开发、可靠性和有效性的安全使用助行器检查表 (SUMAC) 为四轮助行器在痴呆患者中的使用。
Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia.
机构信息
School of Physical Therapy, University of Western Ontario, Room 1588, Elborn College, London, ON, N6G 1H1, Canada.
Faculty of Biological Sciences, Sport and Exercise Science, University of Leeds, Leeds, England.
出版信息
BMC Geriatr. 2020 Nov 11;20(1):468. doi: 10.1186/s12877-020-01865-5.
BACKGROUND
Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.
METHODS
Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman's rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman's rank-order correlations.
RESULTS
Three focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (r = 0.84), but not EQ (r = 0.39).
CONCLUSIONS
The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.
背景
平衡和步态问题在痴呆症中很常见且呈进行性发展。使用助行器可提供身体支撑和信心。然而，痴呆症患者使用助行器会使跌倒的风险增加三倍。目前还没有专门用于评估痴呆患者助行器安全性的评估工具。本研究的目的是：1）开发一种用于评估痴呆患者使用四轮助行器的身体功能和安全使用的工具，2）评估其结构和标准效度、评分者间信度和重测信度以及最小可检测变化。
方法
有经验的康复痴呆患者的医疗保健专业人员（HCP）参加了焦点小组，为新工具，即安全使用助行器检查表（SUMAC）生成项目。SUMAC 评估了日常生活中九项任务的身体功能（PF）和设备安全使用（EQ）。通过 HCP（n=5）对使用四轮助行器进行 SUMAC 的痴呆患者（n=10）的视频进行评分，评估了可靠性。使用组内相关系数（ICC）评估了评分者间和重测信度。使用 Spearman 等级相关评估了 HCP 的结构效度得分与共识 HCP 小组。使用 Spearman 等级相关评估了标准效度，将 SUMAC-PF 与表现导向的移动评估（POMA）步态分量表进行比较。
结果
三个焦点小组（n=17）生成了一个工具，其中包含九个任务和每个任务的身体功能和安全使用组件。SUMAC-PF（ICC=0.92，95%CI（0.81，0.98），p<0.001）和 SUMAC-EQ 的评分者间信度具有统计学意义。（ICC=0.82，95%CI（0.54，0.95），p<0.001）。SUMAC-PF（ICC=0.89，95%CI（0.81，0.94），p<0.001）和 SUMAC-EQ 的重测信度具有统计学意义。（ICC=0.88，95%CI（0.79，0.93），p<0.001）。正如假设的那样，POMA 步态分量表与 SUMAC-PF 呈强相关（r=0.84），但与 EQ 不相关（r=0.39）。
结论
焦点小组和研究团队开发了一种工具，其中包含九个任务，用于评估痴呆症患者四轮助行器的身体功能和安全使用。SUMAC 工具具有整体内容效度，对 SUMAC-PF 和 SUMAC-EQ 具有良好的结构和标准效度。SUMAC 的子评分具有极好的评分者间和重测信度。
Zotero 插件