基于移动应用的国际功能、残疾和健康分类在评估脊髓损伤患者功能中的应用：Rasch 分析。
Using a Mobile App-Based International Classification of Functioning, Disability, and Health Set to Assess the Functioning of Spinal Cord Injury Patients: Rasch Analysis.
机构信息
School of Nursing, Sun Yat-sen University, Guangzhou, China.
Department of Spinal Cord Injury Rehabilitation, Sichuan Provincial Rehabilitation Hospital, Chengdu, China.
出版信息
JMIR Mhealth Uhealth. 2020 Nov 11;8(11):e20723. doi: 10.2196/20723.
BACKGROUND
The International Classification of Functioning, Disability, and Health (ICF) is a unified system of functioning terminology that has been used to develop electronic health records and assessment instruments. Its application has been limited, however, by its complex terminology, numerous categories, uncertain operationalization, and the training required to use it well. Together is a mobile health app designed to extend medical support to the families of spinal cord injury (SCI) patients in China. The app's core framework is a set of only 31 ICF categories. The app also provides rating guidelines and automatically transforms routine assessment results to the terms of the ICF qualifiers.
OBJECTIVE
The goal of the research is to examine the suitability of the ICF set used in the app Together for use as an instrument for assessing the functioning of SCI patients.
METHODS
A cross-sectional study was conducted including 112 SCI patients recruited before discharge from four rehabilitation centers in China between May 2018 and October 2019. Nurses used the app to assess patient functioning in face-to-face interviews. The resulting data were then subjected to Rasch analysis.
RESULTS
After deleting two categories (family relationships and socializing) and one personal factor (knowledge about spinal cord injury) that did not fit the Rasch model, the body functions and body structures, activities and participation, and contextual factors components of the ICF exhibited adequate fit to the Rasch model. All three demonstrated acceptable person separation indices. The 28 categories retained in the set were free of differential item functioning by gender, age, education level, or etiology.
CONCLUSIONS
Together overcomes some of the obstacles to practical application of the ICF. The app is a reliable assessment tool for assessing functioning after spinal cord injury.
背景
《国际功能、残疾和健康分类》（ICF）是一个统一的功能术语系统，用于开发电子健康记录和评估工具。然而，由于其术语复杂、类别众多、操作不确定以及使用所需的培训，其应用受到限制。Together 是一款移动健康应用程序，旨在为中国脊髓损伤（SCI）患者的家属提供医疗支持。该应用程序的核心框架是一套仅包含 31 个 ICF 类别。该应用程序还提供了评分指南，并自动将常规评估结果转换为 ICF 限定符的术语。
目的
本研究旨在检验 Together 应用程序中使用的 ICF 集作为评估 SCI 患者功能的工具的适用性。
方法
采用横断面研究，纳入 2018 年 5 月至 2019 年 10 月期间在中国 4 家康复中心出院前的 112 名 SCI 患者。护士使用该应用程序通过面对面访谈评估患者的功能。然后对所得数据进行 Rasch 分析。
结果
在删除了两个不符合 Rasch 模型的类别（家庭关系和社交）和一个个人因素（脊髓损伤知识）后，ICF 的身体功能和身体结构、活动和参与以及环境因素三个组成部分均与 Rasch 模型适配良好。这三个组成部分的个体分离指数均为可接受水平。该集合中保留的 28 个类别在性别、年龄、教育程度或病因方面没有差异项目功能。
结论
Together 克服了 ICF 实际应用的一些障碍。该应用程序是评估脊髓损伤后功能的可靠评估工具。
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