School of Rural Public Health, Texas A&M Health Science Centre, Texas, USA.
Disabil Rehabil. 2011;33(21-22):2013-22. doi: 10.3109/09638288.2011.555596. Epub 2011 Feb 23.
Meeting the personal care challenges of children with special health care needs (CSHCN) living in the community demands a reliable assessment of their abilities to perform activities of daily living (ADLs). This research investigates factors affecting the inter-rater reliability of functional assessments of CSHCN conducted in the home.
Dual-standardised assessments were conducted with 236 community-dwelling CSHCN seeking or receiving Medicaid Personal Care Services (PCS) in a single state in USA.
Analyses revealed that assessments of CSHCN with the greatest or least amount of activity limitations exhibited the greatest agreement. The greatest disagreement occurred when assessors faced children with moderate to moderately severe activity limitations. Specific ADLs, where the greatest and least agreements occurred, varied by the level of the child's overall activity limitation.
These results imply that the most serious challenges to the reliability of home-based assessment of ADLs among CSHCN occur in cases of children with moderate or moderately severe activity limitations.
满足社区中具有特殊医疗需求的儿童（CSHCN）的个人护理挑战需要可靠地评估他们进行日常生活活动（ADL）的能力。本研究调查了影响在家中对 CSHCN 进行功能评估的评分者间可靠性的因素。
在美国的一个州，对 236 名寻求或接受医疗补助个人护理服务（PCS）的社区居住的 CSHCN 进行了双重标准化评估。
分析表明，对活动受限程度最大或最小的 CSHCN 的评估表现出最大的一致性。当评估者面对中度至中度严重活动受限的儿童时，分歧最大。最大和最小一致性出现的特定 ADL 因儿童整体活动受限程度而异。
这些结果表明，在家中对 CSHCN 的 ADL 进行评估的可靠性最严重的挑战发生在中度或中度严重活动受限的儿童中。
