施加加,孙悦,孙莹,等.简短版扩展Barthel指数量表的编制及心理计量学分析[J].中华物理医学与康复杂志,2025,47(3):198-203
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| 简短版扩展Barthel指数量表的编制及心理计量学分析 |
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| DOI：10.3760/cma.j.cn421666-20240914-00749 |
| 中文关键词: 扩展Barthel指数 日常生活活动 信度 效度 脑卒中 脑外伤 |
| 英文关键词: Extended Barthel index Activities of daily living Reliability Validity Stroke Brain trauma |
| 基金项目:苏州市科技发展计划项目（SKYD2022018）；昆山市科技计划项目（KS2250，KS2367，KS2462） |
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| 中文摘要: |
| 目的 简介简短版扩展Barthel指数量表的编制，并分析该量表在脑卒中或脑外伤患者日常生活活动（ADL）能力评定中的心理计量学特征。 方法 回顾性收集295例脑卒中或脑外伤出院患者的人口统计、诊断、功能评估［包括扩展Barthel指数（EBI）、功能独立性量表（FIM）、改良Barthel指数(MBI)及蒙特利尔认知评估量表(MoCA)评分］信息，将其中120例患者资料信息作为简短EBI测试版的分析集，使用项目总体优势指数构建条目数量不同的简短EBI测试版（5~10项）；余175例患者资料信息作为简短EBI测试版的验证集，分析各简短EBI测试版（5~10项）在量表接受度、反应度、信度、效度及结果一致性方面的心理计量学表现，并将心理计量学表现最好的简短EBI测试版推荐为正式的简短版EBI。 结果 通过比较，最终推荐的简短版EBI其评估条目包括个人卫生、穿衣/脱衣、轮椅/床间转移、行走、社会交往、解决问题、记忆力、学习能力及定向力共7项，每个条目分值0~4分，满分28分。简短版EBI具有较好的接受度，其得分覆盖量表全程评分范围，得分中位数及均值均接近量表满分的半值水平，且未出现明显的天花板或地板效应。简短版EBI的反应度（d值）为0.19，高于EBI的反应度（0.14）。简短版EBI的信度Cronbach′s α系数为0.885，测量标准误(SEM)为9.11分。简短版EBI对EBI得分的解释率（adj.R2）为0.954，与EBI的同时效度ρ系数为0.975（P＜0.001），与FIM、MBI、MoCA的校标效度ρ系数分别为0.956、0.889、0.806（P＜0.001）。简短版EBI与EBI的组内相关系数(ICC)为0.967（95%CI：0.769-0.989），与EBI的得分配对差值为（6.48±6.56）分。 结论 简短版EBI具有优异的接受度、反应度、信度、效度及结果一致性，适用于脑卒中或脑外伤患者的ADL能力评定。 |
| 英文摘要: |
| Objective To analyze the psychometric properties of the short-form Extended Barthel Index (EBI) in assessing ability in the activities of daily living (ADL). Methods Data describing 295 discharged patients with stroke or traumatic brain injury were collected retrospectively, including their demographics, diagnoses, and functional assessments (EBI, FIM, MBI and MoCA). Then, data on 120 of them were used to construct short-form EBI models based on item-total advantage indices, while the remaining 175 patients served as a validation set to evaluate the acceptability, responsiveness, reliability, validity, and outcome consistency of the models. The optimal model was selected as the recommended short-form EBI. Results The short-form EBI comprises seven items: personal hygiene, dressing/undressing, wheelchair-bed transfer, walking, social interaction during walking, problem-solving, and memory/learning/orientation, with each item scored 0-4 (total range: 0-28). The short-form EBI demonstrated good acceptability, with median and mean scores near the scale′s midpoint and no significant ceiling or floor effects. Its responsiveness (d=0.19) surpassed that of the original EBI (d=0.14). Moreover, the short-form EBI showed excellent reliability (Cronbach′s α=0.885; SEM=9.11) and validity, explaining 95.4% of the variance in EBI scores (adj. R2=0.954). Concurrent validity with the EBI was strong (ρ=0.975, P≤0.001), and criterion validity with ρ=0.956 for FIM, 0.889 for MBI, and 0.806 for MoCA. The short-form and the original EBI exhibited good agreement ［ICC=0.967 (95% CI: 0.769-0.989); score difference: 6.48±6.56］. Conclusions The short-form EBI demonstrates excellent acceptability, responsiveness, reliability, validity, and outcome consistency, making it a practical tool for ADL assessment in cases of stroke or traumatic brain injury. |
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