Validation of Comprehensive Assessment of Activities of Daily Living in Stroke Survivors

本研究目的探討功能獨立自主量表 (Functional Independence Measure，FIM) 及芙蘭切活動量表 (Frenchay Activities Index，FAI) 是否能夠組合成為腦中風患者預後全面性日常生活活動評估量表。研究對象來至南臺灣某大學附設醫院神經科或復健科住院中風病患，共計徵召有 209 位初次腦中風患者於發病一年後在門診、居家或長期照護機構完成病患訪視及量表評估。使用無母數因素分析來檢定 FIM 及 FAI 量表組合成為全面性量表各個項目之共同建構特質，然後依據 FIM 及 FAI 量表個別得分，檢定兩種不同統計組合得分分佈情況。結果發現可以由三個共同因素來解釋量表 90% 的整體變異量，其中一個因素包括所有 FIM 測量項目，FAI 項目分別包含於另外兩個因素中，顯示 FIM 及 FAI 量表組合並無重疊項目。兩種量表組合後得分數不會出現個別使用時得分有上限或下限的效應。兩者組成全面性日常生活活動量表具備良好的建構效度，更適合使用於臨床及研究中風病患預後全面性日常生活活動能力的評估。

關鍵字

日常生活活動；腦中風；建構效度； Functional Independencemessure

並列摘要

This study determined whether the Functional Independence Measure (FIM) and the Frenchay Activities Index (FAI) could be used together as a more comprehensive score to assess the activities of daily living (ADL) in stroke survivors. Subjects were recruited from stroke patients consecutively admitted to the inpatient neurology or rehabilitation department at a university hospital in southern Taiwan. We interviewed 209 first stroke survivors at least 1 year after stroke onset during their clinical visits, at home, or in long-term care institutions. Combinations of FIM and FAI as a comprehensive assessment of ADL were measured. All items of the FIM and the FAI were included in a non-parametric factor analysis to determine their underlying constructs. Two comprehensive functional independence scores were then computed as functions of the FIM and FAI scores. The distributional characteristics of the comprehensive scores were examined. Approximately 90% of the total variation was explained by three factors. One single factor comprised all the items from FIM, while the FAI items loaded on two other factors, suggesting that FIM supplements FAI without overlap in content. We further demonstrated that the presence of ceiling or floor effects when either the FIM or the FAI was used could be removed using combined scores of the two instruments. The FIM and the FAI assessed different domains with good construct validity. A comprehensive assessment of functional independence obtained by combining the FIM and the FAI scores is potentially more appropriate and useful for clinical and research applications in stroke patients.

並列關鍵字

activities of daily living ； construct validity ； stroke ； Functional Independence Measure ； Frenchay Activities Index

國際替代計量

Validation of Comprehensive Assessment of Activities of Daily Living in Stroke Survivors

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