a School of Psychology , University of Aberdeen , Aberdeen , UK .
Psychol Health. 2013;28(12):1391-406. doi: 10.1080/08870446.2013.814773. Epub 2013 Jul 18.
Previous research has supported an integrated biomedical and behavioural model explaining activity limitations. However, further tests of this model are required at the within-person level, because while it proposes that the constructs are related within individuals, it has primarily been tested between individuals in large group studies. We aimed to test the integrated model at the within-person level.
Six correlational N-of-1 studies in participants with arthritis, chronic pain and walking limitations were carried out. Daily measures of theoretical constructs were collected using a hand-held computer (PDA), the activity was assessed by self-report and accelerometer and the data were analysed using time-series analysis.
The biomedical model was not supported as pain impairment did not predict activity, so the integrated model was supported partially. Impairment predicted intention to move around, while perceived behavioural control (PBC) and intention predicted activity. PBC did not predict activity limitation in the expected direction.
The integrated model of disability was partially supported within individuals, especially the behavioural elements. However, results suggest that different elements of the model may drive activity (limitations) for different individuals. The integrated model provides a useful framework for understanding disability and suggests interventions, and the utility of N-of-1 methodology for testing theory is illustrated.
先前的研究支持了一个综合生物医学和行为模型，用于解释活动受限。然而，还需要在个体内部水平上进一步检验该模型，因为尽管它提出了这些结构在个体内部是相关的，但它主要是在大群体研究中在个体之间进行测试的。我们旨在个体内部水平上检验综合模型。
在关节炎、慢性疼痛和行走受限的参与者中进行了六项相关的 N-of-1 研究。使用手持电脑（PDA）每天收集理论结构的测量数据，通过自我报告和加速度计评估活动，并使用时间序列分析进行数据分析。
生物医学模型未得到支持，因为疼痛损伤不能预测活动，因此综合模型部分得到支持。损伤预测了四处走动的意愿，而感知行为控制（PBC）和意愿预测了活动。PBC 没有按照预期的方向预测活动受限。
在个体内部，残疾的综合模型得到了部分支持，特别是行为因素。然而，结果表明，不同的模型元素可能为不同的个体驱动活动（受限）。综合模型为理解残疾提供了一个有用的框架，并提出了干预措施，还说明了 N-of-1 方法在检验理论方面的效用。
