Medical Psychology and Medical Sociology, Clinic for Psychiatry and Psychotherapy, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen Nürnberg, Erlangen, Germany.
BMC Psychiatry. 2012 Nov 23;12:208. doi: 10.1186/1471-244X-12-208.
The everyday practical capabilities of dementia patients have a direct influence on a patient's independence and thus on the person's quality of life and on the amount of care needed. These capabilities are therefore important as therapeutic goals and are also important from a health-economic point of view. To date, no economical and valid performance test is available. The E-ADL-Test developed by Gräβel et al. in 2009 is a short performance test that has, however, only been validated on a small sample thus far. The objective of the present study is to re-validate the E-ADL-Test and explore possibilities for further development.
The data were obtained from an RCT with a sample of 139 dementia patients in 5 nursing homes in Bavaria (Germany). The internal consistency was calculated as a measure of reliability. An item analysis was performed for the sample and subgroups with various degrees of dementia. Criterion and construct validity were tested based on five hypotheses. For validation, the residents' capabilities were examined using the Barthel-Index (BI), the Nurses' Observation Scale for Geriatric Patients (NOSGER), the Alzheimer's Disease Assessment Scale (ADAS), and the Mini-Mental Status Examination (MMSE).
The internal consistency was .68 for the sample and .73 for the subgroup with severe dementia. The item analysis yielded good difficulty indices and discrimination power for moderate and severe dementia. The tasks were found to be too easy for mild dementia. The predictive criterion-related validity was confirmed by a correlation of r = .54 with the care level after 22 months and significant mean differences in the E-ADL-Test between persons with and without an increase in the care level. A differentiated correlation profile supported the three hypotheses on construct validity.
The E-ADL-Test in its current form is a valid and reliable instrument for assessing the ADL capabilities of patients with moderate and severe dementia. More difficult items should be developed for use with mild dementia.
http://www.isrctn.com Identifier: ISRCTN87391496.
痴呆症患者的日常实际能力直接影响患者的独立性，从而影响患者的生活质量和所需的护理量。因此，这些能力是治疗目标的重要组成部分，从健康经济学的角度来看也是重要的。迄今为止，没有经济有效的绩效测试可用。Graβel 等人于 2009 年开发的 E-ADL-Test 是一种简短的绩效测试，但迄今为止仅在小样本中进行了验证。本研究的目的是重新验证 E-ADL-Test 并探索进一步发展的可能性。
数据来自于一项在巴伐利亚州（德国）5 家养老院进行的 RCT，样本量为 139 名痴呆症患者。可靠性采用内部一致性来衡量。对样本和不同程度痴呆症的亚组进行了项目分析。基于五个假设，对标准和结构效度进行了测试。为了验证，使用 Barthel 指数（BI）、老年患者护士观察量表（NOSGER）、阿尔茨海默病评估量表（ADAS）和简易精神状态检查（MMSE）对居民的能力进行了检查。
样本的内部一致性为 0.68，重度痴呆亚组为 0.73。项目分析得出了中度和重度痴呆症的良好难度指数和区分力。对于轻度痴呆症，任务过于简单。预测标准相关的有效性通过与 22 个月后的护理水平相关的 r = 0.54 得到证实，并且在 E-ADL-Test 中，具有和不具有护理水平增加的患者之间存在显著的平均差异。不同的相关分布支持了关于结构有效性的三个假设。
E-ADL-Test 目前的形式是一种评估中度和重度痴呆症患者日常生活能力的有效且可靠的工具。对于轻度痴呆症，应该开发更难的项目。
http://www.isrctn.com 标识符：ISRCTN87391496。
Zotero 插件