ICF通用组合在中国人群临床应用中的效度研究

摘要

Objective:To explore the construct validity of ICF generic set as a functioning measure tool in routine clinical practice of China.Method:Totally 4510 patients covering departments of rehabilitation,neurology or cerebral surgery,cardiology,pneumology and orthopedics from 50 hospitals in 21 provinces of mainland China were enrolled in this multicenter study.Each patient was assessed by the same rater with ICF generic set at the time of baseline and discharge.Result:At the time of discharge,with exception of the scores of item d850,the scores of ICF generic set is (15.25±13.48),which is lower than that of the baseline (23.76±15.15).Two common factors which come from factor analysis are almost consisted with theoretic structure,and the contributing rate of cumulative sums was 78.018％.Confirmatory factor analysis indicated that the model was consistent with the theoretical assumption,and the fitness indexes were RMSEA=0.026,NFI=0.999,CFI=0.999,AGFI=0.994.Conclusion:The construct validity of ICF generic set is good,The ICF generic is a useful functioning measure tool in routine clinical practice.%目的:探讨ICF通用组合在中国人群临床功能评估中的结构效度,为其临床应用提供依据.方法:采用ICF通用组合功能评估量表,于入院和出院时两个时间点对来自全国21个省份和自治区50家医院康复医学科、神经内科或脑外科、心血管科、呼吸科和骨科4510名患者进行评估.所得数据用于评价ICF通用组合在临床功能评估中的结构效度.结果:“d850有报酬的就业”不适用于NRS评分,缺失值较大.除去此项,患者出院时ICF通用组合评分(15.25±13.48)分,低于入院时(23.76±15.15)分,差异有显著性意义(P＜0.001).探索性因子分析结果表明,抽取特征根＞1的公因子共有2个,累积贡献率为78.018％.采用结构方程模型方法,拟合了“b130能量和驱力功能”、“b152情感功能”、“b280痛感”、“d230执行日常事务”、“d450步行”、“d455到处移动”关系模型,结构方程模型调整的拟合优度指数RMSEA=0.026,NFI=0.999,CFI=0.999,AGFI=0.994,模型较好的拟合了数据.结论:ICF通用组合能反映出、入院时患者的不同功能状态且其结构效度良好,是一种临床上有效的测量患者功能状态的工具.