Mortenson William B, Miller William C, Auger Claudine
Occupational Therapy, Long-Term Care, Vancouver Coastal Health, Vancouver, BC, Canada.
Arch Phys Med Rehabil. 2008 Jun;89(6):1177-86. doi: 10.1016/j.apmr.2008.01.010.
To use the World Health Organization's International Classification of Functioning, Disability and Health as a framework to identify and to evaluate wheelchair-specific outcome instruments that are useful for measuring activity and participation.
CINHAL, PsychInfo, EMBASE, Google Scholar, Dissertation Abstracts Medline databases, and conference proceedings.
Activity and participation measures that were specifically intended for adults who use wheelchairs and that were published in English in a peer-reviewed journal were included in this review. Based on electronic database searches using a variety of search terms, articles were identified by title, and appropriate abstracts were retrieved. Articles were obtained for all relevant abstracts. For peer-reviewed measures included in the review, we obtained any instruction manuals and related publications, frequently published in conference proceedings and theses or available electronically, on the development and testing of the measure.
Tools included in the review were evaluated based on their conceptual coverage, reliability, validity, responsiveness, usefulness, and wheelchair contribution, which indicated how well the tool isolated the effect of the wheelchair on activity and participation outcomes.
A number of conceptual, psychometric, and applicability issues were identified with the 11 wheelchair-specific measures included in the review. A majority of the measures were mobility focused. No single tool received excellent ratings in all areas of the review. Some of the most frequent issues identified included a failure to account for differences attributable to different wheelchairs and wheelchair seating, limited psychometric testing, and high administrative and respondent burden.
Good reliability evidence was reported for most of the measures, but validity information was only available for 6 of the 11 measures, and responsiveness information for 3. This review suggests that these measures could be improved with further psychometric testing and with some modification to ensure that the contribution of the wheelchair to activity and participation outcomes is clearly identified.
采用世界卫生组织的《国际功能、残疾和健康分类》作为框架，识别并评估有助于测量活动和参与度的轮椅专用结局指标。
护理学与健康领域数据库、心理学文摘数据库、荷兰医学文摘数据库、谷歌学术、学位论文摘要数据库、医学期刊数据库以及会议论文集。
本综述纳入了专门针对使用轮椅的成年人、以英文发表在同行评审期刊上的活动和参与度测量指标。通过使用各种检索词在电子数据库中进行检索，根据标题识别文章，并检索合适的摘要。获取了所有相关摘要的文章。对于综述中纳入的同行评审测量指标，我们获取了任何使用说明手册和相关出版物，这些通常发表在会议论文集和论文中，或者以电子方式提供，内容涉及该测量指标的开发和测试。
基于其概念覆盖范围、信度、效度、反应度、实用性和轮椅贡献对综述中纳入的工具进行评估，轮椅贡献表明该工具在多大程度上分离了轮椅对活动和参与度结局的影响。
在综述纳入的11项轮椅专用测量指标中，发现了一些概念、心理测量和适用性问题。大多数测量指标侧重于 mobility（此处原文mobility含义不明，可能是“移动性”等类似意思）。没有一个工具在综述的所有领域都获得优秀评级。发现的一些最常见问题包括未能考虑不同轮椅和轮椅座位造成的差异、心理测量测试有限以及管理和受访者负担过重。
大多数测量指标报告了良好的信度证据，但仅11项测量指标中的6项有效度信息，3项有反应度信息。本综述表明，通过进一步的心理测量测试和一些修改，以确保清楚识别轮椅对活动和参与度结局的贡献，这些测量指标可能会得到改进。
