兒童室內輪椅操控移動測試之發展及初步信效度評估

背景與目的：準確地鑑別兒童輪椅移動操控（maneuverability）能力，對於兒童輪椅使用者的評估及選擇適當的治療方式來說都是很重要的。然而，過去在測試兒童於室內輪椅推進能力的標準化流程、環境擺設的資訊缺乏。因此，本初步研究的目的為發展一個兒童室內輪椅操控移動測試（pediatric indoor wheelchair maneuverability test, PIWMT），並且測試內容效度和信度。方法：經文獻回顧整理及臨床討論發展出一個標準化的迴圈式輪椅測試及評分系統，自8名物理治療師進行內容效度的檢測。以方便取樣的方式，徵召10位腦性麻痺兒童及2位物理治療師參與信度測試。兒童室內輪椅推進能力測試共包含10項評分項目，及7項時間和空間參數。使用內容效度指標（content validity index, CVI ）、組內相關係數（intraclass correlation coefficients, ICC）及Kappa進行統計分析。結果：兒童室內輪椅操控移動測試的項目CVI值介於0.88～1.00，評分項目的施測者間和再測一致性為好到非常好（x＝0.71～1.00）。時間和空間參數，施測者間呈現好的信度， ICC（下標括號2.1）值介於0.97～1.00，再測信度為差到好信度間，ICC（下標括號3.1）值介於0.45～1.00。測驗過程中未發生不良傷害的事件。結論：本先驅性研究提供兒童室內輪椅操控移動測試的初步信效度資料。在決定兒童室內輪椅操控移動測試臨床的使用性前，未來尚需進一步心理計量學特質的建構。

關鍵字

輪椅；兒童；移動操控；信度；效度

並列摘要

Background and Purposes: The accurate identification of wheelchair maneuverability is important not only for assessment but also for the selection of appropriate intervention for pediatric wheelchair users. A lack of information regarding standardized protocols as well as environmental setting for testing the indoor wheelchair maneuverability abilities in pediatric population was identified. The objective of this preliminary study was to develop the Pediatric Indoor Wheelchair Maneuverability Test (PIWMT), and explore its content validity and reliability. Methods: A standardized wheelchair test circuit and scoring system of PIWMT were developed after a series of literature review and clinical discussions. Eight physical therapists participated in the content validity of PIWMT. For examining the inter-rater reliability, convenience samples of 10 children with cerebral palsy and two physical therapists were recruited. The PIWMT consisted of 10 indoor wheelchair test scoring item s and 7 spatial-temporal parameters. Content validity index (CYI), intraclass correlation coefficients (ICC) and Kappa statistic were used for statistical analysis. Results: There were no adverse incidents. Individual CYIs ranged from 0.88 to 1.00 for the PIWMT. The intra-rater and inter-rater agreements ranged from good to very good (x = 0.71-1.00). Inter-rater reliabilities were found to be good (ICC(subscript (2.1))= 0.97- 1.00),whereas the test-retest reliabilities were low to good (ICC(subscript (3.1) = 0.45-1 .00). Conclusions: This preliminary study provided some preliminary reliability and validity test of the PIWMT. More Psychometric properties of the PIWMT are warrant before determining its clinical usage.

並列關鍵字

WheeIchair ； Pediatric ； Maneuverability ； Reliability ； Validity

國際替代計量

兒童室內輪椅操控移動測試之發展及初步信效度評估

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