Huijbregts Maria P J, Teare Gary F, McCullough Carolyn, Kay Theresa M, Streiner David, Wong Steve K C, McEwen Sara E, Otten Ingrid
Quality, Risk, & Patient Safety, Baycrest Centre for Geriatric Care, Poslun's Building, Room 414B, 3560 Bathurst St, Toronto, Ontario M6A2E1, Canada.
Phys Ther. 2009 Jun;89(6):546-55. doi: 10.2522/ptj.20080287. Epub 2009 Apr 9.
There is a lack of standardized mobility measures specific to the long-term care (LTC) population. Therefore, the Continuing Care Activity Measure (CCAM) was developed.
This study determined levels of reliability, validity for clinical utilization, and sensitivity to change of this measure.
This was a prospective longitudinal cohort study among elderly people with primarily physical or medical impairments who were residing in LTC institutions that provide nursing home and more-complex care, with access to physical therapy services.
The CCAM, the Clinical Outcome Variables Scale (COVS), the Social Engagement Scale (SES) of the Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0 instrument, and the Resource Utilization Groups, version 3, (RUG-III) were administered by clinical and research physical therapists, with timing dictated by the study purpose.
The participants were 136 residents of LTC institutions and 21 physical therapists. The CCAM interrater reliability (intraclass correlation coefficient [ICC]) was .97 (95% confidence interval=.91-1.00), and test-retest reliability (ICC) over a period of 1 week was .99 (95% confidence interval=.93-1.00). Over 6 months, the absolute change in total score was 5.88 for the CCAM and 4.26 for the COVS; the CCAM was 28% more responsive across all participants (n=105) and 68% more responsive for those scoring in the lower half (n=49). The minimal detectable difference of the CCAM was 8.6 across all participants. The CCAM correlated with the COVS, nursing care hours inferred from the RUG-III, and the SES.
Some participants were lost to follow-up.
The CCAM is a reliable and valid tool to measure gross motor function and physical mobility for elderly people in LTC institutions. It discriminates among functional levels, measures individual functional change, and can contribute to clinical decision making.
缺乏针对长期护理（LTC）人群的标准化活动能力测量方法。因此，开发了持续护理活动测量法（CCAM）。
本研究确定了该测量方法的可靠性水平、临床应用的有效性以及对变化的敏感性。
这是一项前瞻性纵向队列研究，研究对象为居住在提供养老院及更复杂护理服务且可获得物理治疗服务的长期护理机构中的主要存在身体或医疗损伤的老年人。
由临床和研究物理治疗师使用CCAM、临床结局变量量表（COVS）、居民评估工具 - 最小数据集（RAI - MDS）2.0工具中的社会参与量表（SES）以及资源利用组第3版（RUG - III），测量时间由研究目的决定。
参与者包括136名长期护理机构居民和21名物理治疗师。CCAM的评分者间信度（组内相关系数[ICC]）为0.97（95%置信区间 = 0.91 - 1.00），1周内的重测信度（ICC）为0.99（95%置信区间 = 0.93 - 1.00）。在6个月的时间里，CCAM总分的绝对变化为5.88，COVS为4.26；在所有参与者（n = 105）中，CCAM的反应性高28%，在得分较低的参与者（n = 49）中高68%。所有参与者中CCAM的最小可检测差异为8.6。CCAM与COVS、从RUG - III推断出的护理小时数以及SES相关。
一些参与者失访。
CCAM是一种可靠且有效的工具，可用于测量长期护理机构中老年人的总体运动功能和身体活动能力。它能够区分功能水平，测量个体功能变化，并有助于临床决策。
