Sakzewski Leanne, Boyd Roslyn, Ziviani Jenny
School of Physotherapy, La Trobe University, Bundoora, Australia.
Dev Med Child Neurol. 2007 Mar;49(3):232-40. doi: 10.1111/j.1469-8749.2007.00232.x.
This study systematically reviewed the validity, reliability, sensitivity to change, and clinical utility of measurements of participation for children with cerebral palsy. Sixteen measures were identified and seven met the inclusion criteria of having 30% content measuring participation, for use with children aged 5 to 13 years with physical disability, and were condition specific. The Children's Assessment of Participation and Enjoyment (CAPE) assessed participation in leisure and recreation, while the School Function Assessment (SFA) and School Outcome Measure addressed participation in the school environment. The Assessment of Life Habits for Children (LIFE-H) measured participation in home, school, and community life, and the Children Helping Out: Responsibilities and Expectations assessed children's participation in household duties. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were individualized tools used to evaluate goal achievement. Results showed most instruments had adequate reliability and validity. The COPM and GAS were the only measures that reported adequate responsiveness to detect clinically significant change. Limited data are currently available to determine the responsiveness of the CAPE, LIFE-H, and SFA. A combination of assessments is required to capture participation of children in home, school, and community environments.
本研究系统回顾了脑瘫患儿参与度测量的有效性、可靠性、对变化的敏感性及临床实用性。共识别出16项测量方法,其中7项符合纳入标准,即30%的内容用于测量参与度,适用于5至13岁身体残疾儿童,且具有疾病特异性。儿童参与和享受评估(CAPE)评估休闲和娱乐活动中的参与度,而学校功能评估(SFA)和学校成果测量则针对学校环境中的参与度。儿童生活习惯评估(LIFE-H)测量家庭、学校和社区生活中的参与度,儿童帮助他人:责任与期望评估儿童在家务劳动中的参与度。加拿大职业表现测量(COPM)和目标达成评定量表(GAS)是用于评估目标达成情况的个体化工具。结果显示,大多数工具具有足够的可靠性和有效性。COPM和GAS是仅有的报告显示对检测临床显著变化具有足够反应性的测量方法。目前可用于确定CAPE、LIFE-H和SFA反应性的数据有限。需要综合多种评估方法来全面了解儿童在家庭、学校和社区环境中的参与情况。