Tsuji T, Sonoda S, Domen K, Saitoh E, Liu M, Chino N
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
Am J Phys Med Rehabil. 1995 Nov-Dec;74(6):432-8. doi: 10.1097/00002060-199511000-00007.
The difficulty patterns of FIM (Functional Independence Measure) in Japan were determined and compared with patterns found in the United States to assess whether FIM can be used for worldwide comparisons of ADL (the activities of daily living). The FIM was measured for 190 stroke patients in several hospitals throughout Japan. The scores at admission and discharge were converted to an interval scale by Rasch analysis. Right and left brain lesion patients were analyzed separately. The FIM items were divided into two groups: motor items and cognitive items to minimize misfit. A degree of misfit was acceptable, except for bowel and bladder management, stairs, bathing, and expression. Motor items, eating, and bowel and bladder management were the easiest; stairs, bathing, and tub/shower transfers were the most difficult. The difficulty patterns of patients with left and right hemisphere lesions were almost identical. Bathing and tub/shower transfer were more difficult for Japanese patients than for those studied in the United States. Concerning the cognitive items, expression was easiest for patients with right hemisphere lesions but most difficult for those with left hemisphere lesions. Social interaction was easier for Japanese patients with left hemisphere lesions than the other patients. The item difficulty patterns in Japan differs slightly from those in the United States because of cultural differences. As countries show different patterns of difficulty, we must be careful when making international comparisons of FIM data converted by Rasch analysis.
确定了日本功能独立性测量（FIM）的难度模式，并与美国的模式进行比较，以评估FIM是否可用于全球日常生活活动（ADL）的比较。对日本多家医院的190名中风患者进行了FIM测量。通过Rasch分析将入院和出院时的得分转换为区间量表。分别对右脑和左脑病变患者进行分析。FIM项目分为两组：运动项目和认知项目，以尽量减少不匹配情况。除了肠道和膀胱管理、上下楼梯、洗澡和表达外，一定程度的不匹配是可以接受的。运动项目、进食以及肠道和膀胱管理最容易；上下楼梯、洗澡和浴缸/淋浴转移最困难。左脑和右脑病变患者的难度模式几乎相同。与在美国研究的患者相比，洗澡和浴缸/淋浴转移对日本患者来说更困难。关于认知项目，表达对右脑病变患者来说最容易，但对左脑病变患者来说最困难。对于左脑病变的日本患者，社交互动比其他患者更容易。由于文化差异，日本的项目难度模式与美国略有不同。由于各国显示出不同的难度模式，在对通过Rasch分析转换的FIM数据进行国际比较时，我们必须谨慎。
