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：长期护理保险（LTC）在残疾评估方面的通用标准目前尚付阙如。国际功能、残疾与健康分类（ICF）旨在对健康与功能进行更为详尽的描述，因而能够填补残疾评估标准之需求缺口，并有望成为长期护理保险体系构建之有力工具。目标：本研究旨在验证基于ICF的残疾评估量表在中国长期护理环境中的应用。方法：本研究为横断面研究。在研究初期，通过参考其他评估工具并举行专家共识会议，开发了一套基于ICF的残疾评估工具。该工具被用于评估1,610名长期护理机构的老年个体。采用Cronbach's α系数和分半信度检验工具的内部一致性，而采用组内相关系数（ICC）评估评分者间可靠性（IRR）。通过因子分析验证工具的结构效度。将医疗结果简明问卷-12（SF-12）的得分与残疾评估工具的得分进行相关性分析，以评估其标准关联效度。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。总量表及量表中20个项目的ICC分别为0.85和0.78至0.94之间。通过分析，项目被划分为三个因素，与结构预期一致。每个项目的得分以及残疾评估量表的总分均与SF-12中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内部一致性、评分者间可靠性、结构效度和标准关联效度。结论：基于ICF的残疾评估工具是收集跨各种长期护理环境中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。