Pomykalska E, Pajak A, Szczudlik A
Pracowni Epidemiologii Klinicznej i Badań Populacyjnych, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 1998;55(12):683-8.
Mini-Mental State Examination (MMSE) can be used for screening procedures by personnel with no university training in psychology. However, little is known on the reliability of the results of MMSE obtained by medical personnel with little experience in cognitive function assessment. The goal of the paper was to assess the agreement between the results of MMSE obtained by trained community nurses and by psychologists, and to study whether the agreement depends on age, sex and education of examined persons. Studied group were 92 women and 90 men at age 65-78 years. Most of them (81.3%) had only elementary education. There was no significant difference between the distribution of the results obtained by nurses and obtained by psychologists. Individual difference < or = 2 points was found in 63.1% participants and difference < or = 3 points in 78.4% participants. There was a significant correlation between the results obtained by nurses and by psychologists (r = 0.64, p < 0.001). The correlation was also significant within the age, sex and education strata. Variation of the results obtained by nurses was explained in 42% by variation of the results obtained by psychologists. The best agreement in classification in cognitive function was found for the MMSE cut-off point < or = 19 (kappa = 0.75 in women and kappa = 0.58 in men). The worst agreement was found for the cut-off point < or = 25. Also weak agreement was found for the cut-off point < or = 23. There was a significant agreement between the results of MMSE obtained by nurses and results obtained by psychologists on the population level. However at the level of individuals the agreement in classification of cognitive function depended of cut-off point used. The agreement was only fair if cut-off point < or = 23 and < or = 25 were used.
简易精神状态检查表（MMSE）可由未接受过心理学大学培训的人员用于筛查程序。然而，对于认知功能评估经验不足的医务人员所获得的MMSE结果的可靠性知之甚少。本文的目的是评估经过培训的社区护士和心理学家所获得的MMSE结果之间的一致性，并研究这种一致性是否取决于被检查者的年龄、性别和教育程度。研究对象为92名女性和90名年龄在65 - 78岁的男性。他们中的大多数（81.3%）只有小学教育程度。护士所获得的结果分布与心理学家所获得的结果分布之间没有显著差异。63.1%的参与者个体差异≤2分，78.4%的参与者个体差异≤3分。护士和心理学家所获得的结果之间存在显著相关性（r = 0.64，p < 0.001）。在年龄、性别和教育程度分层内，这种相关性也很显著。护士所获得结果的变异中有42%可由心理学家所获得结果的变异来解释。对于MMSE截止点≤19，在认知功能分类中发现了最佳一致性（女性kappa = 0.75，男性kappa = 0.58）。对于截止点≤25，发现一致性最差。对于截止点≤23，也发现一致性较弱。在总体水平上，护士所获得的MMSE结果与心理学家所获得的结果之间存在显著一致性。然而，在个体水平上，认知功能分类的一致性取决于所使用的截止点。如果使用截止点≤23和≤25，一致性仅为一般。
