墨尔本低视力日常生活活动指数的加权版本：一种残疾影响的衡量指标。

A weighted version of the Melbourne Low-Vision ADL Index: a measure of disability impact.

作者信息

Haymes S A, Johnston A W, Heyes A D

机构信息

Department of Optometry and Vision Sciences, University of Melbourne, Carlton, Victoria, Australia.

出版信息

Optom Vis Sci. 2001 Aug;78(8):565-79. doi: 10.1097/00006324-200108000-00008.

DOI:10.1097/00006324-200108000-00008

PMID:11525547

Abstract

OBJECTIVE

To develop a version of the Melbourne Low-Vision ADL Index that measures the personal impact of disability in activities of daily living (ADL's). Also, to determine the relationship between clinical measures of vision impairment and disability impact.

METHODS

The Melbourne Low-Vision ADL Index (MLVAI) is a desk-based clinical assessment of disability in ADL's. Ability to perform each item is rated on a five-level descriptive scale from zero to four. In this study, the original version of the MLVAI was modified to measure disability impact. The simple modification involved weighting each item by the importance of that item to the person being tested. Importance was also rated on a five-level scale from zero to four. The validity and reliability of the Weighted Melbourne Low-Vision ADL Index (MLVAI(W)) was determined for 97 vision-impaired subjects in a cross-sectional study.

RESULTS

Cronbach's alpha coefficient indicated an internal reliability of 0.94, and an intraclass correlation coefficient indicated an overall reliability of 0.88. The standard error of measurement was 24.7 points (out of a possible score of 400). There was a statistically significant difference in test scores between normal subjects and vision-impaired subjects. All vision measures had a high, statistically significant correlation with MLVAI(W) score. Near-word acuity had the strongest correlation (r(s) = 0.78, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (r(s) = -0.72, p < 0.001). Visual field had the weakest correlation (r(s) = -0.52, p < 0.001). The best predictive model of MLVAI(W) score incorporated the variables age, near-word acuity, and visual field. Together, these variables accounted for 65.1% of the variance in MLVAI(W) score.

CONCLUSIONS

The MLVAI is highly valid and reliable when weighted by a scale that reflects the personal importance of ADL's. The MLVAI(W) can provide information over and above that obtained with the usual clinical vision measures and may be used to assess low-vision patients and to measure low-vision rehabilitation outcomes. It is suggested that the assessment of disability using the original MLVAI and the assessment of the impact of disability using the MLVAI(W) should be kept separate to facilitate the clear interpretation of the outcomes of low-vision rehabilitation.

摘要

目的

开发一个墨尔本低视力日常生活活动指数版本，用以衡量残疾对日常生活活动（ADL）的个人影响。此外，确定视力损害的临床测量指标与残疾影响之间的关系。

方法

墨尔本低视力日常生活活动指数（MLVAI）是一种基于案头的ADL残疾临床评估方法。执行每个项目的能力按从0到4的五级描述性量表进行评分。在本研究中，对MLVAI的原始版本进行了修改以测量残疾影响。简单的修改包括根据每个项目对被测者的重要性对其进行加权。重要性也按从0到4的五级量表进行评分。在一项横断面研究中，对97名视力受损受试者确定了加权墨尔本低视力日常生活活动指数（MLVAI(W)）的有效性和可靠性。

结果

克朗巴哈系数表明内部信度为0.94，组内相关系数表明总体信度为0.88。测量的标准误差为24.7分（满分400分）。正常受试者和视力受损受试者之间的测试分数存在统计学上的显著差异。所有视力测量指标与MLVAI(W)分数均具有高度的、统计学上的显著相关性。近视力敏锐度的相关性最强（斯皮尔曼等级相关系数r(s)=0.78，p<0.001），其次是墨尔本边缘测试对比敏感度（r(s)=-0.72，p<0.001）。视野的相关性最弱（r(s)=-0.52，p<0.001）。MLVAI(W)分数的最佳预测模型纳入了年龄、近视力敏锐度和视野这些变量。这些变量共同解释了MLVAI(W)分数中65.1%的方差。