DEVELOPMENT AND TESTING OF IMPROVED MEASURES OF FUNCTION AND DISABILITY

身体功能障碍表现为不能 日常生活中的日常活动是一个严重的问题 上了年纪的人。虽然已经对以下措施给予了相当的关注 身体机能用于基于人口的残疾估计， 已经完成了有限的工作来开发一种灵敏的测量方法 对特定干预措施作出反应的变化。此外，没有电流 身体功能的测量利用残疾框架作为 用于评估物理功能域中的变化的概念模型。 本研究的具体目的是：(1)使用残疾框架 开发一种响应性措施，用于评估 旨在改善身体机能的干预措施：(A) 为残疾框架的两个级别建立项目比额表 (B)评估其比额表 属性；(2)估计评分者内部信度、重测信度和 肢体残障工具的内部一致性，(3)评估 文书在以下方面的有效性：(A)已知群体 比较，(B)身体机能的现有衡量标准，(C)预测 功能受限与残疾之间的关系，以及(4) 确定文书在以下方面的响应性：(A) 比较工具，以及(B)实物的独立评级 答辩人的职能改变和(C)案件管理人或照顾者。 这项研究的最终成果将是一个概念上扎根的、响应性的 可用于评估临床试验疗效的仪器 旨在最大限度地减少功能限制和 残疾。这项措施的制定将基于来自以下方面的投入 专家和消费者并在概念框架内构建 致残的过程。该仪器将进行现场测试和样品测试 代表社区健康、社区虚弱和身体康复 人口。在残障框架内建立仪器 提供的优点是通过以下方式描述物理功能的变化 概念模型的方法，该概念模型假设 导致身体残疾的因素。

Difficulties with physical functioning represented by the inability to perform routine activities of daily living are a serious problem among older adults. While considerable attention has been given to measures of the physical functioning for population-based estimates of disability, limited work has been accomplished to develop a measure that is sensitive to changes in response to specific interventions. Furthermore, no current measure of physical functioning has utilized the disablement framework as a conceptual model for evaluating changes in the physical function domain. The Specific Aims of this study are to: (1) use he disablement framework to develop a responsive measure for use in evaluating the efficiency of interventions directed toward improving physical functioning by: (a) building item scales for two levels of the disablement framework (functional limitations and disability) and (b) evaluating their scale properties; (2) estimate the intra-rater, test-retest reliability and internal consistency of the physical disablement instrument, (3) assess the validity of the instrument in relation to: (a) known-group comparisons, (b) existing measures of physical functioning, (c) predicted relationships between functional limitations and disability, and (4) determine the responsiveness of the instrument in relation to: (a) comparative instruments, and (b) independent ratings of physical functioning changes by the respondent and (c) case managers or caregivers. The final product of the study will be a conceptually grounded, responsive instrument that can be used to assess the efficacy of clinical trials directed towards minimizing the effects of functional limitations and disability. The development of this measure will be based on input from experts and consumers and constructed within the conceptual framework of the disablement process. The instrument will be field-tested with samples representing community-well community-frail and physical rehabilitation populations. Building the instrument within the disablement framework offers the advantage of describing changes in physical functioning by means of a conceptual model that hypothesizes interrelationships among factors that lead to physical disability.