中文修訂版照顧者負擔量表測量失智症主要照顧者負擔之信效度

The Reliability and Validity of Modified Version of Chinese Caregiver Burden Inventory in Dementia

郭穎樺(Ying-Hua Kuo) ； 劉文良(Wen-Liang Liu) ； 甄瑞興(Sui-Hing Yan)

《北市醫學雜誌》 11卷1期 (2014/03) Pp. 63-76

https://doi.org/10.6200/TCMJ.2014.11.1.07

摘要

目的：探討照顧者負擔量表中文修訂版的信度與效度，並以失智症患者的主要照顧者為研究對象。方法：本研究採橫斷式研究設計；從96年8月至99年8月三年期間，90位至臺北市立醫院仁愛院區記億門診被診斷為失智症的患者及其主要照顧者同意參加本研究。主要照顧者的照顧負擔以香港中文大學翻譯修訂的照顧者負擔量表中文修訂版測量；失智症患者的嚴重程度，則分別以簡短式智能篩檢量表（Mini-Mental State Examination, MMSE）、臨床失智症評分量表（Clinical Dementia Rating, CDR）及神經精神量表（Neuropsychiatric Inventory, NPI）來評估。照顧者負擔中文修訂量表的效度分別以建構效度及臨床效度確認；主成份分析用來分析負擔量表的建構效度，皮爾森相關係數則用來評估照顧者負擔程度與患者的失智程度及神經精神症狀的相關。量表的信度則分別以Cronbach's α及折半信度來測量。結果：主成份分析篩選出四個特徵值大於1的因素，分別與原始量表的時間負荷、身體負荷、社會負荷及情緒負荷有高度相關；照顧者負擔也與失智症的認知障礙嚴重度與神經精神症狀如幻覺、焦躁、冷漠、夜晚行為問題呈現顯著相關。照顧者負擔量表中文修訂版呈現高度內部一致性信度（α = 0.947），折半信度亦達0.875。結論：本研究證實照顧者負擔量表中文修訂版具有良好的效度與信度。此量表可應用在臨床及研究上，作為評估失智症患者主要照顧者負擔的量測工具。然囿於本研究的 研究對象係來自單一機構的小樣本，其外推性可能受限；未來可將此量表用於多中心或大樣本的研究，以確認該量表的外推性及施測的穩定度。

關鍵字

照顧者負擔量表 ； 失智症 ； 信度 ； 效度

並列摘要

Objectives: This study examined the reliability and validity of a modified version of the Chinese Caregiver Burden Inventory (CCBI), which was administrated to primary caregivers of dementia patients to evaluate caregivers' burden. Methods: Cross-sectional methodology was used in this study. Between August, 2007 and August, 2010, 90 dyads of family caregivers and care recipients in the Taipei City Hospital Ren-Ai Branch agreed to participate in this study. The modified CCBI was used to evaluate caregivers' burden, while MMSE and CDR were used to evaluate mental status of dementia patients. Neuropsychological behavior of dementia patients were evaluated using Neuropsychiatric Inventory (NPI). Principal component analysis was used to evaluate construct validity of burden scale, while Cronbach's α was used to assess the internal consistency of reliability. Pearson correlation was used to evaluate correlation between the burden score and MMSE, CDR and NPI. Results: The modified CCBI demonstrated good psychometric properties similar to those of previous studies. Principle component analysis retrieved four loading factors (highly correlated with subsets of time burden, physical burden, family burden, and emotional burden). Reliability internal consistency of Cronbach's alpha was high (α = 0.947). The study further showed that CCBI significantly correlated with CDR, MMSE and NPI. The CCBI score also significantly correlated with several items of NPS (hallucination, apathy, agitation, and nighttime behavior problem). Conclusions: The modified CCBI demonstrated good psychometric properties. It can be one of the useful screening instruments to evaluate the caregiver burden of dementia patient in Taiwan.

並列關鍵字

Caregiver Burden Inventory ； dementia ； reliability ； validity