Department of Movement Sciences, University of Idaho, Moscow.
WWAMI Medical Education Program, University of Washington School of Medicine, Moscow, ID.
J Athl Train. 2020 Nov 1;55(11):1181-1189. doi: 10.4085/1062-6050-0302.19.
The increased emphasis on implementing evidence-based practice has reinforced the need to more accurately assess patient improvement. Psychometrically sound, patient-reported outcome measures are essential for evaluating patient care. A patient-reported outcome instrument that may be useful for clinicians is the Disablement in the Physically Active Scale (DPAS). Before adopting this scale, however, researchers must evaluate its psychometric properties, particularly across subpopulations.
To evaluate the psychometric properties of the DPAS in a large sample using confirmatory factor analysis procedures and assess structural invariance of the scale across sex, age, injury status, and athletic status groups.
Observational study.
Twenty-two clinical sites.
Of 1445 physically active individuals recruited from multiple athletic training clinical sites, data from 1276 were included in the analysis. Respondents were either healthy or experiencing an acute, subacute, or persistent musculoskeletal injury.
MAIN OUTCOME MEASURE(S): A confirmatory factor analysis was performed on the full sample, and multigroup invariance testing was conducted to assess differences across sex, age, injury status, and athletic status. Given the poor model fit, alternate model generation was used to identify a more parsimonious factor structure.
The DPAS did not meet contemporary fit index recommendations or the criteria to demonstrate structural invariance. We identified an 8-item model that met the model fit recommendations using alternate model generation.
The 16-item DPAS did not meet the model fit recommendations and may not be the most parsimonious or reliable measure for assessing disablement and quality of life. Use of the 16-item DPAS across subpopulations of interest is not recommended. More examination involving a true cross-validation sample should be completed on the 8-item DPAS before this scale is adopted in research and practice.
对实施循证实践的重视程度不断提高，这使得我们更加需要准确地评估患者的改善情况。具有良好心理测量学特性的患者报告结局测量指标对于评估患者护理至关重要。一种可能对临床医生有用的患者报告结局工具是身体活跃人群残疾量表（DPAS）。然而，在采用该量表之前，研究人员必须评估其心理测量学特性，尤其是在亚人群中。
使用验证性因子分析程序评估大量样本中 DPAS 的心理测量学特性，并评估该量表在性别、年龄、损伤状况和运动状况亚组中的结构不变性。
观察性研究。
22 个临床地点。
从多个运动训练临床地点招募了 1445 名身体活跃的个体，其中 1276 人的数据纳入分析。受访者要么健康，要么患有急性、亚急性或持续性肌肉骨骼损伤。
对全样本进行验证性因子分析，并进行多组不变性检验，以评估性别、年龄、损伤状况和运动状况的差异。由于模型拟合不佳，我们使用替代模型生成来确定更简约的因子结构。
DPAS 不符合当代拟合指数建议或结构不变性的标准。我们使用替代模型生成确定了一个符合模型拟合建议的 8 项模型。
16 项 DPAS 不符合模型拟合建议，可能不是评估残疾和生活质量最简约或最可靠的测量工具。不建议在感兴趣的亚人群中使用 16 项 DPAS。在研究和实践中采用该量表之前，应该使用真正的交叉验证样本对 8 项 DPAS 进行更多检查。
