findings show a single factor for the DASH and dual factors for the QuickDASH. However, CFA for the DASH has only been published in 2 studies and both showed a 3-factor structure. No study has investigated the QuickDASH with CFA making this a necessity. Conclusion: The internal consistency of the DASH in this study was <0.95 indicating no item redundancy and was lower than that found in other studies with smaller samples. Both DASH and QuickDASH factor structure under CFA showed dual or multi fac- tors. These findings raise further concerns on use of the DASH and QuickDASH in research and clinical settings as their psychometric characteristics indicate they may be unsuitable for single sum- mated scores. Further research is needed in larger samples to verify both the internal consistency and the factor structure. Results: The internal consistency showed the DASH at a ¼ 0.93 and the QuickDASH at 0.87. The EFA provided a single factor solution for the DASH and a dual factor for the QuickDASH. The CFA however demonstrated a three-factor model for the DASH and a two-factor model for the QuickDASH. Methods: Participants with upper limb conditions referred to and included in registered studies were de-identified and pooled to two separate data bases with baseline measures for the DASH (n ¼ 459) and QuickDASH (n ¼ 566). Internal consistency was determined on both samples. Factor structure was determined in two stages, initial EFA and subsequent CFA for the full sample with models compared empirically for the best fit. The CFA calculated factor loadings of the variables included in the models and against the EFA findings. The maximum likelihood extraction (MLE) method was used. 5 Experiences of Individuals in Upper Extremity Rehabilitation With Incongruence Between Their Quickdash and Groc Scores: A Phenomenological Study E. SMITH-FORBES 1, 4 , D.M. HOWELL 2,1 , R. MORGAN 3 , K. CLARK 3 , S. HALL 3 , J. WILLOUGHBY 3 , H. ARMSTRONG 3 , G. PITTS 3,1 , T.L. UHL 1, 3 1 Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, United States 2 Occupational Therapy, Eastern Kentucky University, Richmond, Kentucky, United States 3 Kentucky Hand and Physical Therapy/Drayer Physical Therapy Institute, Lexington, Kentucky, United States 4 Graduate Medical Education, United States Army, Fort Sam Houston, Kentucky, United States Purpose: Study design: Qualitative phenomenological. Back- ground: The multidimensional adherence model (MAM) published by the World Health Organization (WHO) in 2003 identifies Patient related factors as one of five dimensions that influence adherence. Patient’s perception of treatment success in acute hand therapy has been found to be multifactorial. Two subjective forms often used in hand therapy to capture these factors are the Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) and the Global Rate of Change scale (GROC). However, it is not uncommon for there to be directionality incongruence between the two forms, which may indicate patient dissatisfaction with care or a lack of progress. Purpose: To describe the experiences and expectations of rehabil- itation of patients who demonstrated incongruence between their QuickDASH and GROC forms, in addition to their decisions to adhere and comply with their treatment plan. Conclusion: Interventions where patients viewed therapists as dedicated tended to improve patient adherence. Early therapist and patient agreement of what was minimally clinically important may improve patient adherence. Teamwork at three levels was essential, between: therapist and patient, therapist and staff, and therapist liaising with the healthcare system. When patients exhibit an incongruence in patient reported outcomes, therapist can listen to patients with empathy in order to build trust and establish a pa- tient-centered approach to the intervention. Disclaimer: The opin- ions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the US Army or Department of Defense. Results: From 10 participants, 289 codes were extracted, leading to 151 significant statements, yielding five themes and seven sub- themes. Themes were: 1) Desire to return to normal, 2) Anticipation of a brief recovery, 3) Trust or mistrust of therapist impacts recovery, 4) Can’t stop living because of injury or rehabilitation, 5) Feelings of ambivalence towards the recovery process. All themes and sub- themes were represented in the WHO MAM. The “Essence” or exhaustive description of the phenomenon of incongruence means getting back into life. “Back into life” represents being able to return to prior function, to physically accomplish tasks, to return to work or to sports. Patients view themselves as laymen, and seek the knowledge of a dedicated therapist who they trust, to spend time with them to understand what they value as important, and clarify their injury, and collaboratively make goals, and explain the intervention to get them in essence, “back into life”, in the minimal required time. Methods: Participants were patients in an outpatient hand ther- apy clinic who demonstrated incongruence between their Quick- DASH and GROC forms beyond measurement error. Research was carried out independent from treating therapists. Semi-structured interviews were digitally recorded and transcribed, and analyzed using Colaizzi’s phenomenological method until attaining satura- tion. Another researcher checked the interviews for accuracy. 6 Determining Validity of Measures of Pain and Perceived Effort of Women With Hand Osteoarthritis During a Jar Opening Task C. MCGEE, N. AFFELDT, S. BRASKI, M. KLOKE, K. STOKKE, K. THOMASON University of Minnesota Program in Occupational Therapy, Rochester, Minnesota, United States Purpose: Joint protection strategies are often recommended for individuals with hand arthritis. However, there is little research Selected Examples of Significant Statements of People Experiencing Incongruence Between Their QuickDASH and GRC and Related Formulated Meanings Significant statement Formulated meaning “I know before, I started physical therapy, I had no motion, I couldn’t move my wrist, there was a lot more pain, I couldn’t work, at least I am back at work. So, therapy has gotten me back into life.”” Back into life encompasses returning to normal, being back at work, being able to regain functional ability “A little bit, is not good enough. I can do this [flexes DIP’s approx 20 degrees], or a little more, it doesn’t help me fix the muffler on my car. You know, so I can move it a little bit more, a little bit more is not making a fist.[pause]” Incremental gains of ROM do not matter unless a functional outcome to perform a task is achieved “Yeah, you put a lot of trust in a therapist.and when a therapist doesn’t give you a 100% of what they are suppose to do. I’ma layman. I don’t know what I’m suppose to go through when I go through physical therapy for a knee, or a hand or for whatever. That’s why I’m coming to a physical therapist.” Patients view themselves as laymen and expect their therapists to have their best interest in mind. “I guess when that happens, you kind of expect instant gratification. You want it to come right back, but from what I heard, I think its pretty much on track. [pause]. I think they said 12 weeks, and we are almost at week 8 and I feel like that’s a good goal.” Patients initially anticipate a swift recovery, but often come to realize their recovery is a slow process. Abstracts / Journal of Hand Therapy 29 (2016) 356e384 358