Franchignoni F, Ferriero G, Giordano A, Guglielmi V, Picco D
Unit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Veruno, Italy.
Eura Medicophys. 2007 Dec;43(4):451-61.
The aim of this study was to assess the psychometric properties of the Impact on Participation and Autonomy (IPA) questionnaire, in its two scales: IPA-I, perceived limitations in participation and autonomy; IPA-II, perceived problems in participation.
The IPA data underwent Rasch analysis for rating scale diagnostics and a reliability and validity study. The work and education domain was left out of the analysis due to its low applicability to our subjects. A convenience sample of 100 patients with Parkinson's disease (PD) (41 male, 59 female; mean age 72+/-7 years) were consecutively observed at our Rehabilitation Clinic.
According to Rasch analysis, two response categories of IPA-I were collapsed into one and 1 item (''intimate relationship'') was deleted. The remaining 24 items fitted the unidimensional construct that the scale was intended to measure. IPA-I demonstrated good reliability (person separation = 0.93, item separation = 0.97) and internal construct validity. All six IPA-II items proved to belong to the same construct. For IPA-II, item separation = 0.97, person separation = 0.71. The targeting and spread of item difficulty and the quite low person separation reliability of IPA-II made it possible only to differentiate people with low vs high level of problems in participation. Both scales showed the expected correlation with PD-specific clinical and quality of life measures.
IPA-I shows promise as a tool for measuring participation in people with PD. IPA-II has acceptable psychometric characteristics for measuring perceived problems in participation. Additional steps to improve their metric properties and further studies in people with different kinds of health conditions need to be carried out.
本研究旨在评估参与和自主功能影响量表（IPA）两个分量表的心理测量特性，这两个分量表分别为：IPA - I，感知到的参与和自主功能受限；IPA - II，感知到的参与问题。
对IPA数据进行拉施分析以进行量表诊断以及可靠性和有效性研究。由于工作和教育领域对我们的研究对象适用性较低，因此未纳入该领域的分析。在我们的康复诊所连续观察了100例帕金森病（PD）患者（41例男性，59例女性；平均年龄72±7岁）的便利样本。
根据拉施分析，IPA - I的两个反应类别合并为一个，删除了1个条目（“亲密关系”）。其余24个条目符合该量表旨在测量的单维结构。IPA - I显示出良好的可靠性（个人分离度 = 0.93，条目分离度 = 0.97）和内部结构效度。IPA - II的所有6个条目都被证明属于同一结构。对于IPA - II，条目分离度 = 0.97，个人分离度 = 0.71。IPA - II条目的难度定位和分布以及相当低的个人分离可靠性使得仅能区分参与问题程度低和高的人群。两个分量表均显示出与PD特异性临床和生活质量测量指标的预期相关性。
IPA - I有望成为测量PD患者参与度的工具。IPA - II在测量感知到的参与问题方面具有可接受的心理测量特征。需要采取额外措施来改善其测量特性，并在不同健康状况的人群中开展进一步研究。
