改良Barthel指数（简体中文版）量表评定脑卒中患者日常生活活动能力的效度和信度研究

Validity and reliability of the simplified Chinese version of modified Barthel index for Chinese stroke patients

目的探讨改良Barthel指数（MBI）简体中文版评定脑卒中患者日常生活活动能力（ADL）的效度、信度和敏感度，为其临床广泛应用提供客观依据。方法共选取40例脑卒中患者，其中男26例，女14例；年龄（59．65±11．68）岁；病程（21．20±19．44）d。2名评定员使用MBI、原始Barthel指数（BI）和功能独立性测定（FIM）中的运动部分（M—FIM）对上述患者进行ADL评定，各量表分别评定3次。将MBI结果分别与BI、M—FIM结果进行Spearman相关性分析以检验MBI的效度；对不同评定员间的MBI结果进行等级间相关系数（ICC）分析以检验MBI的内部信度和评定员之间信度；对治疗前、后的MBI结果进行符号秩和检验和配对t检验，从而分析MBI敏感度。结果MBI结果与BI各项及总分均具有高度相关性（r=0．816～1．000，P〈0．01），与M—FIM总分也有高度相关性（r=0．935～0．981，P〈0．01）；MBI在同一评定者及不同评定者间均有良好的信度（ICC=0．866～0．997）；患者经治疗后，发现其MBI评定中的进食、修饰、穿衣、床椅转移、上下楼梯及总分项目与治疗前比较，差异均有统计学意义（P〈0．05），而BI评定中仅上下楼梯及总分项目差异具有统计学意义（P〈0．05），表明MBI敏感度优于BI。结论MBI量表具有良好的效度、信度和敏感度，对评定脑卒中患者ADL具有重要意义。

Objective To study the validity, reliability and sensitivity of the simplified Chinese version of modified Barthel index （MBI） in evaluation of activities of daily living （ADL） of Chinese stroke patients. Methods Forty Chinese stroke patients （26 males and 14 females, aged 59.65 ± 11.68 years） participated in the study. The duration of the disease averaged 21.20 ± 19.44 days. All the patients were evaluated for three times with MBI, Barthel Index （BI） and the motor component of Functional Independence Measure （M-FIM） independently by twophysiatrists. Spearman correlation coefficients between MBI and Barthel index （BI） , between MBI and M-FIM were used to test the validity of MBI. Intraclass correlation coefficients （ICC） were used to test both interrater and intra rater reliability of MBI. Sensitivity of MBI was analyzed with the Wilcoxon signed rank test and paired t-test. Results MBIwas highly correlated with BIin each item and total score （r=0.816-1.000, P〈0.01）, and with M-FIM in total score （r = 0. 935 -0. 981,P 〈 0.01 ）. There were high reliability with MBI in the results collected by same assessor and different assessors （ICC = 0. 866 - 0. 997）. Furthermore, MBI was more sensitive than BI in majorities of its items and its total scores as well. Conclusions MBI has good validity and reliability as well as sensitivity in assessment of ADL of Chinese stroke patients.