Table_2_Validation of a Disability Assessment Tool Based on the International Classification of Functioning, Disability, and Health in the Chinese Context.DOCX

Background:The common standards of disability assessment for long-term care (LTC) insurance are currently absent. The International Classification of Functioning, Disability and Health (ICF) was designed for a better description of health and functioning, which could fill the demand gap for the standards of disability assessment and be a promising tool for the development of LTC insurance system.ObjectivesTo validate a disability assessment scale for disabled elderly individuals based on the ICF for LTC in the Chinese context.MethodsThe present study is a cross-sectional study. A disability assessment tool based on the ICF was developed by referring to other assessment tools and an expert consensus meeting in the initial phase of the study. The developed tool was used to evaluate 1,610 elderly individuals in the LTC institutions. The Cronbach's α coefficient and split-half reliability were applied to test the internal consistency of the tool, while the Interclass correlation coefficients (ICCs) were used to evaluate the interrater reliability (IRR). Factor analysis was performed to verify the construct validity of the tool. The scores from the Medical Outcomes Short Form-12 (SF-12) were correlated with that from the disability assessment tool, to assess the criterion-related validity.ResultsThe Cronbach's α coefficient and split-half reliability of the disability assessment tool were 0.969 and 0.877, respectively. The ICCs of the sum scale was 0.85, and the ICCs of each of the 20 items in the scale ranged from 0.78 to 0.94. The items were divided into three factors through analysis, which is consistent with the structure expectation. The scores of each item and the sum score of the disability assessment scale were negatively correlated with the scores of the physical and psychological fields in SF-12 (p < 0.001). Overall, the data indicated that the tool was characterized by good internal consistency, IRR, construct validity, and criterion-related validity.ConclusionsThe disability assessment tool based on the ICF is a reliable and valid tool for the collection of information on functioning across various LTC settings. The information of disability provided evidence for the distribution of LTC service and guided the development of LTC insurance standards.

背景：当前长期护理保险（LTC）的残疾评估标准尚不统一。国际功能、残疾与健康分类（ICF）旨在对健康和功能进行更精确的描述，填补了残疾评估标准的需求空白，并有望成为长期护理保险体系发展的有力工具。目标：在中文语境下，验证基于ICF的针对失能老年人的残疾评估量表。方法：本研究为横断面研究。在研究初期，参照其他评估工具并经专家共识会议，开发了一种基于ICF的残疾评估工具。该工具用于评估长期护理机构中的1,610名老年人。应用Cronbach's α系数和分半信度检验工具的内部一致性，同时使用组内相关系数（ICC）评估评定者间可靠性（IRR）。通过因子分析验证工具的构念效度。将医学结果简表-12（SF-12）的分数与残疾评估工具的分数相关联，以评估标准关联效度。结果：残疾评估工具的Cronbach's α系数和分半信度分别为0.969和0.877。总和量表的ICC为0.85，该量表20个条目的ICC值介于0.78至0.94之间。分析结果表明，条目可分为三个因素，与结构预期一致。每个条目和残疾评估量表的总分与SF-12的生理和心理领域的得分呈负相关（p < 0.001）。总体而言，数据表明该工具具有良好的一致性、可靠性、构念效度和标准关联效度。结论：基于ICF的残疾评估工具是长期护理不同场景下收集功能信息的可靠且有效的工具。提供的残疾信息为长期护理服务的分配提供了证据，并指导了长期护理保险标准的制定。