Meester-Delver Anke, Beelen Anita, Hennekam Raoul, Nollet Frans, Hadders-Algra Mijna
Department of Rehabilitation, Academic Medical Center, Amsterdam, The Netherlands.
Dev Med Child Neurol. 2007 May;49(5):355-60. doi: 10.1111/j.1469-8749.2007.00355.x.
The aim of this study was to determine the interrater reliability and stability over time of the Capacity Profile (CAP). The CAP is a standardized method for classifying additional care needs indicated by current impairments in five domains of body functions: physical health, neuromusculoskeletal and movement-related, sensory, mental, and voice and speech, in children from 3 to 18 years of age. The intensity of care in each domain is defined from 0 (no need for additional care) to 5 (needs help with every activity). The intensity of additional care in each of the five separate domains indicates the CAP for the individual child. We developed the CAP to inform the parents and other caregivers of children with non-progressive, permanent neurodevelopmental disabilities, such as cerebral palsy and myelomeningocele, about the consequences of these conditions. To determine interrater agreement and stability over time, the CAPs of 67 children (39 males, 28 females) with a neurodevelopmental disability (mean age 18y [SD 1.2y]; range 14-22y) were assessed based on a semi-structured interview. In addition, the CAPs of the same individuals at the age of 3 years were determined based on a chart review. Interrater agreement of the CAP at the age of 3 was good to very good (weighted kappa 0.64-0.92). Agreement between the CAP at the age of 18 and the CAP at the age of 3 (providing evidence for stability over time) was also good (weighted kappa 0.68-0.77), except for the domain 'physical health functions', about which agreement was relatively poor (0.47). We conclude that the CAP is a reliable instrument for classifying the additional needs of a child with a non-progressive, permanent neurodevelopmental disability. The preliminary evidence for the stability over time of such needs according to the CAP should be validated in a prospective study.
本研究的目的是确定能力概况（CAP）评估者间的可靠性及随时间的稳定性。CAP是一种标准化方法，用于对3至18岁儿童身体功能五个领域（身体健康、神经肌肉骨骼及运动相关、感官、心理、声音和言语）当前损伤所表明的额外护理需求进行分类。每个领域的护理强度从0（无需额外护理）到5（每项活动都需要帮助）进行定义。五个单独领域中每个领域的额外护理强度表明了个体儿童的CAP。我们开发CAP是为了让患有非进行性、永久性神经发育障碍（如脑瘫和脊髓脊膜膨出）儿童的父母及其他照料者了解这些病症的后果。为了确定评估者间的一致性及随时间的稳定性，基于半结构化访谈对67名患有神经发育障碍（平均年龄18岁[标准差1.2岁]；范围14 - 22岁）的儿童（39名男性，28名女性）的CAP进行了评估。此外，基于病历回顾确定了这些个体3岁时的CAP。3岁时CAP的评估者间一致性良好至非常好（加权kappa值为0.64 - 0.92）。18岁时的CAP与3岁时的CAP之间的一致性（为随时间的稳定性提供证据）也良好（加权kappa值为0.68 - 0.77），但“身体健康功能”领域的一致性相对较差（0.47）。我们得出结论，CAP是一种可靠的工具，可用于对患有非进行性、永久性神经发育障碍儿童的额外需求进行分类。根据CAP得出的此类需求随时间稳定性的初步证据应在前瞻性研究中得到验证。
