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物理治療

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篇名 功能獨立量表訪談式問卷於腦中風病人之信度檢定
卷期 27:4
並列篇名 Reliability of the Interview-Based Functional Independence Measure in Patients with Stroke
作者 廖麗君林昭宏朱允慧劉景寬
頁次 174-182
關鍵字 訪談法功能獨立量表信度中風InterviewFunctional Independence MeasureReliabilityStrokeTSCI
出刊日期 200207

中文摘要

背景與目的,本研究主要目的在於探討英文版功能獨立量表(Functional Independence Measure, FIM)訪談式問卷之可行性,經由檢測訪談法之評估者內信度(intra-rater reliability)與評估者間信度(inter-rater reliability),同時分析訪談法與家訪觀察法間之相等信度(equivalence reliability)。方法:評估者內信度部分評估20位中風病人,兩次訪談時間在7天內完成。評估者間信度由兩位物理治療師各自獨立訪談另外20位中風病人。訪談問卷與家訪觀察之相等信度部分是評估35位門診中風病人,由一位治療師在門診完成訪談法評估FIM,再由另一位物理治療師至病人家中實際觀察FIM之表現。結果,評估者內信度統計分析結果顯示FIM總分、動作領域及認知領域ICC(Intraclass Correlation Coefficient)值皆達0.99以上;Kappa一致性解釋度皆在良好(含)以上。評估者間信度結果顯示FIM總分、動作領域(自我照顧、排便、移位及走動)及認知領域(溝通及社會認知)ICC值分別為0.99,0.98,0.99;Kappa一致性解釋度有77%在中等程度以上。相等信度統計分析結果顯示FIM總分、動作領域及認知領域ICC值分別為0.98,0.99,0.90;Kappa一致性解釋度有83%在良好或中等程度。結論:FIM以訪談方式評估具有很好的評估者內信度及評估者間信度,和家訪觀察法之間也具有良好的相等信度,本研究結果可提供臨床人員用訪談方式代替直接觀察使用英文版FIM於中風病人之參考依據。

英文摘要

Background and purpose: The main purpose of this study was to investigate the feasibility of scoring Functional Independence Measure (FIM) by interview. The intra-rater and inter-rater reliability of the interviewed FIM, and the comparison of home-visit and interviewed FIM were
investigated. Methods: Twenty stroke patients were interviewed twice in 7 days for the intra-rater reliability, while another 20 stroke patients were interviewed by two physical therapists within 7 days for inter-rater reliability. Thirty-five stroke patients were recruited for testing the equivalence of direct observed and interviewed FIM. Results: The results indicated that the scores of FIM total, motor domain and cognitive domain achieved excellent intra-rater reliability (ICC≥0.99) with good strength of Kappa coefficient. The inter-rater reliability of the respective scores showed similar finding (ICC≥0.98, 77% with moderate or higher strength of Kappa coefficient). For the equivalence analysis (interview vs. direct observation), the ICC values were 0.98, 099 and 0.90,
respectively (83% with moderate or good strength of Kappa coefficient). Conclusions: The interview-based FIM has been shown good reliability in this study. The results of this study suggest the interview-based FIM is able to provide clinicians an alternative of functional assessment.

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