Linking the Klein-Bell Activities of Daily Living Scale to the International Classification of Functioning, Disability and Health.
OBJECTIVE
The main objective of this study was to link the Klein-Bell activities of daily living (KB) Scale to the International Classification of Functioning, Disability and Health (ICF), in order to validate the KB Scale content-wise.


DESIGN
A qualitative approach was used with directed content analysis.


METHODS
Concepts in the KB Scale items were linked to ICF categories according to established rules. This was followed by 4 analyses: examination of the linked categories' frequency distribution; comparison of these categories with core sets for spinal cord injury (SCI) and occupational therapists; calculation of content density, content diversity and range of linked categories; and calculation of agreement between two independent linkage versions.


RESULTS
All except one identified KB Scale concept could be linked to ICF categories. The occupational therapists Core Sets were most consistent with linked categories in the KB Scale. Content density, content diversity and range varied between the different KB Scale dimensions. Agreement was reliable for the whole KB Scale and for 5 of 6 dimensions.


CONCLUSION
The ICF has provided a valuable reference to identify and quantify the concepts in the KB Scale. Furthermore, comparison between the KB Scale and ICF Core Sets provides insights into areas covered by these instruments.