Velozo Craig A, Byers Katherine L, Wang Ying-Chih, Joseph Bryttnee Roberts
North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA.
J Rehabil Res Dev. 2007;44(3):467-78. doi: 10.1682/jrrd.2006.06.0068.
Setting-specific outcome measures present a major barrier to monitoring patient progress across the continuum of care. This study demonstrated Rasch analysis for the creation of a crosswalk between the Functional Independence Measure (FIM), which is used in inpatient rehabilitation, and the Minimum Data Set (MDS), which is used in skilled nursing facilities. To create the crosswalk, we used data from a sample of 236 patients from four Department of Veterans Affairs' facilities who had had both the FIM and the MDS administered within 7 days. The combined FIM-MDS analysis showed good internal consistency (Cronbach alpha = 0.94), with 21 of the 26 items showing acceptable fit statistics. FIM and MDS raw scores correlated at -0.81 and the measures, corrected for scale direction, correlated at 0.78. Future validity testing will be necessary to determine the accuracy and applicability of the crosswalk.
特定环境下的结局指标是监测患者在连续护理过程中进展情况的主要障碍。本研究展示了如何运用拉施分析来创建一个在住院康复中使用的功能独立性测量（FIM）与在熟练护理机构中使用的最低数据集（MDS）之间的对照表。为了创建该对照表，我们使用了来自四个退伍军人事务部设施的236名患者样本的数据，这些患者在7天内同时接受了FIM和MDS评估。FIM与MDS的联合分析显示出良好的内部一致性（克朗巴赫α系数 = 0.94），26个项目中有21个显示出可接受的拟合统计量。FIM和MDS的原始分数相关性为 -0.81，经量表方向校正后的测量值相关性为0.78。未来需要进行效度测试以确定该对照表的准确性和适用性。
