Chien C-W, Brown T, McDonald R, Yu M-L
Occupational Therapy Division, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.
Child Care Health Dev. 2014 Jan;40(1):134-44. doi: 10.1111/j.1365-2214.2012.01429.x. Epub 2012 Aug 29.
Children's hand skills when performing in real-life contexts have been commonly thought as a possible determinant of their self-care function; however, there is a paucity of research investigating this potential predictive relationship. The purpose of this study was to provide evidence regarding whether children's real-life hand skill performance is contributive to or predictive of their self-care function by considering other child and cultural factors.
A total of 139 typically developing children and 114 with disabilities, ages 2-12 years from Australia and Taiwan, participated in the study. The outcome measures used were the Assessment of Children's Hand Skills (a measure of real-life hand skill performance) and the Personal Living Skills subscale of the Vineland Adaptive Behavior Scales - Classroom Edition (a measure of self-care function).
Hierarchical regression analysis revealed that the children's demographic variables (age, gender, disability status, handedness and cultural context) accounted for 43% of the variance of the self-care function in the combined group of children with and without disabilities. Age, presence of disability and cultural context were the statistically significant independent factors. However, after the entry of the real-life hand skill performance factor, the contributing values of age and disability status decreased and the age factor became non-significant. The hand skill performance factor was found to be the strongest, and its addition led to significant increments of 24.6% of the explained variance for children's self-care function. Similar results were also found in the regression analyses based on separate groups of typically developing children or those with disabilities.
The findings provide evidence that children's real-life hand skill performance is a contributing factor of their self-care function. The assessment of children's hand skill performance in real-life contexts is therefore needed.
在现实生活情境中儿童的手部技能通常被认为可能是其自我照顾功能的一个决定因素；然而，研究这种潜在预测关系的研究却很匮乏。本研究的目的是通过考虑其他儿童和文化因素，提供关于儿童在现实生活中的手部技能表现是否有助于或预测其自我照顾功能的证据。
共有来自澳大利亚和台湾地区的139名2至12岁发育正常的儿童以及114名残疾儿童参与了该研究。所使用的结果测量指标包括儿童手部技能评估（一种现实生活中手部技能表现的测量方法）以及《文兰适应行为量表 - 课堂版》中的个人生活技能分量表（一种自我照顾功能的测量方法）。
分层回归分析显示，儿童的人口统计学变量（年龄、性别、残疾状况、利手和文化背景）在有残疾和无残疾儿童的合并组中占自我照顾功能方差的43%。年龄、残疾状况和文化背景是具有统计学意义的独立因素。然而，在纳入现实生活中的手部技能表现因素后，年龄和残疾状况的贡献值下降，年龄因素变得不再显著。发现手部技能表现因素是最强的，其加入导致儿童自我照顾功能的解释方差显著增加了24.6%。在基于发育正常儿童或残疾儿童单独组的回归分析中也发现了类似结果。
研究结果提供了证据，表明儿童在现实生活中的手部技能表现是其自我照顾功能的一个促成因素。因此，需要在现实生活情境中评估儿童的手部技能表现。
