功能獨立量表訪談式問卷於腦中風病人之信度檢定

Reliability of the Interview-Based Functional Independence Measure in Patients with Stroke

廖麗君(Lih-Jiun Liaw) ； 林昭宏(Jau-Hong Lin) ； 朱允慧(Yun-Huei Ju) ； 劉景寬(Ching-Kuan Liu)

《物理治療》 27卷4期 (2002/08) Pp. 174-182

摘要

背景與目的，本研究主要目的在於探討英文版功能獨立量表(Functional Independence Measure, FIM)訪談式問卷之可行性，經由檢測訪談法之評估者內信度(intra-rater reliability)與評估者間信度(inter-rater reliability)，同時分析訪談法與家訪觀察法間之相等信度(equivalence reliability)。方法：評估者內信度部分評估20位中風病人，兩次訪談時間在7天內完成。評估者間信度由兩位物理治療師各自獨立訪談另外20位中風病人。訪談問卷與家訪觀察之相等信度部分是評估35位門診中風病人，由一位治療師在門診完成訪談法評估FIM，再由另一位物理治療師至病人家中實際觀察FIM之表現。結果，評估者內信度統計分析結果顯示FIM總分、動作領域及認知領域ICC(Intraclass Correlation Coefficient)值皆達0.99以上；Kappa一致性解釋度皆在良好（含）以上。評估者間信度結果顯示FIM總分、動作領域（自我照顧、排便、移位及走動）及認知領域（溝通及社會認知）ICC值分別為0.99，0.98，0.99；Kappa一致性解釋度有77%在中等程度以上。相等信度統計分析結果顯示FIM總分、動作領域及認知領域ICC值分別為0.98，0.99，0.90；Kappa一致性解釋度有83%在良好或中等程度。結論：FIM以訪談方式評估具有很好的評估者內信度及評估者間信度，和家訪觀察法之間也具有良好的相等信度，本研究結果可提供臨床人員用訪談方式代替直接觀察使用英文版FIM於中風病人之參考依據。

關鍵字

訪談法 ； 功能獨立量表 ； 信度 ； 中風

並列摘要

Background and purpose: The main purpose of this study was to investigate the feasibility of scoring Functional Independence Measure (FIM) by interview. The intra-rater and inter-rater reliability of the interviewed FIM, and the comparison of home-visit and interviewed FIM were investigated. Methods: Twenty stroke patients were interviewed twice in 7 days for the intra-rater reliability, while another 20 stroke patients were interviewed by two physical therapists within 7 days for inter-rater reliability. Thirty-five stroke patients were recruited for testing the equivalence of direct observed and interviewed FIM. Results: The results indicated that the scores of FIM total, motor domain and cognitive domain achieved excellent intra-rater reliability (ICC≥0.99) with good strength of Kappa coefficient. The inter-rater reliability of the respective scores showed similar finding (ICC≥0.98, 77% with moderate or higher strength of Kappa coefficient). For the equivalence analysis (interview vs. direct observation), the ICC values were 0.98, 099 and 0.90, respectively (83% with moderate or good strength of Kappa coefficient). Conclusions: The interview-based FIM has been shown good reliability in this study. The results of this study suggest the interview-based FIM is able to provide clinicians an alternative of functional assessment.

並列關鍵字

Interview ； Functional Independence Measure ； Reliability ； Stroke