Higashi Yasuhiro, Kaneda Toshikatsu, Horimoto Takumi, Kiku Shuichiro, Somei Yuta, Ono Soji, Hirayama Kimiaki, Atosako Haruka, Yuri Yoshimi
Faculty of Rehabilitation, Morinomiya University of Medical Sciences, Osaka, JPN.
Department of Rehabilitation, Osaka General Hospital of West Japan Railway Company, Osaka, JPN.
Cureus. 2025 Jan 7;17(1):e77075. doi: 10.7759/cureus.77075. eCollection 2025 Jan.
This study assessed the psychometric properties of the Toileting Behaviour Evaluation (TBE), a tool designed to address the limitations of traditional assessments like the Functional Independence Measure and Barthel Index in capturing the complexities of toileting activities among wheelchair users. Conducted with 250 wheelchair users from six rehabilitation hospitals in Japan, the study used Rasch analysis to evaluate the TBE's internal validity, reliability, and unidimensionality across 22 toileting components. The analysis confirmed the TBE's fit to the Rasch model, with a raw variance explained by measures of 70.1%, a person separation index of 3.82 (reliability coefficient=0.94), and an item separation index of 5.94 (reliability coefficient=0.97), supporting its use as a valid and reliable tool. Additionally, a conversion table was developed to transform ordinal scores into interval measures, enhancing clinical applicability. The study suggests that the TBE is a psychometrically sound instrument for assessing toileting behavior in wheelchair users. However, further research is recommended to explore its effectiveness in clinical interventions and its applicability across different populations and diagnoses.
本研究评估了如厕行为评估量表（TBE）的心理测量特性。该工具旨在解决传统评估方法（如功能独立性测量和巴氏指数）在捕捉轮椅使用者如厕活动复杂性方面的局限性。该研究对来自日本六家康复医院的250名轮椅使用者进行了调查，采用拉施分析方法评估了TBE在22个如厕组成部分上的内部效度、信度和单维度性。分析证实TBE符合拉施模型，测量解释的原始方差为70.1%，人员分离指数为3.82（信度系数 = 0.94），项目分离指数为5.94（信度系数 = 0.97），支持其作为有效且可靠工具的使用。此外，还制定了一个转换表，将顺序分数转换为区间测量值，提高了临床适用性。该研究表明，TBE是一种心理测量学上合理的工具，用于评估轮椅使用者的如厕行为。然而，建议进一步研究以探索其在临床干预中的有效性及其在不同人群和诊断中的适用性。
