Keleman Audrey A, Bollinger Rebecca M, Rodakowski Juleen, Chang Chih-Hung, Kehrer-Dunlap Abigail L, Ances Beau M, Stark Susan L
Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA.
Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
J Appl Gerontol. 2025 Jun;44(6):981-993. doi: 10.1177/07334648241292968. Epub 2024 Oct 24.
Performance-based assessments of instrumental activities of daily living (IADL) can detect subtle functional impairments better than self-reported questionnaires. While most performance-based IADL assessments were developed for in-person administration, remote administration could increase access to vulnerable older adults. This study compared in-person and remote administration of IADL tasks from the Performance Assessment of Self-Care Skills. Community-dwelling older adults completed tasks (shopping, checkbook balancing, and medication management) at baseline (in-person) and follow-up (either in-person or remote, with modifications) two years later. Scores between the two follow-up groups, change in scores from baseline to follow-up, and differential item functioning (DIF) between the two administration methods at follow-up were examined. There were no differences in scores between methods of administration, but remote tasks took longer, and one item had significant DIF ( < .01). Clinicians found remote administration acceptable and feasible. With minor adaptations, remote administration of the three tasks was supported. Further validation research is needed.
基于表现的日常生活工具性活动（IADL）评估比自我报告问卷能更好地检测出细微的功能损伤。虽然大多数基于表现的IADL评估是为面对面施测而开发的，但远程施测可以增加弱势老年人接受评估的机会。本研究比较了自我护理技能表现评估中IADL任务的面对面施测和远程施测。社区居住的老年人在基线（面对面）和两年后的随访（面对面或远程，有修改）时完成任务（购物、支票簿核对和药物管理）。检查了两个随访组之间的分数、从基线到随访的分数变化以及随访时两种施测方法之间的差异项目功能（DIF）。施测方法之间的分数没有差异，但远程任务耗时更长，且有一个项目存在显著的DIF（<0.01）。临床医生认为远程施测是可接受且可行的。经过微小调整后，支持对这三项任务进行远程施测。还需要进一步的验证研究。
