Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi-cho Kodaira, Tokyo 187-8551, Japan.
Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi Shinjuku, Tokyo 160-8582, Japan.
Behav Neurol. 2021 Feb 9;2021:8825192. doi: 10.1155/2021/8825192. eCollection 2021.
The Kessler Foundation Neglect Assessment Process (KF-NAP) is an assessment tool for unilateral spatial neglect (USN), which is the scoring method for the Catherine Bergego Scale (CBS) based on detailed instructions. This study is aimed at determining the reliability and validity of the Japanese version of the KF-NAP (KF-NAP-J), evaluating the improvement of neglect assessment with KF-NAP-J, and comparing it with the original CBS for subacute stroke patients. We assessed subacute stroke patients admitted to our intensive rehabilitation hospital. Two KF-NAP-trained occupational therapists (OTs) assessed 22 patients. Before implementing the KF-NAP at the hospital, two other OTs assessed the other 23 patients using the CBS. We evaluated the interrater reliability of the KF-NAP and CBS using intraclass correlation coefficients (ICC) for the total scores, weighted kappa statistics for each subscale, and internal consistency using Cronbach's alpha. We assessed the validity of the KF-NAP against the Behavioral Inattention Test (BIT) and Functional Independence Measure (FIM) using Spearman's correlation coefficient. The reliability of both the KF-NAP and CBS was excellent. The weighted kappa results demonstrated that each subscale was in better agreement with the KF-NAP than with the CBS. In the KF-NAP, all eight subscales in which weighted kappa could be calculated were in significant agreement, and two were almost in perfect agreement. The KF-NAP moderately correlated with the subscales of BIT and FIM representing USN and activities of daily living. The USN detection rates of KF-NAP and BIT in the KF-NAP group were 63.6% and 22.7%, respectively. These results suggest that the KF-NAP, as well as the CBS, is useful to assess USN, which strongly impacts the rehabilitation outcomes in subacute stroke patients.
凯斯勒基金会忽视评估过程（KF-NAP）是一种单侧空间忽略（USN）的评估工具，它是基于详细说明的凯瑟琳·贝尔戈量表（CBS）的评分方法。本研究旨在确定日本版 KF-NAP（KF-NAP-J）的可靠性和有效性，评估 KF-NAP-J 对忽视评估的改善，并将其与亚急性脑卒中患者的原始 CBS 进行比较。我们评估了入住我们强化康复医院的亚急性脑卒中患者。两名接受过 KF-NAP 培训的作业治疗师（OT）评估了 22 名患者。在医院实施 KF-NAP 之前，另外两名 OT 使用 CBS 评估了另外 23 名患者。我们使用组内相关系数（ICC）评估 KF-NAP 和 CBS 的总分的评分者间信度，用每个子量表的加权kappa 统计量评估每个子量表的评分者间信度，用 Cronbach's alpha 评估内部一致性。我们使用 Spearman 相关系数评估 KF-NAP 与行为疏忽测试（BIT）和功能独立性测量（FIM）的效度。KF-NAP 和 CBS 的可靠性均为优。加权kappa 结果表明，每个子量表与 KF-NAP 的一致性均优于与 CBS 的一致性。在 KF-NAP 中，所有八个可以计算加权 kappa 的子量表都具有显著一致性，两个几乎完全一致。KF-NAP 与代表 USN 和日常生活活动的 BIT 和 FIM 的子量表中度相关。KF-NAP 组和 BIT 组的 USN 检出率分别为 63.6%和 22.7%。这些结果表明，KF-NAP 和 CBS 均有助于评估 USN，这对亚急性脑卒中患者的康复结果有重要影响。
