A Psychosocial Adjustment Measure for Persons With Upper Limb Amputation.
A Psychosocial Adjustment Measure for Persons With Upper Limb Amputation.
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DOI：
10.33137/cpoj.v5i1.37873
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Clark, M A
中科院分区：
文献类型：
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作者：
Resnik, L J;Ni, P;Borgia, M L;Clark, M A
测量上肢截肢后的心理社会调整可能有助于确定哪些人可能从心理治疗和/或支持团体等干预措施中受益。然而，现有的肢体丧失后心理社会调整措施目前仅适用于假肢使用者。建立一个可以由个人完成的，无论是否使用假肢的患者的心理社会调整措施。我们修改了现有的Trinity截肢和假体经验调查（TAPES）措施的项目，并生成了与未使用假体的人相关的新项目。项目内容通过认知访谈和试点测试进行了完善。对727名严重抑郁症患者（63.6%为男性，平均年龄54.4岁）进行了电话调查。在探索性和验证性因素分析（EFA和CFA）后，Rasch分析用于评估反应类别，项目拟合和差异项目功能（DIF）。项目-人的地图，分数分布，和个人和项目的可靠性进行了检查。在50人的子样本中评估了重测信度。EFA和CFA表明一个双因素的解决方案。Rasch分析得出7项限制调整子量表（CFI=0.96，TLI=0.95，RMSEA=0.128）和9项工作和独立子量表（CFI=0.935，TLI=0.913，RMSEA=0.193）。调整限制子量表的Cronbach α和ICC分别为0.82和0.63，工作和独立子量表分别为0.90和0.80。本研究编制了截肢心理社会适应量表，包括两个分量表：1）限制适应和2）工作与独立。该测量具有良好的结构效度，良好的个人和项目的信度，和中度到良好的重测信度。
Measurement of psychosocial adjustment after upper limb amputation (ULA) could be helpful in identifying persons who may benefit from interventions, such as psychotherapy and/or support groups. However, available measures of psychosocial adjustment after limb loss are currently designed for prosthetic users only. To create a measure of psychosocial adjustment for persons with ULA that could be completed by individuals regardless of whether a prosthesis is use. We modified items from an existing Trinity Amputation and Prosthesis Experience Survey (TAPES) measure and generated new items pertinent to persons who did not use a prosthesis. Item content was refined through cognitive interviewing and pilot testing. A telephone survey of 727 persons with major ULA (63.6% male, mean age of 54.4) was conducted after pilot-testing. After exploratory and confirmatory factor analyses (EFA and CFA), Rasch analyses were used to evaluate response categories, item fit and differential item functioning (DIF). Item-person maps, score distributions, and person and item reliability were examined. Test-retest reliability was evaluated in a 50-person subsample. EFA and CFA indicated a two-factor solution. Rasch analyses resulted in a 7-item Adjustment to Limitation subscale (CFI=0.96, TLI=0.95, RMSEA=0.128) and a 9-item Work and Independence subscale (CFI=0.935, TLI=0.913, RMSEA=0.193). Cronbach alpha and ICC were 0.82 and 0.63 for the Adjustment to Limitation subscale and 0.90 and 0.80 for the Work and Independence subscale, respectively. This study developed the Psychosocial Adjustment to Amputation measure, which contains two subscales: 1) Adjustment to Limitation and 2) Work and Independence. The measure has sound structural validity, good person and item reliability, and moderate to good test-retest reliability.