Tsuji T, Liu M, Toikawa H, Hanayama K, Sonoda S, Chino N
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
Am J Phys Med Rehabil. 1999 May-Jun;78(3):208-12. doi: 10.1097/00002060-199905000-00003.
The Functional Independence Measure for Children (WeeFIM) instrument was developed, based on the FIM instrument, to assess disability in children aged 6 mo to 7 yr. Normative data are reported for American and Japanese children, and it is increasingly used for the disabled. Our purpose was to confirm scale quality and to determine the difficulty pattern of the WeeFIM in Japan. The WeeFIM was measured in 225 children (113 girls and 112 boys) aged 6 mo to 7 yr without developmental delays. The scores were converted to an interval scale by Rasch analysis, which assumes unidimensionality of the measurement items, determines the degree of the fit to the assumption, and decides item difficulty. When the WeeFIM items were divided into two groups of motor and cognitive items to minimize misfit, the degree of misfit was acceptable, except for eating, bladder management, tub/shower transfer, and comprehension. For the motor items, grooming, bathing, and bladder control were more difficult, and stairs, bed/chair transfer, and walk or wheelchair were easier. Concerning the cognitive items, expression and comprehension were easier, and problem-solving was most difficult. When we compared item difficulty patterns in the four age groups (6-21 mo, 22-45 mo, 46-62 mo, and 63-100 mo), we found no differences, except in toilet transfer. It was more difficult for younger children, possibly because of its different pattern of chronological change, which shows rapid changes from dependent to independent levels over a short period of time. Our study confirmed the scale quality of the WeeFIM instrument with Rasch analysis and demonstrated the difficulty pattern of the WeeFIM in nondisabled Japanese children.
儿童功能独立性测量量表（WeeFIM）是在功能独立性测量量表（FIM）的基础上开发的，用于评估6个月至7岁儿童的残疾情况。已报告了美国和日本儿童的常模数据，并且该量表在残疾儿童中越来越常用。我们的目的是确认该量表的质量，并确定WeeFIM在日本的难度模式。对225名年龄在6个月至7岁且无发育迟缓的儿童（113名女孩和112名男孩）进行了WeeFIM测量。通过Rasch分析将分数转换为区间量表，该分析假定测量项目具有单维性，确定与该假设的拟合程度，并确定项目难度。当将WeeFIM项目分为运动和认知两组以尽量减少不拟合时，除进食、膀胱管理、盆浴/淋浴转移和理解外，不拟合程度是可以接受的。对于运动项目，修饰、洗澡和膀胱控制更难，而上下楼梯、床/椅转移以及行走或使用轮椅更容易。关于认知项目，表达和理解更容易，而解决问题最难。当我们比较四个年龄组（6 - 21个月、22 - 45个月、46 - 62个月和63 - 100个月）的项目难度模式时，除了马桶转移外，我们没有发现差异。对于年幼儿童来说，马桶转移更难，可能是因为其按年龄变化的模式不同，即在短时间内从依赖水平到独立水平有快速变化。我们的研究通过Rasch分析确认了WeeFIM量表的质量，并展示了WeeFIM在非残疾日本儿童中的难度模式。
