目的运用Rasch分析检验Barthel指数在内科老年住院患者日常生活活动能力评估中的适用性。方法采用便利抽样法,选择在广州市某三级甲等医院住院治疗的老年患者190例进行Barthel指数评估,从信度、区分度、单维性、匹配度、条目难度、响应...目的运用Rasch分析检验Barthel指数在内科老年住院患者日常生活活动能力评估中的适用性。方法采用便利抽样法,选择在广州市某三级甲等医院住院治疗的老年患者190例进行Barthel指数评估,从信度、区分度、单维性、匹配度、条目难度、响应阈值有序性、条目功能差异等方面对评估结果进行Rasch分析。结果Barthel指数的受试者信度和条目信度分别为0.90和1.00,受试者区分度和条目区分度分别为3.08和16.19。残差主成分分析中第一维度解释了78.3%的变异,第二维度解释了5.1%的变异;除条目“平地行走”和“床椅转移”的加权拟合均方(Infit Mean square)>1.5外,其余条目均与Rasch模型拟合较好;“控制大便”和“控制小便”之间的残差相关系数>0.7。受试者能力(0.01±0.75Logit)与条目难度匹配可接受,仍有14.2%的受试者未被条目覆盖。条目难度排序为:洗澡>修饰>上下楼梯>如厕>穿衣>进食>控制小便>控制大便>平地行走>床椅转移。条目响应水平的阈值有序,但条目“上下楼梯”、“平地行走”和“床椅转移”中存在难度间距过小的响应水平(<1.4 Logit)。未检测到功能偏倚的条目。结论Barthel指数是一个信度和区分能力良好的单维性工具,但在评估老年住院患者日常生活活动能力时仍存在一定的局限性,活动相关条目与模型拟合欠佳,评估界限有待明晰;大、小便控制条目相互依赖性高,因此需谨慎解读内科老年住院患者的Barthel指数总分。展开更多
Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and ski...Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.展开更多
目的:旨在基于Rasch模型分析冠心病心脏康复护理相关《国际功能、残疾和健康分类》(Inter-national Classification of Functioning,Disability and Health,ICF)类目的测量学特征。方法:通过便利抽样选取100例冠心病心脏康复患者,对其...目的:旨在基于Rasch模型分析冠心病心脏康复护理相关《国际功能、残疾和健康分类》(Inter-national Classification of Functioning,Disability and Health,ICF)类目的测量学特征。方法:通过便利抽样选取100例冠心病心脏康复患者,对其采用冠心病心脏康复护理相关ICF类目和简明生活质量量表(the MOS 36-Item Short-Form Health Survey,SF-36)进行调查,运用Winsteps 3.66.0软件对每一类目进行测量学检验,统计指标包括单维性检验、类目拟合度、个人和项目分离信度。结果:共58个心脏康复护理评估类目,包括“身体功能”(23个类目)、“身体结构”(2个类目)、“活动与参与”(17个类目)、“环境因素”(16个类目)4个维度。总类目的Cronbach’sα系数为0.879,各类目拟合度较高,各维度项目分离信度分别为0.95、0.96、0.91、0.94,与SF-36具有较高的同时效度。结论:冠心病心脏康复护理评估类目具有较好的心理测量学属性,可有效评价心脏康复患者的健康状况。展开更多
文摘目的运用Rasch分析检验Barthel指数在内科老年住院患者日常生活活动能力评估中的适用性。方法采用便利抽样法,选择在广州市某三级甲等医院住院治疗的老年患者190例进行Barthel指数评估,从信度、区分度、单维性、匹配度、条目难度、响应阈值有序性、条目功能差异等方面对评估结果进行Rasch分析。结果Barthel指数的受试者信度和条目信度分别为0.90和1.00,受试者区分度和条目区分度分别为3.08和16.19。残差主成分分析中第一维度解释了78.3%的变异,第二维度解释了5.1%的变异;除条目“平地行走”和“床椅转移”的加权拟合均方(Infit Mean square)>1.5外,其余条目均与Rasch模型拟合较好;“控制大便”和“控制小便”之间的残差相关系数>0.7。受试者能力(0.01±0.75Logit)与条目难度匹配可接受,仍有14.2%的受试者未被条目覆盖。条目难度排序为:洗澡>修饰>上下楼梯>如厕>穿衣>进食>控制小便>控制大便>平地行走>床椅转移。条目响应水平的阈值有序,但条目“上下楼梯”、“平地行走”和“床椅转移”中存在难度间距过小的响应水平(<1.4 Logit)。未检测到功能偏倚的条目。结论Barthel指数是一个信度和区分能力良好的单维性工具,但在评估老年住院患者日常生活活动能力时仍存在一定的局限性,活动相关条目与模型拟合欠佳,评估界限有待明晰;大、小便控制条目相互依赖性高,因此需谨慎解读内科老年住院患者的Barthel指数总分。
文摘Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.
基金教育部考试中心—英国文化教育协会2020年度英语测评科研课题资助:Issues of Assessing Senior High Schools'English Programs Based on China's Standard of English Language Ability from the Perspective of Curriculum Ideology,项目负责人:彭康洲。
文摘目的:旨在基于Rasch模型分析冠心病心脏康复护理相关《国际功能、残疾和健康分类》(Inter-national Classification of Functioning,Disability and Health,ICF)类目的测量学特征。方法:通过便利抽样选取100例冠心病心脏康复患者,对其采用冠心病心脏康复护理相关ICF类目和简明生活质量量表(the MOS 36-Item Short-Form Health Survey,SF-36)进行调查,运用Winsteps 3.66.0软件对每一类目进行测量学检验,统计指标包括单维性检验、类目拟合度、个人和项目分离信度。结果:共58个心脏康复护理评估类目,包括“身体功能”(23个类目)、“身体结构”(2个类目)、“活动与参与”(17个类目)、“环境因素”(16个类目)4个维度。总类目的Cronbach’sα系数为0.879,各类目拟合度较高,各维度项目分离信度分别为0.95、0.96、0.91、0.94,与SF-36具有较高的同时效度。结论:冠心病心脏康复护理评估类目具有较好的心理测量学属性,可有效评价心脏康复患者的健康状况。
