applied cognition vs. functional cognition vs. everyday cognition

* Applied cognition是由Dr. Coster的團隊在2004年提出，在AM-PAC發展之後，發現其實日常生活功能活動的評估項目可分成與動作及與認知相關的項目，原本的評估就是電腦適性測驗。

Coster, W. J., Haley, S. M., Ludlow, L. H., Andres, P. L., & Ni, P. S. (2004). Development of an applied cognition scale to measure rehabilitation outcomes. Arch Phys Med Rehabil, 85(12), 2030-2035.

* Functional cognition 是由 Dr. Donovan的團隊提出，在2008年和2011年分別提出針對中風和腦外傷個案認知損傷所需，與日常生活相關的認知功能評量層面，都是以發展電腦適性測驗為目標。

Donovan, N. J., Kendall, D. L., Heaton, S. C., Kwon, S., Velozo, C. A., & Duncan, P. W. (2008). Conceptualizing functional cognition in stroke. Neurorehabil Neural Repair, 22(2), 122-135. doi: 10.1177/1545968307306239

Donovan,N. J., Heaton, S. C., Kimberg, C. I., Wen, P. S., Waid-Ebbs, J. K., Coster, W.,. . . Velozo, C. A. (2011). Conceptualizing functional cognition in traumaticbrain injury rehabilitation. Brain Inj,25(4), 348-364. doi: 10.3109/02699052.2011.556105

* Everyday cognition是由Dr. Farias的團隊在2008年提出，針對老人認知功能下降可能對日常生活造成影響而設計了與日常生活相關的認知評量項目，以CFA確認了7個層面(Everyday memory, Language, Visuospatial abilities, Planning, Organization, and Divided attention)。2011年將原本的問卷發展了短版。

Farias,S. T., Mungas, D., Reed, B. R., Cahn-Weiner, D., Jagust, W., Baynes, K., &Decarli, C. (2008). The measurement of everyday cognition (ECog): scaledevelopment and psychometric properties. Neuropsychology,22(4), 531-544. doi: 10.1037/0894-4105.22.4.531

TomaszewskiFarias, S., Mungas, D., Harvey, D. J., Simmons, A., Reed, B. R., & Decarli,C. (2011). The measurement of everyday cognition: development and validation ofa short form of the Everyday Cognition scales. Alzheimers Dement, 7(6), 593-601. doi: 10.1016/j.jalz.2011.02.007

major tasks in summer vacation

1. 修改HBSF MDC論文
目前遇到的困難: 要整合不同co-authors的建議作修改，希望可以理出頭緒，針對自己目前最主要的問題作修改。

2. 上肢關節疼痛與整體健康相關生活品質論文之方法撰寫，並與其他co-authors討論如何解釋結果。

3. Balance CAT收案：施測者間信度的部份還有一些個案未收完(需安排時間請Jenny幫忙收案)，主要也需要再找幾個能力好的個案（施測者間/施測者內)，等待診所回應中。
* 預計7/23那個星期到署北收案。同時要記得寫署北的進度報告！

4. 搜尋認知評量文獻：假設要做中風病人記憶力的評估工具，先確定目前用在中風病人身上的記憶力評估工具有那些，所使用的架構是什麼，有那些優缺點，臨床上使用可能會有那些問題，自己目前可以針對哪些不足思考/找出解決的方法。。。

5. 數理統計之補強：七月中旬開始每週兩天上統計課上到8月底，補強自己之前不足的統計概念（希望課後要記得馬上複習)。

上肢關節疼痛與整體生活品質的關係

單變量分析: 上肢關節疼痛與整體生活品質約呈中度相關(r=0.46)。

多變量分析: 若加上其他變項，BADL，上肢動作，上肢疼痛和年齡(依此順序放進模式)一起能解釋55% 整體生活品質的變異量。

Model Summary

Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.664(a)	.440	.437	8.00911
2	.713(b)	.509	.502	7.53016
3	.728(c)	.530	.521	7.38675
4	.740(d)	.548	.535	7.27388

a  Predictors: (Constant), BINEW

b  Predictors: (Constant), BINEW, FMUE

c  Predictors: (Constant), BINEW, FMUE, UEPAIN

d  Predictors: (Constant), BINEW, FMUE, UEPAIN, AGE

                                                           ANOVA(e)

Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	7524.323	1	7524.323	117.300	.000(a)
	Residual	9557.736	149	64.146
	Total	17082.059	150
2	Regression	8689.967	2	4344.983	76.627	.000(b)
	Residual	8392.092	148	56.703
	Total	17082.059	150
3	Regression	9061.145	3	3020.382	55.355	.000(c)
	Residual	8020.914	147	54.564
	Total	17082.059	150
4	Regression	9357.298	4	2339.325	44.214	.000(d)
	Residual	7724.761	146	52.909
	Total	17082.059	150

 

a  Predictors: (Constant), BINEW

b  Predictors: (Constant), BINEW, FMUE

c  Predictors: (Constant), BINEW, FMUE, UEPAIN

d  Predictors: (Constant), BINEW, FMUE, UEPAIN, AGE

e  Dependent Variable: OQOL

上肢關節疼痛與整體生活品質或各層面生活品質之間的關係

因為後來發現其實大樣本(n=152)的上肢疼痛分數分佈狀況還算接近常態(skewness=-1.4, kurtosis=1.3)，所以就決定採用原來的分數。只是BI分數有太明顯的ceiling effects(44.7%)了，所以還是決定分成兩組(0-15=1, 16-20=2)。

新的單變量分析結果如下:

Correlations
		fmue	binew	oqol	fai	age	uepain
fmue	Pearson Correlation	1	.566**	.592**	.460**	.000	.476**
	Sig. (2-tailed)		.000	.000	.000	.998	.000
	N	152	152	152	152	151	152
binew	Pearson Correlation	.566**	1	.664**	.532**	-.335**	.364**
	Sig. (2-tailed)	.000		.000	.000	.000	.000
	N	152	152	152	152	151	152
oqol	Pearson Correlation	.592**	.664**	1	.691**	-.288**	.459**
	Sig. (2-tailed)	.000	.000		.000	.000	.000
	N	152	152	152	152	151	152
fai	Pearson Correlation	.460**	.532**	.691**	1	-.437**	.473**
	Sig. (2-tailed)	.000	.000	.000		.000	.000
	N	152	152	152	152	151	152
age	Pearson Correlation	.000	-.335**	-.288**	-.437**	1	-.079
	Sig. (2-tailed)	.998	.000	.000	.000		.335
	N	151	151	151	151	151	151
uepain	Pearson Correlation	.476**	.364**	.459**	.473**	-.079	1
	Sig. (2-tailed)	.000	.000	.000	.000	.335
	N	152	152	152	152	151	152
**. Correlation is significant at the 0.01 level (2-tailed). 上肢關節疼痛與整體生活品質的關係: A. 單變量分析: 上肢關節疼痛與整體生活品質約呈中度相關(r=0.46)。 B. 多變量分析: 若加上(BADL/上肢動作)其他變項，BADL，上肢動作和上肢疼痛(依此順序放進模式)一起能解釋53% 整體生活品質的變異量。    Model Summary Model R R Square Adjusted R Square Std. Error of the Estimate 1 .664a .441 .437 8.04814 2 .714b .509 .503 7.56339 3 .729c .532 .523 7.41168 a. Predictors: (Constant), binew b. Predictors: (Constant), binew, fmue c. Predictors: (Constant), binew, fmue, uepain ANOVAd Model Sum of Squares df Mean Square F Sig. 1 Regression 7658.739 1 7658.739 118.240 .000a Residual 9715.891 150 64.773 Total 17374.630 151 2 Regression 8851.094 2 4425.547 77.363 .000b Residual 8523.537 149 57.205 Total 17374.630 151 3 Regression 9244.538 3 3081.513 56.096 .000c Residual 8130.093 148 54.933 Total 17374.630 151 a. Predictors: (Constant), binew b. Predictors: (Constant), binew, fmue c. Predictors: (Constant), binew, fmue, uepain d. Dependent Variable: oqol

上肢關節疼痛與各層面生活品質的關係:

A. 單變量分析 :

		uepain
uepain	Pearson Correlation	1
	Sig. (2-tailed)
	N	152
selfcare	Pearson Correlation	.465**
	Sig. (2-tailed)	.000
	N	152
mobility	Pearson Correlation	.406**
	Sig. (2-tailed)	.000
	N	152
work	Pearson Correlation	.461**
	Sig. (2-tailed)	.000
	N	152
uefunc	Pearson Correlation	.415**
	Sig. (2-tailed)	.000
	N	152
social	Pearson Correlation	.409**
	Sig. (2-tailed)	.000
	N	152
energy	Pearson Correlation	.352**
	Sig. (2-tailed)	.000
	N	152
mood	Pearson Correlation	.306**
	Sig. (2-tailed)	.000
	N	152
vision	Pearson Correlation	.262**
	Sig. (2-tailed)	.001
	N	152
language	Pearson Correlation	.258**
	Sig. (2-tailed)	.001
	N	152
thinking	Pearson Correlation	.152
	Sig. (2-tailed)	.062
	N	152
person	Pearson Correlation	.270**
	Sig. (2-tailed)	.001
	N	152
family	Pearson Correlation	.320**
	Sig. (2-tailed)	.000
	N	152

B. 多變量分析:

1. self-care:  BADL，上肢動作和上肢疼痛(依此順序放進模式)一起能解釋self-care相關生活品質的63%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.745a	.555	.552	.77887
2	.781b	.610	.605	.73147
3	.793c	.628	.621	.71680
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, fmue
c. Predictors: (Constant), binew, fmue, uepain

ANOVAd
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	113.501	1	113.501	187.100	.000a
	Residual	90.995	150	.607
	Total	204.496	151
2	Regression	124.774	2	62.387	116.601	.000b
	Residual	79.722	149	.535
	Total	204.496	151
3	Regression	128.452	3	42.817	83.333	.000c
	Residual	76.044	148	.514
	Total	204.496	151
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, fmue
c. Predictors: (Constant), binew, fmue, uepain
d. Dependent Variable: selfcare

2. mobility:  BADL和上肢疼痛(依此順序放進模式)一起能解釋mobility相關生活品質的55%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.724a	.524	.521	.81544
2	.740b	.548	.542	.79793
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, uepain

ANOVAc
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	109.984	1	109.984	165.402	.000a
	Residual	99.742	150	.665
	Total	209.726	151
2	Regression	114.858	2	57.429	90.199	.000b
	Residual	94.867	149	.637
	Total	209.726	151
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, uepain
c. Dependent Variable: mobility

3. work:  BADL，上肢動作和上肢疼痛(依此順序放進模式)一起能解釋work相關生活品質的55%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.673a	.453	.449	1.01721
2	.726b	.528	.521	.94818
3	.741c	.549	.540	.92990
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, fmue
c. Predictors: (Constant), binew, fmue, uepain

ANOVAd
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	128.373	1	128.373	124.066	.000a
	Residual	155.206	150	1.035
	Total	283.579	151
2	Regression	149.620	2	74.810	83.210	.000b
	Residual	133.959	149	.899
	Total	283.579	151
3	Regression	155.601	3	51.867	59.981	.000c
	Residual	127.978	148	.865
	Total	283.579	151
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, fmue
c. Predictors: (Constant), binew, fmue, uepain
d. Dependent Variable: work

4. UE function: 上肢動作和上肢疼痛(依此順序放進模式)一起能解釋UE function相關生活品質的38%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.601a	.361	.357	1.03651
2	.619b	.383	.375	1.02223
a. Predictors: (Constant), fmue
b. Predictors: (Constant), fmue, uepain

ANOVAc
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	91.126	1	91.126	84.819	.000a
	Residual	161.153	150	1.074
	Total	252.280	151
2	Regression	96.582	2	48.291	46.213	.000b
	Residual	155.698	149	1.045
	Total	252.280	151
a. Predictors: (Constant), fmue
b. Predictors: (Constant), fmue, uepain
c. Dependent Variable: uefunc

5. social role: 上肢疼痛和上肢動作(依此順序放進模式)一起能解釋social role相關生活品質的22%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.409a	.167	.161	1.13486
2	.466b	.217	.207	1.10367
a. Predictors: (Constant), uepain
b. Predictors: (Constant), uepain, fmue

ANOVAc
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	38.731	1	38.731	30.073	.000a
	Residual	193.185	150	1.288
	Total	231.916	151
2	Regression	50.422	2	25.211	20.697	.000b
	Residual	181.494	149	1.218
	Total	231.916	151
a. Predictors: (Constant), uepain
b. Predictors: (Constant), uepain, fmue
c. Dependent Variable: social

6. energy: BADL和上肢疼痛(依此順序放進模式)一起能解釋energy相關生活品質的19%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.365a	.133	.127	1.15440
2	.434b	.188	.178	1.12056
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, uepain

ANOVAc
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	30.652	1	30.652	23.001	.000a
	Residual	199.897	150	1.333
	Total	230.549	151
2	Regression	43.456	2	21.728	17.304	.000b
	Residual	187.093	149	1.256
	Total	230.549	151
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, uepain
c. Dependent Variable: energy

7. mood: BADL和上肢疼痛(依此順序放進模式)一起能解釋mood相關生活品質的17%變異量。

Model Summary
Model	R	R Square	Adjusted R Square	Std. Error of the Estimate
1	.372a	.138	.133	1.10259
2	.415b	.172	.161	1.08456
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, uepain

ANOVAc
Model		Sum of Squares	df	Mean Square	F	Sig.
1	Regression	29.305	1	29.305	24.106	.000a
	Residual	182.355	150	1.216
	Total	211.661	151
2	Regression	36.395	2	18.198	15.471	.000b
	Residual	175.265	149	1.176
	Total	211.661	151
a. Predictors: (Constant), binew
b. Predictors: (Constant), binew, uepain
c. Dependent Variable: mood