Lai Jin-Shei, Hammel Joy, Jerousek Sara, Goldsmith Arielle, Miskovic Ana, Baum Carolyn, Wong Alex W, Dashner Jessica, Heinemann Allen W
Department of Medical Social Sciences and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Occupational Therapy, University of Illinois, Chicago, Chicago, IL.
Arch Phys Med Rehabil. 2016 Dec;97(12):2102-2112. doi: 10.1016/j.apmr.2016.06.010. Epub 2016 Jul 14.
To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life.
Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity.
Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place.
Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking.
Not applicable.
An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities.
We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation.
The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation.
为神经功能障碍患者开发一种对感知到的系统、服务和政策促进因素的测量方法（见《国际功能、残疾和健康分类》第5章），并评估感知到的系统、服务和政策促进因素对健康相关生活质量的影响。
采用定性方法来开发和完善条目。进行验证性因素分析，包括单因素验证性因素分析和双因素分析，以评估条目的单维度性。采用拉施分析来识别不拟合的条目。运用相关性分析和方差分析方法来评估结构效度。
居住在社区的个体参与电话访谈或前往开展本研究的学术医疗中心。
参与者（N = 571）被诊断患有脊髓损伤、中风或创伤性脑损伤。他们年龄在18岁及以上且讲英语。
不适用。
一个条目库，用于评估残疾人的环境可达性以及服务、系统和政策的支持水平。
我们确定了一个被定义为“社区生活层面的服务、系统和政策的可达性与支持水平”的一般因素，以及3个被定义为“健康服务”“社区生活”和“社区资源”的局部因素。系统服务和政策测量与参与测量指标存在中度相关性：社区参与指标（CPI） - 参与度、CPI - 对参与的控制、神经疾病生活质量 - 参与能力、神经疾病生活质量 - 对角色参与的满意度、患者报告结局测量信息系统（PROMIS）参与能力、PROMIS对角色参与的满意度以及PROMIS孤独感。
系统、服务和政策促进因素的测量方法包含与健康服务、社区生活和社区资源相关的条目。研究人员和临床医生可以使用此处描述的条目可靠地测量对系统、服务和政策资源的认知。系统、服务和政策促进因素与PROMIS和CPI变量之间的中度关系为环境对与参与相关的社会功能影响的测量和理论提供了支持。
