Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, New Jersey; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey.
Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina; Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
Arch Phys Med Rehabil. 2022 Nov;103(11):2145-2152. doi: 10.1016/j.apmr.2022.01.165. Epub 2022 Mar 16.
To determine the maximum permissible number of missed items on the 10-item Catherine Bergego Scale administered after the Kessler Foundation Neglect Assessment Process (KF-NAP). Secondary objectives were to determine the frequency, characteristics, and most commonly cited reasons reported for missed items.
Retrospective diagnostic accuracy study.
Sixteen inpatient rehabilitation facilities in the United States.
A consecutive clinical sample of 4256 patients (N=4256) with stroke or other neurologic deficits who were assessed for spatial neglect with the KF-NAP.
Not applicable.
Catherine Bergego Scale via KF-NAP.
The majority (69.7%) of patients had at least 1 missed item on their KF-NAP. Among those with missed items, it was most common to have 2 missed items (51.4%), and few had more than 3 missed items (11.3%). The most commonly missed items were Collisions (37.2%), Cleaning After Meals (36.1%), Meals (34.0%), and Navigation (19.7%). The most commonly reported reasons for missed items included time constraints, cognitive or communication deficits, and behavior or refusal of the therapy session. These reasons were reported for nearly all item types. Item-specific reasons were also commonly reported, such as a lack of a needed resource for task completion or low functional status of the patient. Prorated scoring of measures with up to 3 missed items maintained an acceptable level of concordance with complete measures (Lin's Concordance Correlation Coefficient=0.96, 95% CI, 0.9478-0.9626) for the combination of 3 missed items with lowest concordance.
Clinicians should make every effort to capture all items on the KF-NAP. However, missed items occur in the majority of cases because of patient factors and barriers inherent to the inpatient hospital setting. When missed items are necessary, clinicians can confidently interpret a prorated score when 7 or more items are scored.
确定在 Kessler 基金会忽视评估程序（KF-NAP）后进行的 10 项 Catherine Bergego 量表中允许遗漏的最大项目数。次要目标是确定遗漏项目的频率、特征以及最常报告的遗漏原因。
回顾性诊断准确性研究。
美国的 16 家住院康复设施。
一项连续的临床样本，包括 4256 名患有中风或其他神经功能缺损的患者（N=4256），他们使用 KF-NAP 评估空间忽视。
不适用。
KF-NAP 的 Catherine Bergego 量表。
大多数（69.7%）患者在他们的 KF-NAP 中有至少 1 个遗漏项目。在有遗漏项目的患者中，最常见的是有 2 个遗漏项目（51.4%），很少有超过 3 个遗漏项目（11.3%）。最常遗漏的项目是碰撞（37.2%）、餐后清洁（36.1%）、进餐（34.0%）和导航（19.7%）。最常报告的遗漏项目的原因包括时间限制、认知或沟通障碍以及治疗过程中的行为或拒绝。这些原因几乎适用于所有项目类型。也常报告特定项目的原因，例如完成任务所需资源的缺乏或患者的功能状态较低。最多可遗漏 3 项的措施的分级评分与完整措施保持可接受的一致性（Lin 的一致性相关系数=0.96，95%置信区间，0.9478-0.9626），对于一致性最低的 3 项遗漏项目组合。
临床医生应尽力获取 KF-NAP 的所有项目。然而，由于患者因素和住院医院环境固有的障碍，大多数情况下都会遗漏项目。当需要遗漏项目时，当评分达到 7 项或更多项时，临床医生可以有信心地解释分级评分。
