「電腦化日常注意力測驗」於思覺失調症患者的信效度研究

Reliability and Validity of the Computerized Everyday Attention Test for Patients With Schizophrenia

蘇純瑩(Chwen-Yng Su) ； 邱毓賢(Yu-Hsien Chiu) ； 鄭駿樺(Chun-Hua Cheng) ； 郭乃文(Nai-Wen Guo) ； 陳明德(Ming-De Chen)

《職能治療學會雜誌》 37卷2期 (2019/12) Pp. 211-234

https://doi.org/10.6594/JTOTA.201912_37(2).0004

摘要

背景與目的：「電腦化日常注意力測驗」（Computerized Everyday Attention Test, CEAT）是專為18歲以上有精神／神經疾病診斷的患者所編製。測驗題目是以生活化情境為主，評量三個注意力類型，包括選擇性、交替性和分散性注意力。鑒於注意力損傷常見於思覺失調症患者且國內缺乏成人的多面向注意力測驗，本研究的主要目的即是檢驗CEAT於此臨床族群的信效度。方法：樣本有100位正常人和191位思覺失調症患者。評量工具包含「日常注意力測驗」、「摩斯注意力評定量表」、「簡短精神症狀量表」和CEAT。結果：CEAT題目的鑑別度介於.30至.71之間，間隔7天的再測信度為.81～.88，全測驗區辨正常人和患者的接收者操作特徵曲線下方的面積為.84。參與工作訓練的患者在各分量表的表現皆高於沒有工作者。CEAT總分和「摩斯注意力評定量表」及「簡短精神症狀量表」皆呈現中度相關；和「日常注意力測驗」的探索性因素分析結果支持CEAT各分量表的構念。驗證性因素分析則提供CEAT的一階單因素模式之證據。結論：CEAT具有生態效度，適用於慢性思覺失調症患者的注意力評量。使用者可從年齡參照的百分等級和常態轉換T分數瞭解患者在日常情境的各項注意力表現，據此擬定目標導向的介入方案。

關鍵字

日常注意力 ； 信度 ； 效度 ； 思覺失調症

並列摘要

Background and purpose: The Computerized Everyday Attention Test (CEAT) was developed for patients with neurological and psychiatric disorders aged 18 years and older. It includes selective, alternating and divided attention subscales. Given that attention deficits are common in patients with schizophrenia and there is a lack of tools measuring multiple facets of attention for adults in Taiwan, this study aimed at evaluating the reliability and validity of the CEAT in this clinical population. Methods: 100 normal adults and 191 patients participated in the study. Assessment instruments comprised the Test of Everyday Attention (TEA), Moss Attention Rating Scale (MARS), Brief Psychiatric Rating Scale (BPRS) and the CEAT. Results: The index of discrimination for the CEAT items ranged from .30 to .71 and the test-retest reliability coefficients over a 1-week interval ranged from .81 to .88. The area under a receiver operating characteristic curve for the CEAT total score was .84. Patients in the work skills training group performed higher than those without training. The CEAT was moderately correlated with the MARS and BPRS. Results of exploratory and confirmatory factor analyses lent support to the constructs measured by the CEAT as well as the presence of a single-factor model. Conclusion: The CEAT is ecologically valid and suitable for the assessment of attention in patients with schizophrenia. The test users can have a better understanding of the patients' performances on various aspects of attention involved in real-life situations based on normative data, which in turn, help develop individualized treatment plans.

並列關鍵字

Everyday Attention ； Reliability ； Schizophrenia ； Validity