Preliminary development and validation of the jaw functional limitation scale
Preliminary development and validation of the jaw functional limitation scale
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DOI：
10.1111/j.1600-0528.2007.00397.x
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发表时间：
2008-06-01
影响因子：
2.3
通讯作者：
Dworkin, Samuel
中科院分区：
文献类型：
--
作者：
Ohrbach, Richard;Granger, Carl;Dworkin, Samuel
目的：功能限制是一个不同于残疾的结构，但这些结构之间的区别往往是模糊的，因为测量工具，包括有关机械下颌功能，下颌功能，具有明显的社会影响，只有社会功能的项目重叠测量下颌状态。我们描述的分析，以支持评估功能的限制，不同的残疾，通过使用因素分析和Rasch测量模型在重新分析现有的两个工具，然后创建一个初步版本的新的工具，具有良好的心理测量特性。研究设计和设置：来自两所大学的三项独立研究中的受试者完成了两项现有的自我报告工具（颞下颌关节紊乱病研究诊断标准和下颌关节功能障碍问卷）。在这些分析中使用了Rasch方法，因子分析，以及两者的结合。还评估了支持评估单个结构的工具的一维性。结果如下：在现有的工具中发现的问题，包括规模，内部信度，长度，一维性，和内容效度;初步版本的颌骨功能限制量表（JFLS）解决了这些问题的关键划定功能限制，它表现出的内部信度系数为0.82的人和0.99的项目。结构效度，通过收敛和判别效度与其他相关的结构，JFLS建立通过低相关性与抑郁，焦虑，躯体化，疼痛干扰，无痛开放，触诊敏感性，并通过中度相关性与疼痛和下颌症状。结论：虽然进一步发展的领域进行了概述，我们的结论是，这个初步版本的JFLS是一个有效的工具，用于测量颞下颌关节紊乱病（TMD）相关的功能限制，因此划定功能限制残疾。
Objective: Functional limitation is a construct distinct from disability, but the distinction between these constructs is often blurred when measuring jaw status because of content overlap in measurement instruments that include items pertaining to mechanical jaw functions, jaw functions that have obvious social implications, and only social functions. We describe analyses in support of assessing functional limitation as distinct from disability by using both factor analysis and the Rasch measurement model in reanalyzing two existing instruments and then create a preliminary version of a new instrument that has excellent psychometric properties. Study Design and Setting: Subjects in three separate studies from two university settings completed two existing self-report instruments ( Research Diagnostic Criteria for Temporomandibular Disorders and Mandibular Functional Impairment Questionnaire). Rasch methodology, factor analysis, and the combination of both were used in these analyses. Unidimensionality, in support of an instrument assessing a single construct, was also assessed. Results: Problems identified in the existing instruments included scaling, internal reliability, length, unidimensionality, and content validity; the preliminary version of the Jaw Functional Limitation Scale (JFLS) resolves these problems critical to delineating functional limitation and it exhibits internal reliability coefficients of 0.82 for persons and 0.99 for items. Construct validity, via convergent and discriminant validity with other associated constructs, of the JFLS was established via low correlations with depression, anxiety, somatization, pain interference, pain-free opening, and palpation sensitivity, and via moderate correlations with pain and jaw symptoms. Conclusion: While areas of further development are outlined, we conclude that this preliminary version of the JFLS is a valid instrument for the measurement of temporomandibular disorder (TMD)-related functional limitation, and consequently delineates functional limitation from disability.