Department of Rehabilitation, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Nurs Open. 2023 Mar;10(3):1852-1862. doi: 10.1002/nop2.1448. Epub 2022 Nov 6.
The pictorial Longshi Scale was designed to assess patients' functional ability in the Chinese context, which is gradually used by some informal caregivers. However, its reliability compared with healthcare professionals has not been examined.
A multi-centre cross-sectional study conducted in 24 Chinese hospitals.
We recruited patients undergoing rehabilitation treatment and informal caregiver dyads. Informal caregivers and healthcare professionals evaluated patients' functional ability using the Longshi Scale according to three levels (bedridden, domestic and community). The Kappa coefficient and McNemar-Bowker test were used to examine the consistency and accuracy between the two parallel assessments.
This study involved 947 patients (mean age: 46.07 ± 11.72 years) and informal caregiver dyads (64.86 ± 12.94 years). Most patients were males (66.3%), while most caregivers were females (60.7%). Over 70% of patients and caregiver dyads had a secondary-school education and lower. Around 90% of caregivers were relatives (spouse, 42.8%; offspring, 20.7%; siblings: 13.3%; parent, 12.0%) of patients. The agreement in sub-levels of the Longshi Scale between caregivers and healthcare professionals ranges from 73%-89%, and the corresponding Kappa coefficients range from 0.504-0.786. Caregivers were more likely to assign fewer patients to the bedridden group and more to the domestic group than healthcare professionals. The subgroup analysis by education level indicated that the difference in assigning patients into three degrees of functional disability was only significant in those with primary-school education, while non-significant in those with secondary-school education and higher.
The evaluation outcomes of functional ability using the Longshi Scale are similar between informal caregivers and healthcare professionals. However, informal caregivers' education level is a dominant factor in affecting the assessment accuracy compared with healthcare professionals. Informal caregivers with a secondary-school education and higher are supported to evaluate patients' functional ability independently.
龙氏量表（Longshi Scale）是专为评估中国语境下患者的功能能力而设计的，目前已逐渐被一些非专业照护者使用。然而，其与专业医护人员评估结果的可靠性尚未得到检验。
一项在中国 24 家医院开展的多中心横断面研究。
我们招募了正在接受康复治疗的患者及其非专业照护者。非专业照护者和医护人员按照卧床、国内和社区三个水平使用龙氏量表评估患者的功能能力。采用 Kappa 系数和 McNemar-Bowker 检验评估两种平行评估的一致性和准确性。
本研究共纳入 947 例患者（平均年龄：46.07±11.72 岁）及其非专业照护者（64.86±12.94 岁）。大多数患者为男性（66.3%），而大多数照护者为女性（60.7%）。超过 70%的患者和照护者具有中学及以下学历。大约 90%的照护者是患者的亲属（配偶，42.8%；子女，20.7%；兄弟姐妹，13.3%；父母，12.0%）。照护者和医护人员对龙氏量表亚等级的评估一致性在 73%-89%之间，相应的 Kappa 系数在 0.504-0.786 之间。照护者将更少的患者分配到卧床组，而将更多的患者分配到国内组，这一情况比医护人员更为明显。按教育水平的亚组分析表明，只有在具有小学教育水平的人群中，将患者分配到三个功能障碍程度的差异才具有统计学意义，而在具有中学及以上教育水平的人群中，这种差异则不具有统计学意义。
使用龙氏量表评估功能能力的结果在非专业照护者和专业医护人员之间相似。然而，与医护人员相比，非专业照护者的教育水平是影响评估准确性的主要因素。具有中学及以上教育水平的非专业照护者被支持独立评估患者的功能能力。
