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Originalarbeit

Generische und indikationsspezifische Messeigenschaften des IRES-24-Patientenfragebogen

Ein Vergleich der Skalenstruktur bei orthopädischen und neurologischen Rehabilitationspatientinnen und –patienten mittels Differential Item Functioning

Published Online:November 20, 2017https://doi.org/10.1026/0012-1924/a000193

Abstract

Zusammenfassung. Der Indikatoren des Reha-Status Patientenfragebogen (IRES-24) wird in der medizinischen Rehabilitation als Instrument zur Routinediagnostik der Dimensionen Funktionsfähigkeit im Alltag, Psychisches Befinden, Somatische Gesundheit und Schmerzen eingesetzt. Die generischen und indikationsspezifischen Messeigenschaften des IRES-24 Patientenfragebogen werden in einem Vergleich von Befragten aus der orthopädischen (N = 1 869; 37 % weiblich; MAlter = 50.3 Jahre) und der neurologischen Rehabilitation (N = 881; 49 % weiblich; MAlter = 64.6 Jahre) analysiert. Um Alters- und Geschlechtsverzerrungen zu vermeiden, wurden gematchte Stichproben gezogen (342 Befragte pro Gruppe; 55 % weiblich; MAlter = 51.6 bzw. 52.6 Jahre). Die Analyse erfolgte mittels des Differential Item Functioning auf Basis des ordinalen Rasch-Modells. Während Psychisches Befinden indikationsübergreifend testfair erfasst wird, indizieren einzelne Items der Skala Funktionsfähigkeit im Alltag und Schmerzen die jeweilige latente Merkmalsdimension unterschiedlich sensitiv. Bedeutsame Verletzungen der Homogenität der Skala Somatische Gesundheit, die durch die Erfassung unterschiedlicher Symptomkomplexe bedingt sind, müssen bei indikationsübergreifenden Anwendungen des IRES-24 berücksichtigt werden.


Generic and Indication Group-Specific Measurement Properties of the IRES-24 Patient Questionnaire: A Comparative Analysis of Scale Structures in Samples of Rehabilitation Patients With Musculoskeletal and Neurological Impairments by Means of Differential Item Functioning

Abstract. The Indicators of Rehabilitation Status questionnaire, IRES-24, is used in medical rehabilitation in Germany as a generic screening instrument to assess functionality in everyday life, subjective health, somatic health, and pain. The present study analyzed generic and indication-specific properties of the Rasch-based IRES-24 patient questionnaire in orthopedic and neurologic rehabilitation patients. Data from 1,869 orthopedic (37 % female; mean age = 50.3 years) and 881 neurologic patients (51 % male; mean age = 64.6 years) were analyzed using Rasch analysis and differential item functioning. To avoid age and gender biases, matched samples were drawn (342 patients in each group; 55 % female; mean age = 51.6 years and 52.6 years, respectively). The Subjective Health scale proved to be unbiased. Single items measuring functionality in everyday life and pain were differentially sensitive to underlying impairments. Because the Somatic Health scale assesses different symptom complexes, in cross-indication assessments substantially biasing violations of the homogeneity of the IRES-24 Somatic Health scale have to be considered.

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