Measuring residual limb health in persons with upper limb amputation: Modifications of the Prosthetic Evaluation Questionnaire residual limb health scale.
Measuring residual limb health in persons with upper limb amputation: Modifications of the Prosthetic Evaluation Questionnaire residual limb health scale.
复制标题
测量上肢截肢者的残肢健康：假肢评估问卷残肢健康量表的修改。
DOI：
10.1097/pxr.0000000000000227
复制
发表时间：
2023
影响因子：
1.5
通讯作者：
Ni,Pengsheng
中科院分区：
文献类型：
--
作者：
Resnik,Linda;Borgia,Matthew;Clark,MelissaA;Ni,Pengsheng
背景：考虑到残肢健康与假肢满意度之间的关系，评估残肢使用者对残肢健康问题的看法对截肢护理尤为重要。只有1项测量，假肢评估问卷（PEQ）的残肢健康量表已被验证用于下肢截肢，但未在上肢截肢者（ULA）中进行检查。目的：本研究的目的是在ULA患者样本中检验改良PEQ残肢健康量表的心理测量特性。研究设计：该研究对392名ULA患者进行了电话调查，并进行了40人的复测样本。方法：将PEQ项目反应量表改为李克特量表。在认知测试和先导测试中对项目集和说明进行了完善。描述性分析描述了残肢问题的普遍性。因子分析和Rasch分析评估了单维性、单调性、项目拟合、差异项目功能和可靠性。用类内相关系数评估重测信度。结果：排汗率为90.7%，假体气味率为72.5%；水泡/溃疡（12.1%）和毛发内生（7.7%）是最不常见的问题。为改善单调性，对3项的反应类别进行二分类和三分类。调整残差相关后，验证性因子分析显示可接受的拟合（比较拟合指数= 0.984，Tucker-Lewis指数= 0.970，均方根误差近似= 0.032）。个体信度为0.65。没有项目在年龄或性别上有中度到重度的项目功能差异。重测信度的类内相关系数为0.87 （95% CI, 0.76-0.93）。结论：改进后的量表具有良好的结构效度、一般的人信度、极好的重测信度，无地板效应和天花板效应。该秤推荐用于腕部脱臼、经桡骨截肢、肘部脱臼和肘部以上截肢的患者。
Background:Assessing the user perspective on residual limb health problems is particularly important for amputation care, given the relationship between residual limb health and prosthetic satisfaction. Only 1 measure, the Residual Limb Health scale of the Prosthetic Evaluation Questionnaire (PEQ) has been validated for use in lower limb amputation, but not examined in persons with upper limb amputation (ULA).Objectives:The objective of this study was to examine the psychometric properties of a modified PEQ Residual Limb Health scale in a sample of persons with ULA.Study design:The study involved a telephone survey of 392 prosthesis users with ULA, with a 40-person retest sample.Methods:The PEQ item response scale was modified to a Likert scale. The item set and instructions were refined in cognitive and pilot testing. Descriptive analyses characterized the prevalence of residual limb issues. Factor analyses and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning, and reliability. Test–retest reliability was assessed by an intraclass correlation coefficient.Results:Sweating and prosthesis odor were prevalent at 90.7% and 72.5%, respectively; blisters/sores (12.1%) and ingrown hairs (7.7%) were the least prevalent problems. Response categories were dichotomized for 3 items and trichotomized for 3 items to improve monotonicity. After adjusting for residual correlations, confirmatory factor analyses showed acceptable fit (comparative fit index= 0.984, Tucker–Lewis index= 0.970, and root mean square error approximation= 0.032). Person reliability was 0.65. No items had moderate-to-severe differential item functioning by age or sex. Intraclass correlation coefficient for test–retest reliability was 0.87 (95% CI, 0.76–0.93).Conclusions:The modified scale had excellent structural validity, fair person reliability, very good test–retest reliability, and no floor or ceiling effects. The scale is recommended for use with persons with wrist disarticulation, transradial amputation, elbow disarticulation, and above-elbow amputation.