New Mexico VA Health Care System, Albuquerque, New Mexico.
J Int Neuropsychol Soc. 2011 Sep;17(5):832-40. doi: 10.1017/S1355617711000841.
Neuropsychologists frequently are asked to comment on everyday functioning, but the research relies mostly on questionnaire-based assessment of daily functioning. While performance-based assessment of everyday functioning has many advantages over commonly used questionnaires, there are few empirically validated comprehensive performance-based measures. We present data here on a performance-based battery of daily living skills, the Functional Impact Assessment (FIA) in 47 unilateral stroke patients and 37 matched healthy controls. The FIA was validated by comparing it to performance on the self- and informant-report version of the Functional Activities Questionnaire (FAQ). We also examined the relationship between the FIA and cognitive functioning using the Neuropsychological Assessment Battery (NAB). The stroke group's performance on the FIA, FAQ (self and informant), and NAB (total and domain scores) was significantly (d's ≥ .80) lower than the control group. The NAB total score and all domain scores were highly correlated with the FIA in the stroke group (r's > .7), and only one NAB domain score (visuospatial) was a unique predictor. This may be due to the fact that most of the NAB domains have a statistical problem of multicollinearity, which may explain why only the spatial domain was a unique predictor. While the informant FAQ was significantly correlated with FIA total score (r = .48, p < .01), the NAB total score was a significantly better predictor (r = .83, p < .001) than the informant FAQ. NAB total scaled score of less than 86 predicted impairment on the FIA with 92% sensitivity and 84% specificity. Our findings argue that the FIA is sensitive to deficits associated with stroke and is highly associated with all neuropsychological domains (attention, executive functions, language and spatial skills, and memory).
神经心理学家经常被要求对日常功能进行评价，但研究主要依赖于基于问卷的日常功能评估。虽然基于表现的日常功能评估比常用的问卷有许多优势，但很少有经过实证验证的综合基于表现的测量方法。我们在这里介绍了一种基于表现的日常生活技能评估工具，即功能性影响评估（FIA），该工具在 47 名单侧脑卒中患者和 37 名匹配的健康对照组中进行了验证。通过将 FIA 与功能性活动问卷（FAQ）的自我报告和知情者报告版本进行比较，对其进行了验证。我们还使用神经心理评估量表（NAB）检查了 FIA 与认知功能之间的关系。脑卒中组在 FIA、FAQ（自我和知情者报告）和 NAB（总分和各领域得分）上的表现明显低于对照组（d 值≥0.80）。NAB 总分和各领域得分与脑卒中组的 FIA 高度相关（r 值>0.7），只有一个 NAB 领域得分（视空间）是唯一的预测因素。这可能是因为大多数 NAB 领域存在统计上的多重共线性问题，这可以解释为什么只有空间领域是唯一的预测因素。虽然知情者 FAQ 与 FIA 总分显著相关（r =0.48，p <0.01），但 NAB 总分是更好的预测因素（r =0.83，p <0.001）。NAB 总评分低于 86 分可预测 FIA 得分受损，其敏感性为 92%，特异性为 84%。我们的研究结果表明，FIA 对与脑卒中相关的缺陷敏感，与所有神经心理学领域（注意力、执行功能、语言和空间技能以及记忆）高度相关。
