中文版多元功能評估問卷之信度效度考驗

An Evaluation of the Reliability and Validity of the Chinese-Version Oars Multidimensional Functional Assessment Questionnaire

邱亨嘉(Herng-Chia Chiu) ； 陳怡君(Yi-Chun Chen) ； 毛莉雯(Lih-Wen Mau) ； 蕭世槐(Shih-Huai Shiao) ； 劉宏文(Wen-Liu Hong) ； 黃明賢(Ming-Shyan Huang)

《中華公共衛生雜誌》 16卷2期 (1997/04) Pp. 119-132

https://doi.org/10.6288/CJPH1997-16-02-02

摘要

僅管多數學者專家同意一項完整的健康評估應同時包括身體、心理健康、及社會支持等多面向之功能狀況，國內有關老人健康功能評估之研究仍多限於單面向評估。有鑑於此，本研究小組於1991年獲得美國杜克大學(Duke University)授權使用其所發展之多元功能評估問卷(Multidimensional Functional Assessment Questionnaire, MFAQ)，依台灣之醫療制度、文化背景及社會習俗等各方面因素，修訂成「中文版多元功能評估問卷」(the Chiness-version MFAQ, CMFAQ)，用以瞭解台灣社區及機構老人之社會資源、經濟資源、精神使康狀況、身體健康狀況、及日常活動能力。本研究之主要目的在評估CMFAQ是否為一信度、效度俱佳的多元功能評估工具。其信度考驗包括重到信度及內部一致性；效度考驗包括內容效度及建構效度。信度考驗結果發現：重測一致性百分比以初步測試量表最高(87.5%)，其次為日常活動能力量表(85.75%)，其餘各面向皆在70%以上；同一訪員評分之重測相關係數以社會資源評分相關最高(0.75)，不同訪員評分之重測相關係數則以日常活動能力評分相關最高(0.61)；各面向之Cronbach's α值皆在0.7標凖以上，其中以日常活動能力量表的內部一致性最高，其Cronbach's α值達0.93。就建構效度而言，其因素分析結果顯示CMFAQ之實證建構與理論建構相似，其中日常活動能力、認知功能及經濟資源3因素所組成之變項幾乎與理論建構完全相同。由此可見，中文版多元功能評估問卷不失為一有效可信的功能評估工具，在未來建立全國老人資料庫之際，相關研究者可依不同之研究目的及樣本特質，將多元功能評估問卷修訂為一標準化的老人功能評估工具或簡式多元功能評估問卷。

關鍵字

多元功能評估問卷 ； 健康狀況 ； 功能評估 ； 信度 ； 效度

並列摘要

The most recent wave of health status assessments have been dominated by multidimensional measures. However, the traditional measures of health status in Taiwan still focus on unidimensional approach, which seems to be insufficient by themselves. With respect to a multidimensional approach, the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ) from Duke University has been used widely in gerontological research with established reliability and validity. In order to establish a profile of multidimensional functional status (i.e. social, economic, mental, physical and ADL) of the Taiwanese elderly, the OMFAQ has been tailored into a Chinese-version MFAQ (CMFAQ) in considering the differences in health care delivery systems, culture, and other pertinent characteristics by the Kaohsiung Medical College gerontological research team. The major purpose of this paper is to present the evidence for reliability and validity of the CMFAQ as used in Taiwan.
In examining reliability, test-retest reliability, reliability of the interviewers, and internal consistency were evaluated. In the restretest study, 87% of the responses were identical in cognitive functional scale, followed by 85.7% in activity of daily living (ADL), and more than 70% being identical in the other dimensions. The best rating agreement among intra-raters was found in social resources scale (r=0.75), while the highest rating agreement among inter-raters was found in the ADL scale (r=.61). The internal consistency (inter-item reliability) of the CMFAQ is sufficient; the Cronbach's coefficient for each dimension are all above .70 (except the physical health status), especially the c value for ADL up to 0.93.
In examining validity, the content validity of the CMFAQ is sustained by the manner of item selection by the interdisciplinary team. The results of exploratory factor analyses disclosed that six empirical factors were corresponded closely with theoretical constructs, especially the items consisted in the constructs of ADL, cognitive functioning, and economic resources. In conclusion, the CMFAQ can be served as a reliable and cross-culturally valid measurement tool for the elderly. For the future development, the CMFAQ can be refined into an extended version for comprehensive population survey, or be modified into a shorter version for health status assessments in clinical settings.

並列關鍵字

MFAQ ； Elderly Health Status ； Functional Assessment ； Reliability ； Validity