適用於精神分裂症患者工具性日常生活活動量表初步信、效度分析

Initial Reliability and Validity of the Instrumental Activity of Daily Living Assessment in Schizophrenia

李柏森(Po-Sen Lee) ； 吳裕益(Yuh-Yih Wu) ； 李秉家(Ping-Chia Li) ； 劉靖琁(Chin-Hsuan Liu) ； 鍾秉璁(Ping-Tsung Chung)

《職能治療學會雜誌》 30卷2期 (2012/12) Pp. 153-176

https://doi.org/10.6594/JTOTA.2012.30(2).03

摘要

本研究主要目的是對自編適用於精神分裂症患者工具性日常生活活動量表進行初步信、效度分析，以作為編製正式施測量表之參考。預試之題目主要是根據職能治療實務架構中之工具性日常生活活動之項目所編製，預試之對象為105位精神分裂症患者，研究者以因素分析法檢驗量表是否符合測量單一構念，及找出不符合測量單一構念之題目，以發展能測量單一主要潛在構念之日常生活活動量表。在量表信度檢驗部分，研究者以Cronbach's α內部一致性係數分析整體量表之信度。因素分析之特徵值大於1的因素有3個，第1個因素初始特徵值佔總變異數的比率超過50%，整體量表之Cronbach's α係數為.948。第1個因素初始特徵值相當大，大致支持有單一主要面向之假設，此外，Cronbach's α係數顯示整體量表之信度相當高。依預試結果，本正式量表的總題數修訂為45題，並有14個分量表，包括：基本日常生活活動、照顧他人與養育孩子、使用溝通設備、社區移動能力、財務管理、家庭建立與管理、備餐與清理、安全、購物、人際互動、職前準備、社區資源的認識與使用、休閒娛樂與健康管理。因素分析結果暗示照顧他人與養育孩子以及健康管理二個分量表，可能屬於其他面向概念。未來可進一步進行Rasch模式之單參數題目反應理論模式適合度檢驗。

關鍵字

精神分裂症 ； 工具性日常生活活動

並列摘要

The purpose of this study was to perform an initial reliability and validity on a self-developed instrumental activities of daily living (IADL) assessment in schizophrenia in order to provide a reference for an officially established assessment. Pilot questions were based on the IADL in the occupational therapy practice framework and on items listed in the IADL. The subjects for the pilot study were 105 patients with schizophrenia. The researchers used factor analysis to check whether the assessment measured unidimensionality and to identify questions that did not meet unidimensionality assumptions, so that a scale for activities of daily living with unidimensional variables can be developed. In terms of overall reliability and internal consistency, the scale was analyzed using Cronbach's α. There were 3 factors with eigenvalues ＞1; the initial eigenvalues of the first factor represented ＞50% of the total variance. The Cronbach's α coefficient was .948 for the whole scale. The initial eigenvalues of the first factor were significantly large, which supported the hypothesis of unidimensionality. The overall reliability of the scale was very high in terms of Cronbach's α. The final scale includes 14 subscales and 45 items. The final 14 subscales include: basic activities of daily living, caring for others and child rearing, communication device usage, community mobility, financial management, home establishment and management, meal preparation and cleanup, safety, shopping, interactions with others, prevocational preparation, community resource knowledge and usage, leisure, and health management. According to the factor analysis results, the ＂caring for others and child rearing＂ and ＂health management＂ subscales may belong to different dimensionality. In the future, further goodness-of-fit of the officially assessment would be measured by one-parameter item response theory (IRT) of Rasch model.

並列關鍵字

Schizophrenia ； Instrumental activity of daily living