三層面巴氏量表(The Barthel Index-based
Supplementary Scales, BI-SSs)主要以原始BI為藍圖，除原評量之平常表現外，並加入評量個案自覺困難程度(self-perceived difficulty)及執行能力(ability)兩層面，評估內容涵蓋完整ADL功能層面。以期提供臨床及研究人員充分掌握個案問題進而協助擬定復健治療計畫。
BI-SS之臨床與學術價值大致舉例如下:
1. The Self-perceived Difficulty Scale and the Ability Scale
differ in concept and clinical utility. The Self-perceived Difficulty Scale
assesses a patient’s level of difficulty in performing ADL. The results of the
Self-perceived Difficulty Scale can help identify patients’ needs for
assistance on the basis of patients’ reports.
The Ability
Scale assesses a patient’s ability to execute an ADL in a standardized context
with standardized equipment. Assessing ADL ability provides concrete/objective
information about each ADL task that an individual is physically capable (or
incapable) of doing.
To capture all
aspects of ADL functions, the inclusion of subjective as well as objectives
(e.g., the Self-perceived Difficulty Scale and Ability Scale) are necessary as
they could help clinicians to better target interventions and the outcomes of
patient care.
2. The BI-SS is concise and quick to administer. The Self-perceived Difficulty
Scale consisted of 10 items, and the Ability Scale contained only 8 items. The
total time for completing both scales was appropriately 15 minutes. A short and
quick-to-complete measure can lessen burdens on patients and clinicians, which
is an especially important consideration for patients having severe disability.
Therefore, the BI-SS appears useful in improving practice and enhancing the efficiency
of administration.
3. It is strongly suggested that the BI-SS, which adopted
the items from the original BI, be
used in conjunction with the original BI to facilitate comparison and
comprehensively obtain every aspect of patients’ ADL functions. The Stroke Impact Scale-16
and the Physical Self-Maintenance Scale assess the constructs of
self-perceived difficulty and ability, respectively. However, it is ideal to
use the same items to assess a patient’s actual performance along with
self-perceived difficulty and ability because this makes comparison of these
three ADL functions of patients much more straightforward. The resulting
information could be useful for clinical reasoning and patient management,
which may result in better treatment outcomes. In addition, using the BI-SS and
the BI together can provide comprehensive (including different aspects of ADL
functions) information that is useful for researchers in examining the impacts
of stroke.
相關論文:
Hsieh CL, Hoffmann T, Gustafsson L, Lee YC (2012). The
diverse constructs use of activities of daily living measures in stroke randomized
controlled trials in the years 2005-2009. J Rehabil Med 44: 720-726.
Lee
YC, Chen SS, Koh CL, Hsueh IP, Yao KP, Hsieh CL (2014). Development of two Barthel
Index –based Supplementary Scales for patients with stroke. PLOS ONE xxxxxx.
