- 期刊
- OpenAccess
精神分裂症研究常用之工具性日常生活活動評估工具之心理計量特性回顧
A Review of Psychometric Properties on Instrumental Activities of Daily Living Measures for Working with Patients with Schizophrenia
摘要
工具性日常生活活動（instrumental activities of daily living, IADL）功能受限嚴重影響精神分裂症個案之社區適應能力。臨床人員須使用具備心理計量特性之IADL評估工具，方能精確掌握患者之IADL能力並及早擬定合適之治療計畫。然而目前臨床用於評估精神分裂症個案之IADL工具極少，且心理計量特性仍不清楚。故本研究欲彙整近十年（2003~2013）常用於精神分裂症隨機控制試驗之IADL評估工具，及其心理計量特性驗證資料，以供臨床與研究人員選擇IADL評估工具之參考。研究者合併搜尋中英文電子期刊資料庫，彙整2003－2013年常用於精神分裂症隨機控制試驗之IADL評估工具，再比較上述工具應用於精神分裂症患者之心理計量特性。常用之IADL評估工具共計4項：University of Californiaat San Diego Performance-Based Skills Assessment（UPSA）、Independent Living SkillsSurvey self-report version、Brief UPSA（UPSA-B）與Multnomah Community AbilityScale（MCAS）。上述工具於精神分裂症個案之心理計量特性驗證結果如下：信度部份，僅MCAS之再測信度與施測者間信度皆完整被驗證且結果良好。效度部份，四評估工具之效度驗證皆不足。反應性部分，僅UPSA-B具備小的反應性。本文獻回顧結果顯示常用於精神分裂症研究之IADL評估工具之心理計量特性驗證未臻完備，且缺乏中文版工具及相關實證結果，無法於臺灣臨床或研究使用。建議未來研究亟須進行完整地心理計量特性驗證，並發展中文版且適合臺灣文化之IADL評估工具。
並列摘要
Independent functioning in daily living requires the ability to perform instrumental activities of daily living (IADL). Limited functions in IADL can profoundly interfere with community integration in patients with schizophrenia. Clinicians need IADL measures with sound psychometric properties in order to know the patient's IADL function accurately and precisely as well as to develop appropriate treatment plans early on. However, there are few IADL measures used in clinical settings and their psychometric properties remain uncertain. This study aimed at compiling and appraising the psychometric properties of the IADL measures that have been commonly used in randomized controlled trial for schizophrenia during the past 10 years (2003~2013). We conducted a comprehensive search of electronic citation databases for Chinese-or-English-language articles on IADL measures and their psychometric properties for patients with schizophrenia. Four frequently used IADL measures were identified, which were the University of California at San Diego Performance-Based Skills Assessment (UPSA), the Independent Living Skills Survey self-report version, the Brief UPSA and the Multnomah Community Ability Scale (MCAS). We found that only the MCAS was reported to have good reliability. With respect to the validity and responsiveness, the results of the 4 IADL measures were either poor or unknown. All of the 4 measures are lacking of the Chinese version and related empirical results, hence they are not applicable in research or clinical settings in Taiwan. Further validations of these measures in patients with schizophrenia are warranted and IADL measures suitable for Taiwanese culture need to be developed.
延伸閱讀
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