BAKIMVEREN FONKSİYONEL KULLANIM ANKETİNİN TÜRKÇE VERSİYONUNUN GEÇERLİK VE GÜVENİRLİĞİ

Öz

Amaç: Zayıf bilateral performans unilateral etkilenimi olan serebral palsili (SP) çocuklarda önemli bir fonksiyonel limitasyondur. Bu çalışma, unilateral SP tanılı çocukların el fonksiyonlarını değerlendiren Caregiver Functional Use Survey (CFUS) Türkçe versiyonunun geçerlik ve güvenirliğini değerlendirmek amacıyla yapıldı. Yöntem: Unilateral SP'li 50 çocuk ve ebeveynleri çalışmaya dahil edildi. Test-tekrar test güvenirliği, sınıf içi korelasyon katsayısı (ICC) ile; iç tutarlılık ise, Cronbach alfa değeri hesaplanarak değerlendirildi. Dış yapı geçerliğini belirlemek için Jebsen Taylor El Fonksiyon Testi (JTT) ve Manuel Yetenek Sınıflandırma Sistemi (MACS) ile CFUS'un Türkçe versiyonu arasındaki ilişki incelendi. Faktör analizi ile CFUS un tek boyutlu olduğu doğrulandı. Faktör analizleri, unimanuel ve bimanuel görevler için CFUS’un “kullanım miktarı” ve “hareket kalitesi” bölümlerinin tek boyutlu yapısını incelemek için kullanıldı. Sonuçlar: CFUS'un Türkçe versiyonu yüksek derecede iç tutarlılık gösterdi (Cronbach  =0,92– 0,94). ICC değerlerinin 0,90 ile 0,93 arasında değiştiği bulundu. Tüm CFUS ve MACS ve JTT alt ölçekleri arasında negatif korelasyon vardı (p<0,05). Tartışma: Unilateral SP'li çocuklarda üst ekstremite fonksiyonlarının değerlendirilmesinde CFUS'un Türkçe versiyonunun geçerli ve güvenilir bir araç olduğu sonucuna varıldı.

Anahtar Kelimeler

• Serebral Palsi
• Anket
• Bakımveren

RELIABILITY AND VALIDITY OF THE TURKISH VERSION OF THE CAREGIVER FUNCTIONAL USE SURVEY

Abstract

Purpose: Poor bimanual performance is usually a major functional impairment for children with unilateral cerebral palsy (CP). This study was performed to examine the reliability and validity of the Turkish version of the Caregiver Functional Use Survey (CFUS), which assesses manual function of children with unilateral CP.
Methods: Fifty children with unilateral CP and their parents were included in the study. The test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC), and internal consistency by calculating Cronbach alpha values. Association level between other outcomes measures (Jebsen Taylor Hand Function Test, JTT, and Manual Ability Classification System, MACS) and the Turkish version of the CFUS was analyzed to determine the criterion validity. Four onefactorial confirmatory factor analyses to validate uni-dimensionality of the CFUS were performed. Confirmatory factor analyses confirmed the one-dimensional structure of the “amount of use” and
“quality of movement” parts of the CFUS for unimanual and bimanual tasks.
Results: The Turkish version of the CFUS showed a high degree of internal consistency (Cronbach alpha=0.92-0.94). The ICCs ranged between 0.90 and 0.93. There was a negative correlation between all the subscales of the CFUS and the MACS and the JTT (p<0.05).
Conclusion: The Turkish version of CFUS is a reliable and valid tool for assessing the upper extremity functions in children with unilateral CP.

Keywords

• Cerebral Palsy
• Questionnaires
• Caregivers

References

1. 1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109(suppl 109):8-14.
2. 2. Sakzewski L, Ziviani J, Boyd RN. Efficacy of upper limb therapies for unilateral cerebral palsy: a meta-analysis. Pediatrics. 2014;133(1):e175-e204.
3. 3. Gordon AM. To constrain or not to constrain, and other stories of intensive upper extremity training for children with unilateral cerebral palsy. Developmental medicine & child neurology. 2011;53:56-61.
4. 4. Uvebrant P. Hemiplegic cerebral palsy aetiology and outcome. Acta Paediatrica. 1988;77(s345):1-100.
5. 5. Klingels K, Demeyere I, Jaspers E, De Cock P, Molenaers G, Boyd R, et al. Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy. European Journal of Paediatric Neurology. 2012;16(5):475-84.
6. 6. Gordon AM, Schneider JA, Chinnan A, Charles JR. Efficacy of a hand–arm bimanual intensive therapy (HABIT) in children with hemiplegic cerebral palsy: a randomized control trial. Developmental Medicine & Child Neurology. 2007;49(11):830-8.
7. 7. Klingels K, Jaspers E, Van de Winckel A, De Cock P, Molenaers G, Feys H. A systematic review of arm activity measures for children with hemiplegic cerebral palsy. Clinical rehabilitation. 2010;24(10):887-900.
8. 8. Randall M, Johnson L, Reddihough DS. The Melbourne assessment of unilateral upper limb function: Occupational Therapy Department, Royal Children's Hospital, Melbourne; 1999.

9. 9. Davids JR, Peace LC, Wagner LV, Gidewall MA, Blackhurst DW, Roberson WM. Validation of the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) for children with hemiplegic cerebral palsy. JBJS. 2006;88(2):326-33.
10. 10. Bruininks RH. Bruininks-Oseretsky test of motor proficiency: AGS Publishing Circle Pines, MN; 2005.
11. 11. Charles JR, Wolf SL, Schneider JA, Gordon AM. Efficacy of a child-friendly form of constraint-induced movement therapy in hemiplegic cerebral palsy: a randomized control trial. Developmental medicine and child neurology. 2006;48(8):635-42.
12. 12. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-91.
13. 13. Jebsen RH. An objective and standardized test of hand function. Arch Phys Med Rehabil. 1969;50(6):311-9.
14. 14. Hung Y-C, Charles J, Gordon AM. Bimanual coordination during a goal-directed task in children with hemiplegic cerebral palsy. Developmental Medicine and Child Neurology. 2004;46(11):746-53.
15. 15. Eliasson A-C, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall A-M, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental medicine and child neurology. 2006;48(7):549-54.
16. 16. Akpinar P, Tezel CG, Eliasson A-C, Icagasioglu A. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disability and rehabilitation. 2010;32(23):1910-6.
17. 17. Muthén L, Muthén B. Mplus User’s Guide 5th ed. Los Angeles: CA; 1998-2007. 2011.
18. 18. Pai AL, Mullins LL, Drotar D, Burant C, Wagner J, Chaney JM. Exploratory and confirmatory factor analysis of the child uncertainty in illness scale among children with chronic illness. Journal of Pediatric Psychology. 2006;32(3):288-96.
19. 19. Cronbach LJ. Coefficient alpha and the internal structure of tests. psychometrika. 1951;16(3):297-334.
20. 20. ATEŞ C, ÖZTUNA D, GENÇ Y. Sağlık araştırmalarında sınıf içi korelasyon katsayısının kullanımı. Turkiye Klinikleri Journal of Biostatistics. 2009;1(2):59-64.
21. 21. Cook KF, Kallen MA, Amtmann D. Having a fit: impact of number of items and distribution of data on traditional criteria for assessing IRT’s unidimensionality assumption. Quality of Life Research. 2009;18(4):447-60.
22. 22. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. Journal of clinical epidemiology. 2007;60(1):34-42.
23. 23. Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use: Oxford University Press, USA; 2015.
24. 24. Nunnally J, Bernstein I. Psychometric Theory 3rd edition (MacGraw-Hill, New York). 1994.
25. 25. Marx RG, Menezes A, Horovitz L, Jones EC, Warren RF. A comparison of two time intervals for test-retest reliability of health status instruments. Journal of clinical epidemiology. 2003;56(8):730-5.