麻风病手部功能评估问卷的验证。

Validation of the questionnaire on hand function assessment in leprosy.

机构信息

Rede SARAH de Hospitais de Reabilitação, Brasília, DF, Brasil.

出版信息

Rev Saude Publica. 2012 Jun;46(3):435-45. doi: 10.1590/s0034-89102012000300005.

DOI:10.1590/s0034-89102012000300005

PMID:22635035

Abstract

OBJECTIVE

To validate the psychometric properties of the questionnaire on hand function assessment in leprosy.

METHODS

Study conducted with a convenience sample of 101 consecutive patients in Brasília (Central-Western Brazil), from June 2008 to July 2009. The individuals were adults affected by leprosy, with impairment of the ulnar, median and radial nerves. Interobservers and intraobserver reproducibility was analyzed through successive interviews, and construct validity was analyzed through association between age, clinical form of leprosy, duration of nerve injury, grip and pinch strength measured with a dynamometer, sensibility test performed with Semmes-Weinstein monofilaments and manual ability assessment using the Jebsen test of hand function. Pondered kappa coefficient was calculated and a Bland-Altman plot was constructed to assess the reproducibility of the instrument. For internal consistency, Cronbach's alpha coefficient was utilized. Pearson's correlation coefficient was calculated and a multiple regression model was used.

RESULTS

The pondered kappa values for interobservers and intraobserver assessments ranged from 0.86 to 0.97 and from 0.85 to 0.97, respectively. The value of Cronbach's alpha coefficient was 0.967. Pearson's correlation coefficient showed an association (p < 0.001) among duration of nerve injury, grip and pinch strength, cutaneous sensibility and mean score in the Jebsen Test. The mean score of the questionnaire on hand functional assessment in leprosy was associated with operational classification of leprosy, duration of nerve injury, grip strength, cutaneous sensibility and manual ability (p < 0.0001 for the model as a whole).

CONCLUSIONS

The questionnaire on hand functional assessment in leprosy presents almost perfect interobservers and intraobserver reproducibility, high internal consistency and correlation with operational classification of leprosy, duration of nerve injury, grip strength, cutaneous sensibility in the hands and manual ability.

摘要

目的

验证麻风手功能评估问卷的心理测量学特性。

方法

本研究为便利抽样，于 2008 年 6 月至 2009 年 7 月在巴西利亚（巴西中西部）连续入组 101 例患者。纳入标准为：成人、正中神经、尺神经和桡神经损伤的麻风患者。采用连续访谈评估观察者间和观察者内的可重复性，并通过年龄、麻风临床类型、神经损伤持续时间、握力和捏力（使用测力计测量）、感觉测试（使用 Semmes-Weinstein 单丝）以及使用 Jebsen 手功能测试评估的手功能评估之间的相关性分析结构效度。计算考虑边缘效应的 Kappa 系数并构建 Bland-Altman 图以评估该工具的可重复性。采用 Cronbach's alpha 系数评估内部一致性。计算 Pearson 相关系数并建立多元回归模型。

结果

观察者间和观察者内评估的考虑边缘效应的 Kappa 值分别为 0.86-0.97 和 0.85-0.97。Cronbach's alpha 系数值为 0.967。Pearson 相关系数显示神经损伤持续时间、握力和捏力、皮肤感觉和 Jebsen 测试的平均得分之间存在关联（p<0.001）。麻风手功能评估问卷的平均得分与麻风的操作性分类、神经损伤持续时间、握力、皮肤感觉和手的操作能力（整个模型 p<0.0001）相关。