洛文斯坦職能治療認知評估第二版應用於臺灣不同障礙族群之心理計量特性回顧

A Review of Psychometric Properties of the Loewenstein Occupational Therapy Cognitive Assessment-Second Edition Used in Patients With Different Disabilities in Taiwan

李沛綺(Pei-Chi Li) ； 蔡沛潔(Pei-Chieh Tsai) ； 黃怡靜(Yi-Jing Huang) ； 李士捷(Shih-Chieh Lee) ； 董雅綺(Ya-Chi Tung) ； 謝清麟(Ching-Lin Hsieh) ； 黃小玲(Sheau-Ling Huang)

《職能治療學會雜誌》 36卷2期 (2018/12) Pp. 177-202

https://doi.org/10.6594/JTOTA.201812_36(2).0003

摘要

認知功能是維持日常生活功能及工作的關鍵能力，但腦部疾病多伴隨認知功能的缺損。洛文斯坦職能治療認知評估第二版為目前臨床常用之認知功能評估工具組，然而國內在各障礙族群之心理計量特性驗證文獻相當有限。本研究回顧並彙整國內應用LOTCA-II於不同個案群之心理計量特性文獻。作者合併檢索中、英文之電子期刊資料庫中驗證於臺灣各障礙族群之LOTCA-II之心理計量特性文獻。結果顯示LOTCA-II總分應用於臺灣中風及創傷性腦傷個案整體信度大致良好，但僅部份分量表之內在一致性達良好。其與魏式智力測驗之收斂效度良好，且可區辨個案和健康成人間之認知功能的差異。於思覺失調症個案信度大致良好，其與魏式智力測驗及日常生活功能測驗之收斂效度良好，但無法區辨個案之就業情況。於智能障礙個案中內在一致性大致良好，其與圖形智力測驗之收斂效度良好，但無法區辨個案認知功能受損的嚴重程度。另外，雖有驗證因素效度的研究，但因採用混合樣本，結果難以概化。LOTCA-II於臺灣中風、創傷性腦傷、思覺失調症及智能障礙等族群皆尚未驗證同時效度、預測效度及反應性，且部份已驗證之信、效度結果不佳，亦缺乏驗證各障礙族群之因素效度。未來研究需更深入驗證LOTCA-II之心理計量特性，以提供更完整的實證參考數據。

關鍵字

洛文斯坦職能治療認知評估第二版 ； 中風 ； 思覺失調 ； 認知功能 ； 心理計量特性

並列摘要

Cognitive ability plays a key role in maintaining daily function. Cognitive deficits are common in patients with brain disease. Loewenstein Occupational Therapy Cognitive Assessment-Second Edition (LOTCA-II) is the most widely used cognitive ability battery in clinical practice. However, only few studies in Taiwan have evaluated the psychometric properties of the LOTCA-II. The aim of this study was to review and appraise the psychometric properties of the LOTCA-II in different disability groups in Taiwan. After searching electronic English and Chinese databases, results showed that the LOTCA-II's total score has good reliability in stroke and traumatic brain injury (TBI), but has poor internal consistency in each subtest. In patients with stroke and TBI, LOTCA-II was highly correlated with cognitive tests, which indicates good convergent validity, and can discriminate between patients and healthy adults. In patients with schizophrenia, LOTCA-II has good reliability and good convergent validity, and can discriminate between patients and healthy adults. In patients with intellectual disabilities, LOTCA-II has good internal consistency and good convergent validity, and can discriminate between patients and healthy adults. A few studies investigated factor validity in patients with stroke and TBI collectively, but no studies investigated factor validity in individual disability groups. Our study found that the psychometric properties of the LOTCA-II were limited in patients with stroke, TBI, schizophrenia and intellectual disabilities in Taiwan. Future studies are needed to explore the applicability and psychometric properties of the test in all disability groups. For now, clinicians should be careful when explaining the scores of the LOTCA-II.

並列關鍵字

Cognition ； Loewenstein Occupational Therapy Cognitive Assessment-Second Edition ； Psychometric Properties ； Schizophrenia ； Stroke