社會功能量表精神分裂症患者之心理計量特性

Psychometric Properties of the Social Functioning Scale in Patients with Schizophrenia

邱恩琦(En-Chi Chiu) ； 李恭賢(Kung-Hsien Lee) ； 胡世睿(Shi-Jue Hu) ； 鄭名容(Ming-Rong Cheng) ； 李淑君(Shu-Chun Lee) ； 謝清麟(Ching-Lin Hsieh)

《職能治療學會雜誌》 30卷2期 (2012/12) Pp. 136-152

https://doi.org/10.6594/JTOTA.2012.30(2).02

摘要

社會功能障礙為精神分裂症患者的特徵之一，其影響病患於家庭及社區生活之獨立程度與生活品質。「社會功能量表（Social Functioning Scale, SFS）台灣短版」（SFS-Taiwan short version, SFST）常用以評量精神分裂症患者之社會功能狀況，然而尚無研究驗證SFST於精神分裂症患者之心理計量特性。本研究目的為驗證SFST應用於精神分裂症患者之漏答率、天花板效應／地板效應、內在一致性及收斂效度。研究者由職能治療病歷資料獲得68位精神分裂症患者二個自填量表之資料（SFST和日常生活功能評量表第三版［Activities of Daily Living Rating scale III, ADLRS-III］）。結果發現SFST之項目漏答率高，僅有17.6%的個案完整填答整個量表，特別是三個次量表（獨立－能力、獨立－表現、娛樂）及職業／就業次量表之第1大題，漏答率大於22%以上。SFST之七個次量表都無明顯之地板效應，但二個次量表（獨立－能力、獨立－表現）呈現天花板效應。SFST，除了二個次量表（社交／退縮、人際溝通），具備可接受之內在一致性（Cronbach's alpha ＞ .70）。SFST總分與ADLRS-III總分之間有中度相關（r = .40），顯示SFST有可接受之收斂效度。以上研究結果顯示現行SFST不適於自填方式，且二個次量表因天花板效應難以區辨高社會功能患者之能力差異。研究者建議修改SFST，以期降低漏答率、天花板效應，及提升量表之內在一致性。

關鍵字

社會功能 ； 漏答率 ； 天花板效應 ； 內在一致性 ； 收斂效度

並列摘要

Social dysfunction is one of the main characteristics of patients with schizophrenia and influences patients' daily functions and quality of life. The Social Functioning Scale-Taiwan short form (SFST) is commonly used to measure social function in patients with schizophrenia. However, no study has examined psychometric properties of the SFST in patients with schizophrenia exclusively. Therefore, the study aimed to examine missing rate, ceiling effect/floor effect, internal consistency, and convergent validity of the SFST in patients with schizophrenia. We obtained 68 schizophrenic self-report data (the SFST and the Activities of Daily Living Rating Scale III [ADLRS-III]) from occupational therapy records. The results showed high missing rates on items in the SFST. Only 17.6% of patients completed the full scale. The missing rates were ＞ 22% in 3 subscales (i.e. the independence-competence, independence-performance, and recreation subscales) and the first item of the employment subscale. The floor effects were not observed in 7 subscales, but the independence-competence and independence-performance subscales showed ceiling effects. The SFST demonstrated acceptable internal consistency (Cronbach's alpha ＞ .70), except for the social engagement/withdrawal and interpersonal subscales. Moderate correlation (r = .40) was found between the SFST and the ADLRS-III, indicating that the SFST had acceptable convergent validity. In summary, the results showed that the SFST was not appropriate used through self-administration mode. Moreover, the two subscales having ceiling effects could not discriminate patients with high social function. We recommend modifying the SFST in order to reduce missing rates and ceiling effects, and improve internal consistency.

並列關鍵字

Social function ； Missing rate ； Ceiling effect ； Internal consistency ； Convergent validity