Program on Disability, Aging, and Long-Term Care Policy, Texas A&M Health Science Center, School of Rural Public Health, College Station, Texas, USA.
BMC Health Serv Res. 2012 Jan 23;12:19. doi: 10.1186/1472-6963-12-19.
To test the validity and reliability of scales intended to measure activity limitations faced by children with chronic illnesses living in the community. The scales were based on information provided by caregivers to service program personnel almost exclusively trained as social workers. The items used to measure activity limitations were interRAI items supplemented so that they were more applicable to activity limitations in children with chronic illnesses. In addition, these analyses may shed light on the possibility of gathering functional information that can span the life course as well as spanning different care settings.
Analyses included testing the internal consistency, predictive, concurrent, discriminant and construct validity of two activity limitation scales. The scales were developed using assessment data gathered in the United States of America (USA) from over 2,700 assessments of children aged 4 to 20 receiving Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, specifically Personal Care Services to assist children in overcoming activity limitations. The Medicaid program in the USA pays for health care services provided to children in low-income households. Data were collected in a single, large state in the southwestern USA in late 2008 and early 2009. A similar sample of children was assessed in 2010, and the analyses were replicated using this sample.
The two scales exhibited excellent internal consistency. Evidence on the concurrent, predictive, discriminant, and construct validity of the proposed scales was strong. Quite importantly, scale scores were not correlated with (confounded with) a child's developmental stage or age. The results for these scales and items were consistent across the two independent samples.
Unpaid caregivers, usually parents, can provide assessors lacking either medical or nursing training with reliable and valid information on the activity limitations of children. One can summarize these data in scales that are both internally consistent and valid. Researchers and clinicians can use supplemented interRAI items to provide guidance for professionals and programs serving children, as well as older persons. This research emphasizes the importance of developing medical information systems that allow one to integrate information not only across care settings but also across an individual's life course.
测试旨在衡量社区中患有慢性病的儿童所面临活动限制的量表的有效性和可靠性。这些量表基于服务项目人员从几乎完全接受过社会工作培训的护理人员那里获得的信息编制。用于测量活动限制的项目是 interRAI 项目的补充，以使它们更适用于患有慢性病的儿童的活动限制。此外，这些分析可能有助于收集能够跨越生命历程和不同护理环境的功能信息。
分析包括测试两个活动限制量表的内部一致性、预测性、同时性、判别性和构念效度。这些量表是使用在美国（USA）收集的评估数据开发的，涉及超过 2700 名接受医疗补助早期和定期筛查、诊断和治疗（EPSDT）服务的 4 至 20 岁儿童的评估，特别是个人护理服务，以帮助儿童克服活动限制。美国的医疗补助计划为低收入家庭的儿童提供医疗保健服务。数据于 2008 年末和 2009 年初在美国西南部的一个单一的大型州收集。在 2010 年对类似的儿童样本进行了评估，并使用该样本重复了分析。
这两个量表表现出极好的内部一致性。关于提议的量表的同时性、预测性、判别性和构念效度的证据非常有力。非常重要的是，量表得分与儿童的发育阶段或年龄没有相关（混淆）。这些量表和项目的结果在两个独立样本中是一致的。
无薪照顾者（通常是父母）可以为缺乏医疗或护理培训的评估员提供有关儿童活动限制的可靠和有效的信息。人们可以在内部一致且有效的量表中总结这些数据。研究人员和临床医生可以使用补充的 interRAI 项目为服务儿童以及老年人的专业人员和项目提供指导。这项研究强调了开发医疗信息系统的重要性，该系统不仅可以允许整合护理环境之间的信息，还可以整合个人的生命历程中的信息。
