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作者
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Chen, H-F. †, Wu,
C-Y. †, Lin, K-C.*,
Chen, C-L., Huang, P-C., Hsieh, C-J., Liu, J-S.
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關鍵字
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Cerebrovascular accident, Activities of
daily living, Validity, Rasch analysis,Composite
measure
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摘要
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Background. Tools used to measure poststroke
functional status must include basic and instrumental activities of daily
living (IADL) and reflect the patient’s and the
clinician’s perspective of the disease and its effect
on daily living performance.
Objective. We combined the Functional Independence Measure (FIM) and the
Nottingham Extended Activities of Daily Living (NEADL) to create a scale
providing a comprehensive evaluation of ADL functional status in patients
with stroke.
Methods. The study participants were 188 patients completing the FIM and the
NEADL. The psychometric properties of the combined measure were examined with
Rasch analysis.
Results. A 3-point and a dichotomous scale were suggested for use in the FIM
and the NEADL, respectively. The combined 40 items worked consistently to
reflect a single construct, and “bladder management” and “bowel management” were highly related. After “bowel
management” was removed from the combined scale, all
but 3 items fit the model’s expectations, and the
39-item scale showed reasonable item difficulty hierarchy with high reliability.
The 3 misfit items were removed, and no differences in unidimensionality,
differential item functioning, and reliability were found between the 36-item
and 39-item scales.
Conclusions. The combined measure of the FIM and the NEADL provides a comprehensive
picture of ADL. It extends the utility of the FIM and the NEADL and is
recommended for use to measure independence of patients after discharge to
home.
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