精神病人日常生活功能評量表第三版之信度與效度初探

Reliability and Validity of the Activities of Daily Living Rating Scale III for Psychiatric Patients: A Preliminary Study

褚增輝(Tsang-Fai Chu) ； 謝清麟(Ching-Lin Hsieh)

《職能治療學會雜誌》 22卷 (2004/09) Pp. 1-14

https://doi.org/10.6594/JTOTA.2004.22.01

摘要

本研究旨在修訂精神病人日常生活功能評量表第三版（ADLRS-III)，驗證 ADLRS-III之信度與效度。量表內容包括：獨立能力、衛生習慣、休閒生活、圖像解讀、文字、時事認知、計算金錢、交通、通訊及應變等十類功能。研究對象取自某精神專科醫院精神病人180名與正常人140名。對象年齡分布於18至60歲，教育程度為國小以上者。病例組之診斷別為精神分裂病152名（84%）及其他29名（16%）。量表之內容效度由六位精神醫療或復健醫療臨床專家檢核及修訂之。研究結果顯示：ADLRS-III之再測信度良好（intraclass correlation coefficient =0.87）。各類功能建構上採用Cronbach’s α分析，以選取題目。除衛生習慣α值0.64較低之外，其它九類α值均達0.77至0.86之間，顯示量表項目之同質性高。從建構效度界定 ADLRS-III內容為正常人之基本生活功能，結果126名（90%）正常人通過82%以上內容難度考驗，精神病人只有32名(18%）通過相同難度考驗，其餘病患顯示不同程度生活功能減退現象，顯示ADLRS-III量表具有區辨效度。另精神病人於ADLRS-III得分與臨床復健工作表現具有中度相關，顯示 ADLRS-III具有收斂效度（conver-gent vahdity）。以上初步研究結果顯示ADLRS-III具備潛力，可評量精神病人之日常生活功能。

關鍵字

日常生活功能 ； 評量表 ； 精神病人 ； 職能治療

並列摘要

The purpose of this study was to examine the reliability and validity of the Activities of Daily Living Rating Scale Ill (ADLRS-III) in patients with psychiatric illness. A total of 180 psychiatric patients and 140 psychologically healthy persons aged between 18 and 60 participated in this study. Both patients and normal subjects had completed at least primary school. The ADLRS-III demonstrated good test-retest reliability (ICC = .87, p ＜ .001). Up to 90% of the normal subjects and 18% of the patients scored 82 to 100; 82% patients scored 20 to 81, showing mild to severe deficiency in basic living skill performance. These results suggested that the ADLRS-III had good discriminant validity in the psychiatric patients. The ADLRS-III performance was associated with education and age. The ADLRS-III scores of the patients increased with their level of education, decreased with age, and were unrelated to gender. The psychiatric diagnosis, duration of hospitalization, and stage of rehabilitation were not significantly associated with the ADLRS-III scores of the patients. These results showed that the ADLRS-III had good convergent validity and good reliability. These preliminary findings of the ADLRS- suggest that it can be used to assess psychiatric patients’ADL function.

並列關鍵字

activities of daily living ； rating scale ； psychiatric patient occupational therapy