Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA.
Division of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Spinal Cord. 2018 Jan;56(1):14-21. doi: 10.1038/sc.2017.99. Epub 2017 Sep 12.
Retrospective Longitudinal Study.
(1) To determine whether the Spinal Cord Injury Activities of Daily Living (SCI_ADL) measure shows adequate item-level and precision psychometrics; (2) to investigate whether the SCI_ADL measure effectively detects ADL changes across time; (3) to describe self-care task(s) participants can and cannot do across time.
Two Midwestern hospitals and 1 Southeastern specialty hospital in 1993.
All participants were adults with traumatic SCI of at least 1-year duration at enrollment. We used 20-year (1993-2013) retrospective longitudinal data and categorized participants into three injury levels: C1-C4 (cervical; n=50), C5-C8 (n=126) and T1-S5 (thoracic, lumbar and sacral; n=168). We first examined psychometrics of the SCI_ADL with factor and Rasch analyses; then we investigated longitudinal change of SCI_ADL scores at three time points over 20 years (1993, 2003 and 2013) using generalized linear mixed modeling and post hoc analyses.
The SCI_ADL measure demonstrated unidimensionality, person strata of 2.9, high Cronbach's α (0.93) and fair person reliability (0.76). T1-S5 had the highest measures, following C5-C8 and C1-C4 at three time points (P<0.05). The C1-C4 and T1-S5 groups showed significant decreases from 2003 to 2013; however, none of the three groups showed significant differences from 1993 to 2003 (P<0.05).
The SCI_ADL measure could detect longitudinal ADL changes of the population with SCI across time. The C1-C4 group decreased the most in ADLs, indicating higher need of long-term services and rehabilitation.
回顾性纵向研究。
（1）确定脊髓损伤日常生活活动（SCI_ADL）量表在项目水平和精度心理测量学上是否具有足够的表现；（2）研究 SCI_ADL 量表是否能有效地检测到随时间变化的日常生活活动变化；（3）描述参与者在不同时间内能够完成和无法完成的自我护理任务。
1993 年在中西部的两家医院和东南部的一家专科医院进行。
所有参与者均为入组时患有至少 1 年外伤性 SCI 的成年人。我们使用 20 年（1993-2013 年）的回顾性纵向数据，并将参与者分为三个损伤级别：C1-C4（颈椎；n=50）、C5-C8（n=126）和 T1-S5（胸、腰和骶；n=168）。我们首先使用因子分析和 Rasch 分析检查 SCI_ADL 的心理计量学表现；然后，我们使用广义线性混合模型和事后分析，研究了 20 年内三个时间点（1993 年、2003 年和 2013 年）SCI_ADL 评分的纵向变化。
SCI_ADL 量表表现出单维性、2.9 个人层次、高 Cronbach's α（0.93）和中等个人可靠性（0.76）。T1-S5 在三个时间点的得分最高，其次是 C5-C8 和 C1-C4（P<0.05）。C1-C4 和 T1-S5 组从 2003 年到 2013 年显著下降；然而，三组之间从 1993 年到 2003 年都没有显著差异（P<0.05）。
SCI_ADL 量表能够检测到 SCI 人群随时间推移的日常生活活动的纵向变化。C1-C4 组的日常生活活动下降最多，表明需要长期服务和康复。
