Kottorp A, Bernspång B, Fisher A G
Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Umeå University, Umeå, Sweden.
J Intellect Disabil Res. 2003 Nov;47(Pt 8):597-605. doi: 10.1046/j.1365-2788.2003.00475.x.
Since clients with different types of developmental disabilities often experience difficulties in activities of daily living (ADL), it is critical that assessments of ADL are evaluated in order to ensure that one can make valid judgements based on the results of the appraisal. The purpose of the present study was to evaluate the validity of a specific performance assessment instrument, the Assessment of Motor and Process Skills (AMPS), when used by occupational therapists with clients with developmental disabilities. Unlike global ADL assessments, the AMPS is used not only to evaluate the level of ADL dependence, but also to estimate the quality of each specific action performed when a person is performing ADL tasks.
Data were gathered from 1724 participants with different developmental disabilities, including intellectual disability (ID), cerebral palsy and spina bifida. Many-Facet Rasch (MFR) analysis was used to examine person-response validity, and task and item scale validity.
Goodness-of-fit statistics showed that the tasks and items had acceptable scale validity. The participants had acceptable person-response validity on the ADL motor scale, but had slightly lower than expected levels of person-response validity on the ADL process scale. The results indicate that clients with more severe forms of ID may have a higher proportion of different performance profiles in ADL than is expected by the MFR model of the AMPS. Since the proportion of participants who did not meet the criteria was only 3% lower than expected and in accordance with other studies, the difference may not be clinically meaningful. Otherwise, the results indicated that the AMPS is a valid tool when used with clients with developmental disabilities.
Further research is needed to evaluate the use of the AMPS in clinical assessment and intervention planning for this group of clients.
由于不同类型发育障碍的患者在日常生活活动（ADL）中常常面临困难，因此对ADL进行评估至关重要，以确保能够根据评估结果做出有效的判断。本研究的目的是评估职业治疗师在对发育障碍患者使用特定的表现评估工具——运动与过程技能评估（AMPS）时的有效性。与整体ADL评估不同，AMPS不仅用于评估ADL依赖程度，还用于估计个体在执行ADL任务时每项具体动作的质量。
收集了1724名患有不同发育障碍的参与者的数据，包括智力障碍（ID）、脑瘫和脊柱裂。采用多面Rasch（MFR）分析来检验个体反应效度、任务和项目量表效度。
拟合优度统计显示，任务和项目具有可接受的量表效度。参与者在ADL运动量表上具有可接受的个体反应效度，但在ADL过程量表上的个体反应效度略低于预期水平。结果表明，较严重形式的ID患者在ADL中的不同表现特征比例可能高于AMPS的MFR模型预期。由于未达标准的参与者比例仅比预期低3%，且与其他研究一致，这种差异可能在临床上并无意义。否则，结果表明AMPS在用于发育障碍患者时是一种有效的工具。
需要进一步研究以评估AMPS在该组患者临床评估和干预计划中的应用。
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