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临床医生评定的功能状态访谈与执行功能的关系。

The relationship of the clinician-rated Functional Status Interview with executive functioning.

机构信息

VA Memphis Medical Center, Mental Health Service, Memphis, TN, USA.

The University of Tennessee Health Science Center, Department of Psychiatry, Memphis, TN, USA.

出版信息

Appl Neuropsychol Adult. 2024 Sep-Oct;31(5):879-891. doi: 10.1080/23279095.2022.2084619. Epub 2022 Jun 11.

Abstract

Self/informant-report and performance-based instruments are typically used to measure activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Minimal attention has focused on clinician-rated measures. Executive functioning (EF) contributes significantly to functional independence, and the validity of functional status measures has been examined through its relationship to EF scores. The current study used a clinical sample of older U.S. Veterans who completed a neurocognitive evaluation ( = 266). The psychometric properties of a novel, clinician-rated Functional Status Interview (FSI) and its relationship to EF measures, including the Frontal Assessment Battery (FAB) and Trail Making Test (TMT-A and TMT-B), were explored. Two FSI factors (IADL and ADL) emerged with all items loading strongly onto the subscales as predicted. EF correlated strongly with IADL but had small to medium correlations with ADL. In regression models that controlled for sociodemographic variables, all EF measures uniquely contributed to the IADL model, but only FAB and TMT-A contributed to the model for ADL. Notably, results may have been limited by prominent floor effects on TMT-B. Overall, the FSI is a promising measure with demonstrated content validity. Thus, there is preliminary support for clinicians to incorporate multiple sources of information to rate functional status using the FSI.

摘要

自评和基于表现的工具通常用于测量日常生活活动(ADLs)和工具性日常生活活动(IADLs)。很少有人关注临床医生评定的测量方法。执行功能(EF)对功能独立性有重要贡献,通过其与 EF 分数的关系来检验功能状态测量的有效性。本研究使用了完成神经认知评估的美国老年退伍军人的临床样本( = 266)。探讨了一种新的、临床医生评定的功能状态访谈(FSI)及其与 EF 测量的关系,包括额叶评估量表(FAB)和连线测试(TMT-A 和 TMT-B)。两个 FSI 因子(IADL 和 ADL)出现,所有项目都如预期那样强烈地加载到子量表上。EF 与 IADL 高度相关,但与 ADL 呈小到中等相关。在控制社会人口变量的回归模型中,所有 EF 测量指标都为 IADL 模型提供了独特的贡献,但只有 FAB 和 TMT-A 为 ADL 模型提供了贡献。值得注意的是,结果可能受到 TMT-B 明显地板效应的限制。总体而言,FSI 是一种有前景的测量方法,具有显示出的内容有效性。因此,有初步的证据支持临床医生使用 FSI 根据多个信息来源来评定功能状态。

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