青少年关节炎功能状态指数（JASI）：一项验证研究。

The Juvenile Arthritis Functional Status Index (JASI): a validation study.

作者信息

Wright F V, Kimber J L, Law M, Goldsmith C H, Crombie V, Dent P

机构信息

Arthritis and Orthopaedic Programme, Hugh MacMillan Rehabilitation Centre, Toronto, Ontario, Canada.

出版信息

J Rheumatol. 1996 Jun;23(6):1066-79.

PMID:8782142

Abstract

OBJECTIVE

To evaluate aspects of reliability and validity of the Juvenile Arthritis Functional Status Index (JASI). We developed this questionnaire to assess a variety of daily living and functional mobility tasks in children with juvenile rheumatoid arthritis (JRA). JASI part I consists of 100 functional items divided into 5 activity categories (self-care, domestic, mobility, school, extracurricular). A 7 point degree of difficulty rating scale is used for responses. JASI Part II is a priority function section within which the child identifies and scores important activities for improvement.

METHODS

The JASI was administered to 30 children with JRA 8 to 19 years of age at baseline, 3 weeks, and 3 months to determine test-retest reliability. Various rheumatology measures were used to evaluate the JASI construct validity.

RESULTS

Reliability of JASI Part I was excellent (intraclass correlation coefficients > or = 0.95) for both retest intervals. Reliability was lower for respondents with mild disease than those with polyarticular disease. JASI Part I scores correlated strongly with rheumatology measures including joint count, grip strength, hip synovitis, timed walk and run. ACR functional class, and range of motion (r > 0.50), indicating construct validity. There was fair to good agreement between scores from the child's self-report and those from therapist observation of the child's abilities on the same activities. This provides evidence that children as young as 8 years of age can realistically report on function on their own. In JASI Part II, respondents identified a mean of 5.9 functional items in the baseline priority activity list. Test-retest reliability for JASI Part II was fair (kappa = 0.57). Further work is needed to determine the most reliable and sensitive response sequence for evaluating change in priority functions with JASI Part II.

CONCLUSION

JASI Part I is a reliable and valid functional measure for school age children and adolescents with JRA. Research is under way to evaluate responsiveness to change. Comparisons will be made with shorter JRA functional measures to determine differences in sensitivity.

摘要

目的

评估青少年关节炎功能状态指数（JASI）的可靠性和有效性。我们编制了这份问卷，以评估青少年类风湿性关节炎（JRA）患儿的各种日常生活和功能活动任务。JASI第一部分由100个功能项目组成，分为5个活动类别（自我护理、家务、活动能力、学校活动、课外活动）。采用7分难度评分量表进行作答。JASI第二部分是一个优先功能部分，患儿可在此部分识别并对重要的待改善活动进行评分。

方法

对30名8至19岁的JRA患儿在基线、3周和3个月时进行JASI评估，以确定重测信度。采用多种风湿病学测量方法评估JASI的结构效度。

结果

JASI第一部分在两个重测间隔期的信度均极佳（组内相关系数≥0.95）。病情较轻的受访者的信度低于多关节疾病患者。JASI第一部分得分与包括关节计数、握力、髋关节滑膜炎、定时步行和跑步等风湿病学测量指标、美国风湿病学会功能分级以及活动范围密切相关（r>0.50），表明具有结构效度。患儿自我报告得分与治疗师对患儿在相同活动中的能力观察得分之间的一致性为中等至良好。这证明8岁及以上的儿童能够切实地自行报告功能情况。在JASI第二部分中，受访者在基线优先活动清单中平均识别出5.9个功能项目。JASI第二部分的重测信度为中等（kappa = 0.57）。需要进一步开展工作，以确定使用JASI第二部分评估优先功能变化时最可靠和敏感的应答顺序。