Chang Feng-Hang, Liou Tsan-Hon, Ni Pengsheng, Chang Kwang-Hwa, Lai Chien-Hung
Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei City, Taiwan.
Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei City, Taiwan; Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei City, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
Arch Phys Med Rehabil. 2017 Feb;98(2):286-294. doi: 10.1016/j.apmr.2016.08.462. Epub 2016 Sep 1.
To describe the development of a participation measure that assesses 3 domains (productivity, social, and community) and 4 dimensions (frequency, diversity, desire for change, and perceived difficulty) of participation and to evaluate the initial psychometric properties in rehabilitation outpatients.
A mixed-method approach included a literature review, item selection, expert reviews, cognitive interviews, and field testing with rehabilitation outpatients. Confirmatory factor analysis (CFA) and Rasch analysis were used to validate the construct validity of the difficulty dimension of the instrument.
Outpatient rehabilitation programs.
An expert panel consisting of 12 rehabilitation and measurement experts contributed to measurement development; 20 rehabilitation outpatients participated in cognitive interviews; and a sample of rehabilitation outpatients (N=556) (average age, 61.36±23.62y; 53% men) participated in field testing.
Not applicable.
The Participation Measure-3 Domains, 4 Dimensions (PM-3D4D).
A scoring method for each dimension of the PM-3D4D was established. The instrument displayed good overall model fit in the CFA and unidimensionality across 3 domains after removing and collapsing locally dependent items identified from a principal component analysis. However, considering the poor personal reliability of the social subscale and its high correlation with the community subscale, we decided to merge the 2 subscales into 1. The combined subscale showed improved reliability and good construct validity by demonstrating a good model fit (comparative fit index, .985; Tucker-Lewis Index, .982, root mean square error of approximation, .061) and item fit.
The PM-3D4D is a newly developed participation measure designed to assess multiple domains and dimensions of participation by rehabilitation patients. The psychometric analysis results supported the construct of the instrument and helped item revision. Further examination of the validity and reliability of the PM-3D4D will be conducted.
描述一种参与度测量方法的开发过程，该方法评估参与的3个领域（生产力、社交和社区）和4个维度（频率、多样性、改变意愿和感知难度），并评估康复门诊患者的初始心理测量学特性。
一种混合方法，包括文献综述、项目选择、专家评审、认知访谈以及对康复门诊患者的现场测试。使用验证性因子分析（CFA）和拉施分析来验证该工具难度维度的结构效度。
门诊康复项目。
由12名康复和测量专家组成的专家小组参与了测量方法的开发；20名康复门诊患者参与了认知访谈；一组康复门诊患者样本（N = 556）（平均年龄，61.36±23.62岁；53%为男性）参与了现场测试。
不适用。
参与度测量-3领域，4维度（PM-3D4D）。
建立了PM-3D4D各维度的评分方法。在CFA中，该工具显示出良好的整体模型拟合度，并且在从主成分分析中识别并去除和合并局部相关项目后，在3个领域中具有单维度性。然而，考虑到社会子量表的个人信度较差及其与社区子量表的高度相关性，我们决定将这两个子量表合并为一个。合并后的子量表通过显示良好的模型拟合度（比较拟合指数，.985；塔克-刘易斯指数，.982，近似均方根误差，.061）和项目拟合度，表现出更高的信度和良好的结构效度。
PM-3D4D是一种新开发的参与度测量方法，旨在评估康复患者参与的多个领域和维度。心理测量学分析结果支持了该工具的结构，并有助于项目修订。将对PM-3D4D的效度和信度进行进一步检验。
