Flannery J, Land K
Florida State University, #4310, Tallahassee, FL 32306-4310, USA.
J Neurosci Nurs. 2001 Feb;33(1):50-6. doi: 10.1097/01376517-200102000-00007.
The Levels of Cognitive Functioning Assessment Scale (LOCFAS) is a behavioral checklist used by nurses in the acute care setting to assess the level of cognitive functioning in severely brain-injured patients in the early post-trauma period. Previous research studies have supported the reliability and validity of LOCFAS. For LOCFAS to become a more firmly established method of cognitive assessment, nurses must become familiar with and proficient in the use of this instrument. The purpose of this study was to find the most effective method of instruction by comparing three methods: a self-directed manual, a teaching video, and a classroom presentation. Videotaped vignettes of actual brain-injured patients were presented at the end of each training session, and participants were required to categorize these videotaped patients by using LOCFAS. High levels of reliability were observed for both the self-directed manual group and the teaching video group, but an overall lower level of reliability was observed for the classroom presentation group. Examination of the accuracy of overall LOCFAS ratings revealed a significant difference for instructional groups; the accuracy of the classroom presentation group was significantly lower than that of either the self-directed manual group or the teaching video group. The three instructional groups also differed on the average accuracy of ratings of the individual behaviors; the accuracy of the classroom presentation group was significantly lower than that of the teaching video group, whereas the self-directed manual group fell in between. Nurses also rated the instructional methods across a number of evaluative dimensions on a 5-point Likert-type scale. Evaluative statements ranged from average to good, with no significant differences among instructional methods.
认知功能水平评估量表（LOCFAS）是一种行为检查表，供急症护理环境中的护士用于评估重度脑损伤患者创伤后早期的认知功能水平。先前的研究支持了LOCFAS的可靠性和有效性。为了使LOCFAS成为一种更稳固的认知评估方法，护士必须熟悉并熟练使用该工具。本研究的目的是通过比较三种方法来找到最有效的指导方法：自我指导手册、教学视频和课堂演示。在每次培训课程结束时播放实际脑损伤患者的录像短片，要求参与者使用LOCFAS对这些录像患者进行分类。自我指导手册组和教学视频组的可靠性都很高，但课堂演示组的总体可靠性较低。对LOCFAS总体评分准确性的检查发现，各指导组之间存在显著差异；课堂演示组的准确性明显低于自我指导手册组或教学视频组。这三个指导组在个体行为评分的平均准确性上也存在差异；课堂演示组的准确性明显低于教学视频组，而自我指导手册组则介于两者之间。护士还在5点李克特量表上对多种评估维度的指导方法进行了评分。评估陈述从一般到良好不等，各指导方法之间没有显著差异。
