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中风后的参与度:比较代理人与患者的看法。

Participation after stroke: comparing proxies' and patients' perceptions.

作者信息

Poulin Valérie, Desrosiers Johanne

机构信息

Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada.

出版信息

J Rehabil Med. 2008 Jan;40(1):28-35. doi: 10.2340/16501977-0115.

Abstract

OBJECTIVE

This study aimed: (i) to determine the level of agreement between responses of people with stroke and their proxies on a participation questionnaire, and (ii) to explore patient and proxy characteristics related to disagreement between their responses.

DESIGN

Cross-sectional study.

SUBJECTS

A total of 40 community-dwelling people with stroke and their proxies (total n = 80).

METHODS

Participants were evaluated separately in face-to-face interviews using the Assessment of Life Habits questionnaire (LIFE-H 3.1), which documents participation in daily activities and social roles. Sociodemographic and clinical variables, such as severity of motor impairment and cognitive functions, were also collected.

RESULTS

Moderate to excellent agreement was found for the LIFE-H total score (intraclass correlation coefficient (ICC): 0.82), daily activities (ICC: 0.87) and social roles (ICC: 0.73) sub-scores. Proxies perceived more disruptions in participation than patients in several life domains (p = 0.035-0.001), but the differences between their scores were generally not clinically meaningful. Severity of motor disabilities was the best predictor of disagreement between patients and proxies.

CONCLUSION

These acceptable levels of agreement support the use of proxy responses to estimate the participation of people unable to respond themselves. However, some characteristics contributing to disagreement between respondents, such as severity of motor disabilities, should be considered when interpreting proxy information.

摘要

目的

本研究旨在:(i)确定中风患者及其代理人对一份参与度问卷的回答之间的一致程度,以及(ii)探究与他们回答之间的不一致相关的患者和代理人特征。

设计

横断面研究。

研究对象

共有40名社区居住的中风患者及其代理人(共80人)。

方法

使用生活习惯评估问卷(LIFE-H 3.1)通过面对面访谈分别对参与者进行评估,该问卷记录了日常活动和社会角色的参与情况。还收集了社会人口统计学和临床变量,如运动障碍的严重程度和认知功能。

结果

发现LIFE-H总分(组内相关系数(ICC):0.82)、日常活动(ICC:0.87)和社会角色(ICC:0.73)子分数的一致性为中度到高度。在几个生活领域中,代理人比患者察觉到更多的参与干扰(p = 0.035 - 0.001),但他们分数之间的差异通常在临床上无显著意义。运动残疾的严重程度是患者和代理人之间不一致的最佳预测因素。

结论

这些可接受的一致程度支持使用代理人的回答来估计无法自行回答者的参与情况。然而,在解释代理人信息时,应考虑一些导致回答者之间不一致的特征,如运动残疾的严重程度。

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