Kessler Foundation Neglect Assessment Process uniquely measures spatial neglect during activities of daily living.
Kessler Foundation Neglect Assessment Process uniquely measures spatial neglect during activities of daily living.
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DOI：
10.1016/j.apmr.2014.10.023
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发表时间：
2015-05
影响因子：
4.3
通讯作者：
Barrett AM
中科院分区：
文献类型：
--
作者：
Chen P;Chen CC;Hreha K;Goedert KM;Barrett AM
探讨Kessler基金会忽视评估过程（KF-NAP）的因子结构，评价脑卒中幸存者空间忽视的发生率及临床意义。《盗梦空间》队列。住院康复设施（IRF）121名首次中风单侧脑损伤的参与者在进入IRF的72小时内接受评估，108名在IRF出院前的72小时内再次接受评估。常规和标准的IRF护理。在每次评估期间，职业治疗师使用KF-NAP、功能独立性测量（FIM™）和Barthel指数（BI）测量患者的功能。KF-NAP具有良好的内部一致性和单因素结构。探索性因子分析显示，尽管三个量表都是相关的，但KF-NAP在FIM和BI中都是独一无二的。入院时67.8%的参与者和出院时47.2%的参与者表现出空间忽视的症状（KF-NAP >）。在IRF入院时表现出紊乱的参与者比没有症状的参与者住院时间更长。在有症状的患者中，回归分析显示，在控制了年龄、入院时的FIM和住院时间后，入院时的KF-NAP评分负向预测出院时的FIM评分。KF-NAP通过测量FIM或BI未捕捉到的功能困难，独特地量化了空间忽视的症状。使用KF-NAP测量空间忽视，我们发现这种障碍在住院康复后持续存在，并重复了先前的研究结果，即即使在延长的IRF治疗后，空间忽视也会对康复结果产生不利影响。
To explore the factor structure of the Kessler Foundation Neglect Assessment Process (KF-NAP), and evaluate the prevalence and clinical significance of spatial neglect among stroke survivors. Inception cohort. Inpatient rehabilitation facility (IRF). 121 participants with unilateral brain damage from their first stroke were assessed within 72 hours of admission to an IRF, and 108 were assessed again within 72 hours before IRF discharge. Usual and standard IRF care. During each assessment session, occupational therapists measured patients’ functions with the KF-NAP, Functional Independence Measure (FIM™) and Barthel Index (BI). The KF-NAP showed excellent internal consistency with a single-factor structure. The exploratory factor analysis revealed the KF-NAP to be unique from both the FIM and BI even though all three scales were correlated. 67.8% of the participants at admission and 47.2% at discharge presented with symptoms of spatial neglect (KF-NAP > 0). Participants showing the disorder at IRF admission were hospitalized longer than those showing no symptoms. Among those presenting with symptoms, the regression analysis showed that the KF-NAP scores at admission negatively predicted FIM scores at discharge, after controlling for age, FIM at admission, and length of stay. The KF-NAP uniquely quantifies symptoms of spatial neglect by measuring functional difficulties that are not captured by the FIM or BI. Using the KF-NAP to measure spatial neglect, we found the disorder persistent after inpatient rehabilitation, and replicated previous findings showing that spatial neglect adversely affects rehabilitation outcome even after prolonged IRF care.