Man D W
Division of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China.
Brain Inj. 2001 Nov;15(11):961-73. doi: 10.1080/02699050110065664.
This study was an extension of previous studies on the empowering of families caring for a relative who had experienced brain damage. The demand to adopt a similar empowerment concept in the direct rehabilitation of people with brain damage was proposed.
The development of a theory-driven instrument, in the form of a person-administered empowerment questionnaire, so as to establish the empowerment factors of people with brain damage during their rehabilitation process.
A kind of methodological study was used to develop, validate and evaluate research tools. This study concentrated on the development of a questionnaire that accurately measures empowerment in people with brain damage.
This questionnaire derived items from both the existing literature on brain damage rehabilitation and related studies on people coping with brain damage. Open-ended questions were also included to investigate how patients may be encouraged to achieve successful rehabilitation (such as degree of acceptance, learning of adaptive skills and community re-entry). A structural empowerment model has been constructed by both content validity analysis and construct validity through an explorative factor analysis of 112 people with brain damage.
A 42-item questionnaire has been developed, constructing four interpretable factors: Support (13 items), Skill (14 items), Aspiration (nine items), and Knowledge (six items), which accounted for 49.99% of the total variance. Analyses of open-ended questions showed that they generally lack external resources and support in the coping process. They did not have sufficient information to face their problems in a variety of areas, although they were quite aware of their importance. They could rely only on personal assets and families, and less on friends, work-mates, and external social resources.
It is suggested that the results of this initial empowerment framework can either guide ways to improve the case management of patients with brain damage (in terms of structure, methods, and evaluation mechanisms) or assist in the research and design (R&D) of rehabilitation programmes with better efficacy and effectiveness. Further research using Rasch Analysis is suggested to establish item difficulties, and using the findings as an outcome measure in rehabilitation is recommended.
本研究是先前关于增强照顾脑损伤亲属家庭能力的研究的延伸。有人提出在脑损伤患者的直接康复中采用类似的赋权概念。
开发一种理论驱动的工具，以个人管理的赋权问卷的形式，确定脑损伤患者在康复过程中的赋权因素。
采用一种方法学研究来开发、验证和评估研究工具。本研究专注于开发一份能准确测量脑损伤患者赋权情况的问卷。
该问卷的项目来源于脑损伤康复的现有文献以及应对脑损伤患者的相关研究。还纳入了开放式问题，以调查如何鼓励患者实现成功康复（如接受程度、学习适应技能和重新融入社区）。通过对112名脑损伤患者进行探索性因素分析，采用内容效度分析和结构效度构建了一个结构赋权模型。
已开发出一份包含42个条目的问卷，构建了四个可解释的因素：支持（13个条目）、技能（14个条目）、愿望（9个条目）和知识（6个条目），它们占总方差的49.99%。对开放式问题的分析表明，他们在应对过程中普遍缺乏外部资源和支持。尽管他们非常清楚各种问题的重要性，但他们没有足够的信息来面对这些问题。他们只能依靠个人资产和家庭，而较少依靠朋友、同事和外部社会资源。
建议这一初步赋权框架的结果可指导改善脑损伤患者病例管理的方法（在结构、方法和评估机制方面），或协助研发具有更好疗效和效果的康复项目。建议进一步使用拉施分析来确定项目难度，并建议将研究结果用作康复的结果指标。
