比较功能独立性测量和 interRAI/MDS 在老年人功能评估中的应用：文献综述。
Comparing the functional independence measure and the interRAI/MDS for use in the functional assessment of older adults: a review of the literature.
机构信息
Department of Health Studies and Gerontology, University of Waterloo (200 University Avenue East), Waterloo (N2L 3G1), Canada.
出版信息
BMC Geriatr. 2009 Nov 29;9:52. doi: 10.1186/1471-2318-9-52.
BACKGROUND
The rehabilitation of older persons is often complicated by increased frailty and medical complexity - these in turn present challenges for the development of health information systems. Objective investigation and comparison of the effectiveness of geriatric rehabilitation services requires information systems that are comprehensive, reliable, valid, and sensitive to clinically relevant changes in older persons. The Functional Independence Measure is widely used in rehabilitation settings - in Canada this is used as the central component of the National Rehabilitation Reporting System of the Canadian Institute of Health Information. An alternative system has been developed by the interRAI consortium. We conducted a literature review to compare the development and measurement properties of these two systems.
METHODS
English language literature published between 1983 (initial development of the FIM) and 2008 was searched using Medline and CINAHL databases, and the reference lists of retrieved articles. Relevant articles were summarized and charted using the criteria proposed by Streiner. Additionally, attention was paid to the ability of the two systems to address issues particularly relevant to older rehabilitation clients, such as medical complexity, comorbidity, and responsiveness to small but clinically meaningful improvements.
RESULTS
In total, 66 articles were found that met the inclusion criteria. The majority of FIM articles studied inpatient rehabilitation settings; while the majority of interRAI/MDS articles focused on nursing home settings. There is evidence supporting the reliability of both instruments. There were few articles that investigated the construct validity of the interRAI/MDS.
CONCLUSION
Additional psychometric research is needed on both the FIM and MDS, especially with regard to their use in different settings and with different client groups.
背景
老年人的康复常常因衰弱程度增加和医疗复杂性而变得复杂 - 这些反过来又给健康信息系统的发展带来了挑战。客观调查和比较老年康复服务的效果需要全面、可靠、有效且对老年人临床相关变化敏感的信息系统。功能独立性测量被广泛用于康复环境中 - 在加拿大，它被用作加拿大健康信息研究所国家康复报告系统的核心组成部分。由 interRAI 联盟开发了另一种系统。我们进行了文献综述，以比较这两种系统的开发和测量特性。
方法
使用 Medline 和 CINAHL 数据库以及检索文章的参考文献列表，搜索了 1983 年（FIM 的初始开发）至 2008 年期间发表的英文文献。使用斯特林提出的标准总结和绘制相关文章。此外，还注意了这两个系统解决与老年康复患者特别相关的问题的能力，例如医疗复杂性、合并症以及对微小但具有临床意义的改善的反应能力。
结果
共发现符合纳入标准的 66 篇文章。大多数 FIM 文章研究了住院康复环境；而大多数 interRAI/MDS 文章则侧重于疗养院环境。有证据支持这两种工具的可靠性。几乎没有研究调查 interRAI/MDS 的结构有效性。
结论
需要对 FIM 和 MDS 进行更多的心理测量学研究，特别是在不同环境和不同患者群体中使用时。
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