목적 : 문항반응이론에 기초한 Rasch모형을 적용하여 뇌졸중 입원환자의 일상생활수행 평가도구를 개발하는 것이다.
연구방법 : 2002년 8월 5일부터 2005년 4월 20일까지 전국 18개 재활기관에서 뇌졸중 입원환자 308명을 대상으로,작업치료사가 평가한 6개 영역의 23개 항목으로 구성된 설문지 결과를 수집하여 Winsteps 프로그램으로 라쉬분석하였다.
결과 : 3개 항목이 부적합한 항목으로 판정되었으며,남은 20개 항목의 난이도 순서를 배열하였다.뇌졸중 입원환자의 일상생활 수행능력은 -6.77~6.73 로짓으로 표시할 수 있으며,표준화점수로 표시하기 위한 변환식은 "점수 =(로짓점+6.77)/ (6.77+6.73) 100" 이었다.평가항목의 난이도는 가장 어려운 항목은 보행영역의 ‘계단 오르내리기’ 항목이었으며,가장 쉬운 항목은 식사하기 영역의 ‘음료 마시기’ 항목 이었다.
결론 : 라쉬분석을 이용한 뇌졸중 입원환자의 일상생활수행 항목의 적합도와 난이도에 관한 결과제시로 개발되었으며,신뢰도와 타당도가 입증된 객관적인 평가도구이다.
Objective : To develop the Korean Activities of Daily Living (ADL) evaluation tools for persons with stroke applying the Rasch model based on item response theory. Methods : The total subjects for this study were 308 stroke inpatients at 18 different rehabilitation facilities in Korea. Questionnaires containing ADL evaluation items selected in advance with the Q-sorting method from the preexisting ADL related literatures were distributed to the subjects by mail or visit. Rasch analy- sis was then done by means of the Winsteps program to determine the validity and reliability of the Korean ADL evaluation tools for persons with stroke.
Results : Three items were found to be misfits and the order of item difficulty of the remaining 20 items was arranged. Stroke inpatients' ADL ability is indicated by -6.77~6.73 logit, and the transformation formula is "score= (logit score +6.77) / (6.77+6.73)×100.'' In the order of difficulty of evaluation items, the most difficult item was 'going up and down stairs' one of functional mobility domain. And the easiest item was 'scooping food to mouth' one of feeding domain.
Conclusion : The Korean ADL evaluation tools for persons with stroke inpatient have been proven reliable and valid. Therefore they are expected to he used as effective tools for treatment planning and intervention for persons with stroke.