The Reliability and Validity of the Safety Assessement of Function and the Environment for Rehabilitation (SAFER Tool)

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The Safety Assessment of Function and the Environment for Rehabilitation (SAFER Tool) was developed to assess people's abilities to manage functional activities safely within their homes. The results of a study to evaluate the instrument's inter-rater and test-retest reliability and construct validity are reported.

Reliability was evaluated using kappa for each dichotomous item. For inter-rater reliability, 59 of 66 items had acceptable reliability. For test-retest reliability, 63 of 70 items had acceptable kappa scores. For items where kappa could not be calculated because of limited variation between raters, percentage agreement was over 80%.

For validity, higher SAFER Tool scores (that is, more safety problems) were hypothesised to be associated with less independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) and more cognitive impairment. The correlation between SAFER Tool scores and cognitive impairment supported this hypothesis. The results of the correlations with ADL and IADL scores were less clear. This could be attributed to caregivers' assistance with activities which might have reduced risk, and generally limited variation in ADL scores.

The reliability results from this study are positive. Further research to assure the SAFER Tool's validity and predictive ability are needed.

Document Type: Research Article

Publication date: March 1, 1998

More about this publication?
  • The British Journal of Occupational Therapy (BJOT) is the official journal of the College of Occupational Therapists. Its purpose is to publish articles relevant to theory, practice, research, education and management in occupational therapy internationally.

    BJOT publishes research articles, critical reviews, practice analyses, opinion pieces, editorials, letters to the editor, book reviews and an annual index. Please refer to the author's guide at

    Submissions can be made at

    The 2013 Impact Factor for The British Journal of Occupational Therapy is 0.897.

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