Lansky S B, List M A, Lansky L L, Ritter-Sterr C, Miller D R
Cancer. 1987 Oct 1;60(7):1651-6. doi: 10.1002/1097-0142(19871001)60:7<1651::aid-cncr2820600738>3.0.co;2-j.
The performance status of the child with cancer is an important outcome consideration in pediatric oncology research and practice. However, no single measure for children has been available. This is a report of the development and standardization of such a scale. The play-performance scale for children is a parent-rated instrument which records usual play activity as the index of performance. Performance status ratings were obtained on three groups of children: patients (n = 98), patients' siblings (n = 29), and an independent sample of hospital employees' children (n = 40). Children with all types and stages of childhood malignant neoplasms were represented. Test results established the parent as a competent, reliable rater and demonstrated the validity of the scale. Interrater reliability was examined using correlational statistics and percentage agreement. Agreement between parents was good, and there were no systematic rater biases. In addition, parents' ratings significantly discriminated differences in levels of functioning (mean score, patients 75.4 versus siblings 97.4). Correlational and analysis of variance (ANOVA) procedures demonstrated that the play-performance scale was significantly related to the global performance measures of experienced clinicians and was sensitive to change. Inpatients received a mean score of 42.3, outpatients 90.7, and normals 98.2. These findings indicate that the scale is both feasible and effective. It is concise, can be administered repeatedly even to extremely ill patients, and uses parents as observer reporters. The play-performance scale for children provides quantifiable, reproducible, and meaningful data, which is necessary for effective monitoring and management of the child with cancer.
癌症患儿的功能状态是儿科肿瘤学研究与实践中一个重要的结果考量因素。然而，目前尚无适用于儿童的单一测量方法。本文报告了这样一种量表的开发与标准化过程。儿童游戏功能量表是一种由家长评定的工具，它将日常游戏活动记录为功能指标。对三组儿童进行了功能状态评定：患者（n = 98）、患者的兄弟姐妹（n = 29）以及医院员工子女的独立样本（n = 40）。涵盖了所有类型和阶段儿童恶性肿瘤的患儿。测试结果表明家长是称职、可靠的评定者，并证明了该量表的有效性。使用相关统计和百分比一致性来检验评定者间的信度。家长之间的一致性良好，且不存在系统性的评定者偏差。此外，家长的评定能够显著区分功能水平的差异（平均得分，患者为75.4，兄弟姐妹为97.4）。相关分析和方差分析程序表明，游戏功能量表与经验丰富的临床医生的整体功能测量显著相关，且对变化敏感。住院患者的平均得分为42.3，门诊患者为90.7，正常儿童为98.2。这些结果表明该量表既可行又有效。它简洁明了，即使对重病患者也可重复使用，并且以家长作为观察报告者。儿童游戏功能量表提供了可量化、可重复且有意义的数据，这对于有效监测和管理癌症患儿是必要的。
