Babulal Ganesh M, Tabor Connor Lisa
a Program in Occupational Therapy , Washington University School of Medicine, St. Louis , MO , USA.
b Department of Neurology , Washington University School of Medicine , St. Louis , MO , USA.
Top Stroke Rehabil. 2016 Oct;23(5):348-57. doi: 10.1080/10749357.2016.1143697. Epub 2016 Feb 3.
The purpose of this paper is to present the development and psychometric properties of a new environmental measure that identifies barriers and facilitators in receptivity, physical environment and communication for post-stroke populations, including survivors with aphasia.
The Measure of Stroke Environment (MOSE) was developed using information from semi-structured interviews and three pilot studies. Reliability and validity were assessed in 43 post-stroke participants.
The MOSE contains 47 items across 33 questions in three domains (receptivity, physical environment, communication). Internal consistency reliability was high (.83 to .85) across each domain and over the entire assessment (.91). Convergent validity showed moderate correlation with the Stroke Impact Scale (.33 to .37), the National Institute of Health Stroke Scale (-.31 to -.46) and the Boston Diagnostic Aphasia Examination (.55 to .61). Persons with aphasia had significantly lower scores on the communication domain. Stroke survivors with (26% overall difficulty) and without aphasia (31% overall difficulty) continue to experience difficulty ≥ 2 years post-stroke.
The MOSE offers a brief, reliable and valid assessment of environmental barriers and facilitators to participation for post-stroke survivors reintegrating into their communities. Stroke survivors with very mild deficits continue to experience barriers from the environment many years post-stroke. These barriers are not typically identified during the rehabilitation process but persist post-reintegration.
The MOSE is able to determine how frequently a stroke survivor faces challenges in their environment and how that impacts his or her participation.
本文旨在介绍一种新的环境测量工具的开发过程及其心理测量特性，该工具用于识别中风人群（包括失语症幸存者）在接受能力、物理环境和沟通方面的障碍与促进因素。
中风环境测量工具（MOSE）是利用半结构化访谈信息和三项预试验研究开发而成。对43名中风后参与者进行了信效度评估。
MOSE包含三个领域（接受能力、物理环境、沟通）中33个问题的47个条目。每个领域及整个评估的内部一致性信度都很高（分别为0.83至0.85以及0.91）。聚合效度显示，该工具与中风影响量表（0.33至0.37）、美国国立卫生研究院卒中量表（-0.31至-0.46）和波士顿失语症诊断检查（0.55至0.61）呈中度相关。失语症患者在沟通领域的得分显著较低。有失语症（总体困难率为26%）和无失语症（总体困难率为31%）的中风幸存者在中风后≥2年仍持续存在困难。
MOSE为中风幸存者重新融入社区时参与环境中的障碍与促进因素提供了一种简短、可靠且有效的评估。中风后有非常轻微缺陷的幸存者在中风多年后仍持续面临来自环境的障碍。这些障碍在康复过程中通常未被识别，但在重新融入后依然存在。
MOSE能够确定中风幸存者在其环境中面临挑战的频率以及这对其参与产生的影响。
