Noonan Vanessa K, Kopec Jacek A, Noreau Luc, Singer Joel, Chan Anna, Mâsse Louise C, Dvorak Marcel F
Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
Health Qual Life Outcomes. 2009 Nov 13;7:93. doi: 10.1186/1477-7525-7-93.
The concept of participation is recognized as an important rehabilitation outcome and instruments have been developed to measure participation using the International Classification of Functioning, Disability and Health (ICF). To date, few studies have examined the content of these instruments to determine how participation has been operationalized. The purpose of this study was to compare the content of participation instruments using the ICF classification.
A systematic literature search was conducted to identify instruments that assess participation according to the ICF. Instruments were considered to assess participation and were included if the domains contain content from a minimum of three ICF chapters ranging from Chapter 3 Communication to Chapter 9 Community, social and civic life in the activities and participation component. The instrument content was examined by first identifying the meaningful concepts in each question and then linking these concepts to ICF categories. The content analysis included reporting the 1) ICF chapters (domains) covered in the activities and participation component, 2) relevance of the meaningful concepts to the activities and participation component and 3) context in which the activities and participation component categories are evaluated.
Eight instruments were included: Impact on Participation and Autonomy, Keele Assessment of Participation, Participation Survey/Mobility, Participation Measure-Post Acute Care, Participation Objective Participation Subjective, Participation Scale (P-Scale), Rating of Perceived Participation and World Health Organization Disability Assessment Schedule II (WHODAS II). 1351 meaningful concepts were identified in the eight instruments. There are differences among the instruments regarding how participation is operationalized. All the instruments cover six to eight of the nine chapters in the activities and participation component. The P-Scale and WHODAS II have questions which do not contain any meaningful concepts related to the activities and participation component. Differences were also observed in how other ICF components (body functions, environmental factors) and health are operationalized in the instruments.
Linking the meaningful concepts in the participation instruments to the ICF classification provided an objective and comprehensive method for analyzing the content. The content analysis revealed differences in how the concept of participation is operationalized and these differences should be considered when selecting an instrument.
参与的概念被视为一项重要的康复成果，并且已经开发出一些工具，用于依据《国际功能、残疾和健康分类》（ICF）来衡量参与情况。迄今为止，很少有研究考察这些工具的内容，以确定参与是如何被操作化的。本研究的目的是使用ICF分类来比较参与工具的内容。
进行了一项系统的文献检索，以识别根据ICF评估参与情况的工具。如果工具的各个领域包含至少三个ICF章节（从第3章“沟通”到第9章“社区、社会和公民生活”）的内容，则该工具被视为评估参与情况并被纳入研究，这些章节涵盖在活动与参与部分。通过首先识别每个问题中有意义的概念，然后将这些概念与ICF类别相联系，来检查工具内容。内容分析包括报告：1）活动与参与部分所涵盖的ICF章节（领域）；2）有意义的概念与活动与参与部分的相关性；3）评估活动与参与部分类别时的背景情况。
纳入了八项工具：《对参与和自主性的影响》、《基尔参与评估》、《参与调查/行动能力》、《急性后期护理参与测量》、《参与客观量表/参与主观量表》、《参与量表（P量表）》、《感知参与评分》以及《世界卫生组织残疾评定量表第二版》（WHODAS II）。在这八项工具中识别出了1351个有意义的概念。这些工具在参与的操作化方式上存在差异。所有工具都涵盖了活动与参与部分九章中的六章到八章。P量表和WHODAS II有一些问题不包含与活动与参与部分相关的任何有意义的概念。在这些工具中，ICF的其他组成部分（身体功能、环境因素）以及健康的操作化方式也存在差异。
将参与工具中有意义的概念与ICF分类相联系，为分析内容提供了一种客观且全面的方法。内容分析揭示了参与概念在操作化方式上的差异，在选择工具时应考虑这些差异。
