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Die zunehmende Zahl an Asyl und Schutz suchenden Menschen in Europa und die damit einhergehenden dramatischen Fluchtverläufe mit vielen Todesopfern haben Flucht zu einem Thema gemacht, das eine außerordentliche öffentliche Aufmerksamkeit erlangt hat und gleichzeitig enorm polarisiert und polarisierend verhandelt wird. Besonders auffällig ist die personale Verbindung von Flucht und Flüchtlingen, deren Kategorisierung und Zuschreibung ein wesentliches Merkmal der aktuellen Debatten ist: Geschlecht, Alter, Fluchtgründe und Herkunftsländer sind Merkmale, anhand derer diese Kategorisierung vorgenommen wird und die sowohl faktische Folgen auf das Aufenthaltsrecht haben (vgl. Wild 2010), als auch symbolisch mit Bewertungen und Verwertungslogiken verknüpft sind. Der folgende Artikel geht solchen Kategorisierungen anhand des Merkmals Geschlecht diskursanalytisch nach. Die Analyse bezieht sich auf den aktuellen öffentlich-medialen Diskurs zum Thema Flüchtlinge, in dem - so unsere These - bestimmte geschlechtsspezifische Stereotypisierungen hervor gebracht und essentialisiert werden.
„Hier wie da wird geliebt“: Liebe als universales Phänomen in Verhandlungen zum Familienrecht
(2016)
Obwohl Liebe eines der zentralen Begründungsmotive dauerhafter Paarbeziehungen darstellt, wird der Begriff im deutschen Familienrecht mit Bezug auf die Ehe oder die eingetragene Lebenspartnerschaft nicht genannt. Davon ausgehend, dass in politischen Verhandlungen über Gesetzesänderungen eine Übersetzung gesellschaftlicher Realität in juristische Normen stattfindet, geht der Beitrag der folgenden Frage nach: Wie und wann sprechen Bundestagsabgeordnete von Liebe, wenn im Rahmen familienrechtlicher Reformen über Beziehungen zwischen hetero- und homosexuellen Paaren verhandelt wird? Das Material zeigt eine Spaltung zwischen einer Zuschreibung der Berechtigung von Liebe, die entweder mit sakralen Motiven in Verbindung gebracht wird, oder, wenn sie als unberechtigt gilt, als sexualisiertes Begehren abgewertet wird. Es ist außerdem darstellbar, dass eine universale Zuschreibung von Liebe bei hetero- und homosexuellen Paaren stattfindet, was allerdings wesentlich mit der Bereitschaft zur lebenslangen Unterhaltsverpflichtung zusammenhängt.
Objective: The aims of this study were to evaluate the feasibility of using the International Classification of Functioning, Disability and Health (ICF) Generic Set in routine clinical practice, and of creating a functioning score based on it, and, subsequently, to examine its sensitivity to change.
Methods: In this prospective cohort study, data from 761 adult inpatients from 21 Chinese hospitals were analysed. Each patient was assessed at admission and discharge. Feasibility was evaluated by analysing mean assessment time. The Rasch model was used to create a metric of functioning. Sensitivity to change was analysed with mixed-effects regression and by calculating standardized effect size based on Cohen's f2.
Results: Mean duration of assessment was 5.3 min, with a significant decrease between admission and discharge. After removal of the item remunerative employment, the remaining ICF Generic Set categories fitted the Rasch model well. With a mean improvement in functioning of 12.1 (95% confidence interval (95% CI): 11.5–12.6), this metric proved sensitive to change, both in terms of statistical significance (p < 0.001) and standardized effect size (Cohen's f2 = 2.35).
Discussion: The ICF Generic Set is feasible for use in routine clinical practice and is promising to serve as the basis for the development of a functioning score that is sensitive to change.
Objective
Our aim was to specify the requirements of an architecture to serve as the foundation for standardized reporting of health information and to provide an exemplary application of this architecture.
Methods
The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) served as the conceptual framework. Methods to establish content comparability were the ICF Linking Rules. The Rasch measurement model, as a special case of additive conjoint measurement, which satisfies the required criteria for fundamental measurement, allowed for the development of a common metric foundation for measurement unit conversion. Secondary analysis of data from the North Yorkshire Survey was used to illustrate these methods. Patients completed three instruments and the items were linked to the ICF. The Rasch measurement model was applied, first to each scale, and then to items across scales which were linked to a common domain.
Results
Based on the linking of items to the ICF, the majority of items were grouped into two domains, Mobility and Self-care. Analysis of the individual scales and of items linked to a common domain across scales satisfied the requirements of the Rasch measurement model. The measurement unit conversion between items from the three instruments linked to the Mobility and Self-care domains, respectively, was demonstrated.
Conclusions
The realization of an ICF-based architecture for information on patients’ functioning enables harmonization of health information while allowing clinicians and researchers to continue using their existing instruments. This architecture will facilitate access to comprehensive and consistently reported health information to serve as the foundation for informed decision-making.
Objective
Functioning is an important outcome in hand osteoarthritis (OA). The heterogeneity of patient‐reported outcome measures (PROMs) available challenges the direct comparability of information collected by these instruments. This study aimed to examine whether it is possible to achieve metric equivalence of PROMs commonly used to measure functioning in people with hand OA.
Methods
A secondary analysis of data from 253 persons who participated in the Vienna Hand Osteoarthritis Cohort Study was conducted applying the Rasch measurement model. Participants completed the Health Assessment Questionnaire, the Australian/Canadian Index for Hand Osteoarthritis, the Functional Index for Hand Osteoarthritis (FIHOA), and the Cochin Scale. The assumptions of stochastic ordering, local independence, unidimensionality, and invariance were tested for each scale independently before the scales were co‐calibrated onto a common metric.
Results
Except for the FIHOA, all measures indicated issues of local dependency in the initial analyses. After accommodating those with testlets, all scales satisfied the assumptions of the Rasch model (χ2 > 0.05). Marginal misfit in 2 items was found in the FIHOA, but this did not disturb person estimates. As the 4 scales form a common metric that satisfies the assumptions of the Rasch model, the scores can be equated.
Conclusion
The scores of the 4 hand function measures can be transformed to a common 0–100 metric, such that scores can be interchanged. A user‐friendly transformation table enables clinicians and researchers to have access to the common metric by simply adding up the total score for each instrument and identifying the corresponding transformed score on the common metric.
Objective: A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study.
Methods: A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive.
Results: The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C.
Discussion: This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care.
Metric properties of the Spinal Cord Independence Measure - Self Report in a community survey
(2016)
Objective: The Spinal Cord Independence Measure – Self Report (SCIM-SR) is a self-report instrument for assessing functional independence of persons with spinal cord injury. This study examined the internal construct validity and reliability of the SCIM-SR, when administered in a community survey, using the Rasch measurement model.
Methods: Rasch analysis of data from 1,549 individuals with spinal cord injury who completed the SCIM-SR.
Results: In the initial analysis no fit to the Rasch model was achieved. Items were grouped into testlets to accommodate the substantial local dependency. Due to the differential item functioning for lesion level and degree, spinal cord injury-specific sub-group analyses were conducted. Fit to the Rasch model was then achieved for individuals with tetraplegia and complete paraplegia, but not for those with incomplete paraplegia. Comparability of ability estimates across sub-groups was attained by anchoring all sub-groups on a testlet.
Conclusion: The SCIM-SR violates certain assumptions of the Rasch measurement model, as shown by the local dependency and differential item functioning. However, an intermediate solution to achieve fit in 3 out of 4 spinal cord injury sub-groups was found. For the time being, therefore, it advisable to use this approach to compute Rasch-transformed SCIM-SR scores.