was piloted with (n=20) individuals with a traumatic brain injury. The PLANS was feasible for use with individuals with traumatic brain injuries, and the scoring system demonstrated high inter-rater reliability (kappa=.86). The PLANS demonstrated preliminary construct reliability with measures of executive functioning (p<.05), logical reasoning (p<.05) and planning (p<.01). The PLANS also demonstrated ecological validity through correlations with measures of every-day executive dysfunction (p<.05). Future work supports investigating the utility and validity of the PLANS in community rehabilitation clinical settings.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Knutson, Evaneck26@pitt.edueck260000-0002-3466-3393
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMcCue, Michaelmmccue@pitt.edu
Committee MemberSkidmore, Elizabethskidmore@pitt.edu
Committee MemberTerhorst, Laurenlat15@pitt.edu
Committee MemberArenth, Patriciapatricia.arenth@va.gov
Date: 4 June 2019
Date Type: Publication
Defense Date: 6 March 2019
Approval Date: 4 June 2019
Submission Date: 19 March 2019
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 248
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Traumatic Brain Injury, Naturalistic Instrument, Ecological Validity, Planning,
Date Deposited: 04 Jun 2020 05:00
Last Modified: 04 Jun 2020 05:00
URI: http://d-scholarship.pitt.edu/id/eprint/36077

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