脊髓独立性评定量表Ⅲ中文版的适用性研究

The validity and reliability of Chinese version of spinal cord independence measureⅢ

目的:评价脊髓独立性评定(SCIM)量表Ⅲ中文版的适用性。方法:利用功能独立性评定量表(FIM)和SCIMⅢ中文版对79例急性和27例慢性脊髓损伤患者的功能能力进行评定,通过内部一致信度、重测信度和评定者间信度评价SCIMⅢ中文版的信度,通过效标效度和结构效度评价SCIMⅢ中文版的效度。结果:①中文版SCIMⅢCronbachα系数为0.816,重测相关系数为0.9,总量表评定者间相关系数为0.92;②SCIMⅢ中文版各维度与FIM相对应维度相关系数均在0.806—0.845;SCIMⅢ中文版各维度间相关系数在0.56—0.714,各维度与总量表相关系数在0.732—0.848(P<0.01)。结论:SCIMⅢ中文版具有良好的信度、效度及可行性,适于中国脊髓损伤患者的功能结局评定;但是,呼吸和一些具体活动项目的记分结构或记分标准需要调整以进一步提高其信度、效度和临床应用。

Objective： To assess the validity and rehability of Chinese version of spinal cord independence measure Ⅲ （C-SCIM Ⅲ） in measuring functional ability in patients with spinal cord injury （SCI）. Method： Functional ability was measured with C-SCIM m and functional independence measure （FIM） in 79 patients with acute SCI and 27 patients with chronic SCI. FIM was used as a comparison standard for C-SCIM m. The intra-consistency reliability, intraclass reliability, inter-rater reliability, construct validity, and criterion validity were analyzed to test validity and reliability of C-SCIM m. Result： （1）The Cronbach＇s c~ coefficient of C-SCIM m was 0.816. The intraclass correlation coefficient were above 0.92. The coefficient of Pearson correlation between the paired raters was 0.90. （2）The coefficient of Pearson correlation between-FIM and C-SCIM Ⅲ were 0.806--0.845 in four subgroups. The coefficient of Pearson correlation between four subgroups and the total scale of C-SCIM m were 0.732----0.848, and between four sub- groups each other were 0.56---0.714. Conclusion： C-SCIM Ⅲ is a reliable and valid measure for functional ability in SCI. However, a few modifica- tions of scoring categories in breathe and detailed scoring instructions may further improve the validity, reliability and clinical utility of SCIM Ⅲ .