Crary Michael A, Mann Giselle D Carnaby, Groher Michael E
Department of Communicative Disorders, College of Public Health and Health Professions, University of Florida Health Science Center, Gainesville, FL 32610-0174, USA.
Arch Phys Med Rehabil. 2005 Aug;86(8):1516-20. doi: 10.1016/j.apmr.2004.11.049.
To report on the development and psychometric evaluation of a clinical scale to document change in functional oral intake of food and liquid in stroke patients.
Validity and reliability study.
Tertiary care, academic medical center, metropolitan stroke unit.
Acute stroke patients (N=302).
Not applicable.
Interrater reliability, validity, and sensitivity to change assessments were completed on a 7-point ordinal scale-the Functional Oral Intake Scale (FOIS)-developed to document the functional level of oral intake of food and liquid in stroke patients. Interrater reliability was drawn from FOIS ratings applied to dietary information from patient medical charts. Consensual validity was estimated by rankings from judges against predefined scale scores. Criterion validity was evaluated by comparison to the Modified Rankin Scale, the Modified Barthel Index, and Mann Assessment of Swallowing Ability. Cross-validation was assessed via comparison to 2 physiologic measures of swallowing function. Change in functional oral intake over time was assessed descriptively by applying the scale to dietary information from a cohort of 302 acute stroke patients followed up for 6 months.
Interrater reliability was high, with perfect agreement on 85% of ratings. Kappa statistics ranged from .86 to .91. Consensual validity was high (.90). Criterion validity was high at onset and 1 month poststroke. Significant associations were identified between the FOIS and stroke handicap scales. The FOIS was significantly associated with 2 physiologic measures of swallowing. Scores on the FOIS from the cohort of stroke patients showed a shift toward increased oral intake over a 6-month period.
The FOIS had adequate reliability, validity, and sensitivity to change in functional oral intake. These findings suggest that the FOIS may be appropriate for estimating and documenting change in the functional eating abilities of stroke patients over time.
报告一种临床量表的开发及心理测量评估，该量表用于记录中风患者功能性经口食物和液体摄入量的变化。
效度和信度研究。
三级医疗、学术医学中心、大都市中风单元。
急性中风患者（N = 302）。
不适用。
对一个7分序数量表——功能性经口摄入量量表（FOIS）进行了评分者间信度、效度和变化敏感性评估，该量表用于记录中风患者经口食物和液体摄入的功能水平。评分者间信度来自应用于患者病历饮食信息的FOIS评分。通过与预定义量表分数的评判排名来估计一致效度。通过与改良Rankin量表、改良Barthel指数和吞咽能力Mann评估进行比较来评估标准效度。通过与吞咽功能的2种生理测量方法进行比较来评估交叉效度。通过将该量表应用于302例急性中风患者队列的饮食信息，对6个月随访期间功能性经口摄入量随时间的变化进行了描述性评估。
评分者间信度很高，85%的评分完全一致。Kappa统计量范围为0.86至0.91。一致效度很高（0.90）。中风发作时和中风后1个月的标准效度很高。在FOIS与中风残疾量表之间发现了显著关联。FOIS与2种吞咽生理测量方法显著相关。中风患者队列的FOIS评分在6个月期间显示出口摄入量增加的趋势。
FOIS在功能性经口摄入量方面具有足够的信度、效度和变化敏感性。这些发现表明FOIS可能适用于估计和记录中风患者功能性进食能力随时间的变化。
