Couture Marie-Andrée, Calva Valérie, de Oliveira Ana, LaSalle Léo, Forget Nancy, Nedelec Bernadette
Hôpital de Réadaptation Villa Medica, Canada.
Centre de Recherche, Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada.
Burns. 2018 Jun;44(4):980-994. doi: 10.1016/j.burns.2017.10.024. Epub 2018 Feb 7.
Burns of the face and mouth region have a profound impact on function. Currently the outcome measure that is most commonly used in the burn care literature is horizontal and vertical opening. Impairment-based outcomes such as this do not capture the functional implications of these injuries in spite of the devastating impact they can have on burn survivor's lives.
To generate an assessment that evaluates the impairments, activity limitations, and participation restrictions associated with mouth injuries and prospectively collect data to examine the clinimetric properties.
A multistep assessment development process was undertaken including a comprehensive literature search and review, burn care expert and burn survivor interviews, generation of a preliminary version and field-testing, modifications based on field testing and updated literature review, and further field testing with data collection of 23 burn survivors. Clinimetric properties were examined by evaluating: whether there was a ceiling or floor effect, the internal consistency, construct validity, and responsiveness.
The mouth impairment and disability assessment (MIDA) has a 28 item self-report portion, divided into four subscales, completed by the patient and an impairment-based section completed by the burn therapist. Two items demonstrated a ceiling effect, one was removed the other retained. There was strong and statistically significant (p<0.0001) correlation of the symptoms subscale as well as vertical opening with the functional activities subscale of the MIDA. The functional activities subscale demonstrated good internal consistency and the symptoms subscale was adequate. Re-evaluation approximately seven and a half months after the baseline evaluation demonstrated a statistically significant change with time and treatment.
The MIDA now offers clinicians the ability to assess mouth impairment and disability of burn survivors who have sustained burn injuries to their face and mouth region.
面部和口腔区域烧伤对功能有深远影响。目前烧伤护理文献中最常用的结局指标是水平和垂直开口度。尽管这类基于损伤的结局指标对烧伤幸存者的生活可能产生毁灭性影响，但却未涵盖这些损伤的功能影响。
生成一项评估，以评价与口腔损伤相关的损伤、活动受限和参与限制，并前瞻性收集数据以检验其测量学特性。
开展了一个多步骤的评估开发过程，包括全面的文献检索与综述、烧伤护理专家及烧伤幸存者访谈、生成初步版本并进行现场测试、根据现场测试和更新的文献综述进行修改，以及对23名烧伤幸存者进行进一步现场测试并收集数据。通过评估是否存在天花板效应或地板效应、内部一致性、结构效度和反应度来检验测量学特性。
口腔损伤与残疾评估（MIDA）有一个由28个项目组成的自我报告部分，分为四个子量表由患者完成，还有一个由烧伤治疗师完成的基于损伤的部分。有两个项目显示出天花板效应，一个被删除，另一个保留。MIDA症状子量表以及垂直开口度与功能活动子量表之间存在强且具有统计学意义（p<0.0001）的相关性。功能活动子量表显示出良好的内部一致性，症状子量表也足够。在基线评估后约七个半月进行重新评估显示，随时间和治疗有统计学意义的变化。
MIDA现在使临床医生能够评估面部和口腔区域遭受烧伤的烧伤幸存者的口腔损伤和残疾情况。
