The psychometric properties of the Persian version of the participation measure-3 domains, 4 dimensions in Iranian patients with multiple sclerosis

Abstract

Background: Multiple sclerosis (MS) profoundly influences individuals' participation across various life domains. This study evaluated the psychometric properties of the Persian version of the Participation Measure-3 Domains, 4 Dimensions (PM-3D4D) in people with MS (PwMS).

Methods: In a cross-sectional design with a nested test-retest sub-study, 230 PwMS were assessed. Construct validity was examined through intercorrelations among PM-3D4D dimensions and associations with the Community Integration Questionnaire (CIQ), Participation Measure for Post-Acute Care (PM-PAC), Satisfaction with Life Scale (SWLS), and Purpose in Life Test-Short Form (PIL-SF). The instrument's discriminative capacity across subgroups with different levels of disability and fatigue was also analyzed.

Results: The PM-3D4D demonstrated excellent test-retest reliability [intraclass correlation coefficient (ICC)_(2,1) = 0.81-0.90] and good internal consistency (Cronbach’s alpha = 0.79-0.89). Strong correlations emerged between the diversity and frequency dimensions (r_s = 0.70-0.88), alongside moderate to strong correlations with the difficulty dimension
(r_s = 0.37-0.82). As hypothesized, PM-3D4D scores correlated strongly with CIQ (r_s = 0.71-0.83), and the difficulty dimension was negatively correlated with PM-PAC subscales
(r_s = -0.75 to -0.85). Desire for change showed weak negative correlations with SWLS (r_s = -0.16 to -0.29) and moderate negative correlations with PIL-SF
(r_s = -0.33 to -0.51). The instrument significantly differentiated participants based on disability and fatigue levels (P < 0.001).

Conclusion: The Persian version of the PM-3D4D is a valid and reliable measure for evaluating participation among PwMS in both clinical and research settings.