Heinemann Allen W, Magasi Susan, Hammel Joy, Carlozzi Noelle E, Garcia Sofia F, Hahn Elizabeth A, Lai Jin-Shei, Tulsky David, Gray David B, Hollingsworth Holly, Jerousek Sara
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL.
Arch Phys Med Rehabil. 2015 Apr;96(4):589-95. doi: 10.1016/j.apmr.2013.11.024. Epub 2013 Dec 27.
To describe methods used in operationalizing environmental factors; to describe the results of a research project to develop measures of environmental factors that affect participation; and to define an initial item set of facilitators and barriers to participation after stroke, traumatic brain injury, and spinal cord injury.
Instrument development included an extensive literature review, item classification and selection, item writing, and cognitive testing following the approach of the Patient-Reported Outcomes Measurement Information System.
Community.
Content area and outcome measurement experts (n=10) contributed to instrument development; individuals (n=200) with the target conditions participated in focus groups and in cognitive testing (n=15).
None.
Environmental factor items were categorized in 6 domains: assistive technology; built and natural environment; social environment; services, systems, and policies; access to information and technology; and economic quality of life.
We binned 2273 items across the 6 domains, winnowed this pool to 291 items for cognitive testing, and recommended 274 items for pilot data collection.
Five of the 6 domains correspond closely to the International Classification of Functioning, Disability and Health taxonomy of environmental factors; the sixth domain, economic quality of life, reflects an important construct that reflects financial resources that affect participation. Testing with a new and larger sample is underway to evaluate reliability, validity, and sensitivity.
描述在将环境因素纳入实际操作时所使用的方法；描述一项研究项目的结果，该项目旨在制定影响参与度的环境因素测量方法；并确定中风、创伤性脑损伤和脊髓损伤后参与的促进因素和障碍的初始项目集。
工具开发包括广泛的文献综述、项目分类与选择、项目编写，以及遵循患者报告结局测量信息系统方法的认知测试。
社区。
内容领域和结局测量专家（n = 10）参与了工具开发；患有目标疾病的个体（n = 200）参加了焦点小组和认知测试（n = 15）。
无。
环境因素项目分为6个领域：辅助技术；建成环境与自然环境；社会环境；服务、系统和政策；信息与技术获取；以及经济生活质量。
我们将2273个项目归入6个领域，将这一项目库精简至291个项目用于认知测试，并推荐274个项目用于试点数据收集。
6个领域中的5个与《国际功能、残疾和健康分类》中的环境因素分类法密切对应；第六个领域，经济生活质量，反映了一个重要概念，即影响参与的财务资源。正在使用新的更大样本进行测试，以评估可靠性、有效性和敏感性。
