国际功能、残疾和健康分类康复组合-17在临床多学科住院患者中应用的信效度研究

The reliability and validity of the International Classification of Functioning,Disability and Health′s Rehabil-itation Set for multidisciplinary inpatients

目的验证国际功能、残疾和健康分类(ICF)康复组合-17在临床多学科患者功能评估中的信度和效度。方法选取来自江苏省三家三级医院的康复医学科、骨科、神经内科和神经外科的住院患者359例。在入院和出院时均采用ICF康复组合-17对所有患者进行评估,计算评估工具的内部一致性。用组内相关系数(ICC)检验评估者间和评估者内信度,用主轴法的直接斜交转轴法进行因子分析,检验ICF康复组合-17的结构效度。结果ICF康复组合-17的内部一致性Cronbach′sα系数为0.945。评估者间信度分析显示,ICF康复组合-17总分的ICC为0.946;除b280痛感外,该量表的剩余条目ICC为0.630~0.948(P<0.001)。评估者内信度分析显示,ICF康复组合-17总分和条目的ICC为0.471~0.947(P<0.001)。经过因子分析,得到3个特征值大于1的因子,累计解释变异量为74.123%,无双重负荷的条目。将3个公因子分别命名为"运动能力","睡眠感知交往能力"和"生活自理能力"。结论ICF康复组合-17在多学科住院患者功能评定中具有良好的内部一致性、评估者间信度、评估者内信度和结构效度。

Objective To explore the reliability and validity of the International Classification of Functio-ning,Disability and Health′s 17-item Rehabilitation Set(ICF-RS-17)when used to evaluate multidisciplinary in-patients.Methods A total of 359 inpatients in the departments of rehabilitation,orthopedics,neurology,and neurosurgery of three hospitals in Jiangsu province were assessed with the ICF-RS-17 at admission and at discharge,and the internal consistency of the tool was calculated.Inter-rater and intra-rater reliability were quantified using in-terclass correlation coefficients(ICCs).Structural validity was analyzed using factor analysis.Results The tool′s Cronbach′sαwas 0.945.The overall inter-rater ICC was 0.946 with the ICCs of all of the items except b280 sensa-tion of pain within the range from 0.630 to 0.948.The overall intra-rater ICCs ranged from 0.471 to 0.947.The fac-tor analysis found three factors with eigenvalues greater than 1,accounting for 74%of the variation,without double-loaded items.The three influential factors were exercise ability,sleep perception communication ability and self-care ability.Conclusion The ICF-RS-17 has good internal consistency,inter-rater and intra-rater reliability and structural validity in the evaluation of multidisciplinary inpatients.