Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and ski...Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.展开更多
AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis ...AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.展开更多
目的汉化孕妇尿失禁知信行量表(knowledge,attitude and practice assessment scale for pregnant women on UI,KAP-IU)并评价其信度、效度,为医护人员对孕妇尿失禁知信行情况的评估提供测量工具。方法2022年12月—2023年3月按照国际通...目的汉化孕妇尿失禁知信行量表(knowledge,attitude and practice assessment scale for pregnant women on UI,KAP-IU)并评价其信度、效度,为医护人员对孕妇尿失禁知信行情况的评估提供测量工具。方法2022年12月—2023年3月按照国际通用量表跨文化调适流程对量表进行汉化,形成中文版KAP-IU量表。2023年3月—6月采用便利抽样选取门诊就诊孕妇456例进行调查,基于Rasch模型和经典测量学检验指标进行信度、效度检验。结果430例孕妇完成研究。中文版KAP-IU量表共由23个条目构成,符合Rasch模型单维性假设,Rasch模型解释了66.1%的变异;个人和条目的分隔信度均>0.8,分隔指数≈3,所有条目加权的均方拟合统计量(information-weighted mean square fit statistic,Infit MNSQ)和未加权的均方拟合统计量(unweighted mean square fit statistic,Outfit MNSQ)均方值在0.473~1.611之间,点测量相关系数(point-measure correlation,Pt-Measure Corr)在0.293~0.731之间,个体能力均值比条目难度均值高0.343 Logits;总量表Cronbachα系数为0.783,3个维度(知识、态度和行为)的重测信度分别为0.751、0.815、0.760;条目水平内容效度指数(item-level CVI,I-CVI)为0.810~1.000;量表水平内容效度(scale-level CVI,S-CVI)为0.824。结论中文版KAP-IU量表在国内孕妇人群中经验证信度、效度良好,难度适中,可作为孕妇尿失禁知信行情况评估的可靠工具。展开更多
The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to exam...The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to examine outcome differences between the two groups following post-hospital residential rehabilitation. Participant data were collected from 32 facilities in 16 states. From 2990 neurologically impaired individuals with consecutive admissions from 2011 through 2017, 874 met inclusion criteria: TBI (n = 687) or CVA (n = 187), 18 years or older, minimum length of stay of one month, and maximum chronicity of 1 year. Participants were evaluated at admission and discharge on the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4). Rasch analysis was performed to establish item reliability, construct validity and item difficulty. A Repeated Measures Multivariate Analysis of Covariance (RM MANCOVA) determined group differences and improvement from admission and discharge. Rasch Analysis demonstrated satisfactory construct validity and internal consistency (Person reliability > 0.90, Item reliability > 0.98 for admission and discharge MPAI-4s). Both groups showed significant improvement on the MPAI-4 (p 0.0005). The TBI group was more impaired on the adjustment scale at both admission and discharge (p 0.001). Rasch analysis identified two distinct impairment patterns. CVA participants exhibited deficits characteristic of focal impairment while the TBI group presented with deficits reflective of diffuse impairment. Rehabilitation was shown to be beneficial in reducing disability following neurologic injury in both groups. Importantly, Rasch Analysis accurately produced unique disability profiles that differentiated the treatment groups. This unique statistical technique offers a promising prescriptive hierarchical model for guiding neurological rehabilitation treatment.展开更多
In this paper we aim to analyse temporal variation of CD4 cell counts for HIV-infected individuals under antiretroviral therapy by using statistical methods. This is achieved by resorting to recursive binary regressio...In this paper we aim to analyse temporal variation of CD4 cell counts for HIV-infected individuals under antiretroviral therapy by using statistical methods. This is achieved by resorting to recursive binary regression tree approach [1]?[2]. This approach has made it possible to highlight the existence of several segments of the population of interest described by the interactions between the predictive covariates of the response to the treatment regimen.展开更多
目的翻译前庭活动与参与量表(Vestibular Activities and Participation,VAP)并评价其信效度。方法采用Brislin模式对量表进行翻译,形成中文版VAP量表。对422例良性阵发性位置性眩晕患者和40例前庭康复患者施测,基于Rasch模型分析量表...目的翻译前庭活动与参与量表(Vestibular Activities and Participation,VAP)并评价其信效度。方法采用Brislin模式对量表进行翻译,形成中文版VAP量表。对422例良性阵发性位置性眩晕患者和40例前庭康复患者施测,基于Rasch模型分析量表的信效度。结果中文版VAP量表由活动维度(8个条目)和参与维度(4个条目)构成,维度构成与原量表不同(原量表两个维度各含6个条目);中文版VAP量表两个维度信度均>0.8,分离指数>2;两维度条目难度分布相对集中(均值Logit 0.00±0.19、Logit 0.00±0.30),个体能力相对较广(均值Logit-0.43±1.99、Logit-0.17±2.30);前庭康复前后量表得分差值为5.49分,效应量为0.87(P<0.01),标准化反应均数为0.85。结论中文版前庭活动与参与量表维度构成与原量表不同,经重构后信效度良好,难度适宜,且具有较好的反应度,可作为评价前庭疾病患者活动与参与功能的有效工具。展开更多
文摘Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.
基金Supported by Wenzhou Science and Technology Bureau Project(No.Y2020036)the National Science Foundation of China(No.82000861)National Key Research and Development Program of China(No.2020YFC2008200).
文摘AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.
文摘目的汉化孕妇尿失禁知信行量表(knowledge,attitude and practice assessment scale for pregnant women on UI,KAP-IU)并评价其信度、效度,为医护人员对孕妇尿失禁知信行情况的评估提供测量工具。方法2022年12月—2023年3月按照国际通用量表跨文化调适流程对量表进行汉化,形成中文版KAP-IU量表。2023年3月—6月采用便利抽样选取门诊就诊孕妇456例进行调查,基于Rasch模型和经典测量学检验指标进行信度、效度检验。结果430例孕妇完成研究。中文版KAP-IU量表共由23个条目构成,符合Rasch模型单维性假设,Rasch模型解释了66.1%的变异;个人和条目的分隔信度均>0.8,分隔指数≈3,所有条目加权的均方拟合统计量(information-weighted mean square fit statistic,Infit MNSQ)和未加权的均方拟合统计量(unweighted mean square fit statistic,Outfit MNSQ)均方值在0.473~1.611之间,点测量相关系数(point-measure correlation,Pt-Measure Corr)在0.293~0.731之间,个体能力均值比条目难度均值高0.343 Logits;总量表Cronbachα系数为0.783,3个维度(知识、态度和行为)的重测信度分别为0.751、0.815、0.760;条目水平内容效度指数(item-level CVI,I-CVI)为0.810~1.000;量表水平内容效度(scale-level CVI,S-CVI)为0.824。结论中文版KAP-IU量表在国内孕妇人群中经验证信度、效度良好,难度适中,可作为孕妇尿失禁知信行情况评估的可靠工具。
文摘The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to examine outcome differences between the two groups following post-hospital residential rehabilitation. Participant data were collected from 32 facilities in 16 states. From 2990 neurologically impaired individuals with consecutive admissions from 2011 through 2017, 874 met inclusion criteria: TBI (n = 687) or CVA (n = 187), 18 years or older, minimum length of stay of one month, and maximum chronicity of 1 year. Participants were evaluated at admission and discharge on the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4). Rasch analysis was performed to establish item reliability, construct validity and item difficulty. A Repeated Measures Multivariate Analysis of Covariance (RM MANCOVA) determined group differences and improvement from admission and discharge. Rasch Analysis demonstrated satisfactory construct validity and internal consistency (Person reliability > 0.90, Item reliability > 0.98 for admission and discharge MPAI-4s). Both groups showed significant improvement on the MPAI-4 (p 0.0005). The TBI group was more impaired on the adjustment scale at both admission and discharge (p 0.001). Rasch analysis identified two distinct impairment patterns. CVA participants exhibited deficits characteristic of focal impairment while the TBI group presented with deficits reflective of diffuse impairment. Rehabilitation was shown to be beneficial in reducing disability following neurologic injury in both groups. Importantly, Rasch Analysis accurately produced unique disability profiles that differentiated the treatment groups. This unique statistical technique offers a promising prescriptive hierarchical model for guiding neurological rehabilitation treatment.
文摘In this paper we aim to analyse temporal variation of CD4 cell counts for HIV-infected individuals under antiretroviral therapy by using statistical methods. This is achieved by resorting to recursive binary regression tree approach [1]?[2]. This approach has made it possible to highlight the existence of several segments of the population of interest described by the interactions between the predictive covariates of the response to the treatment regimen.
