日常生活活動功能評量之四十年回顧

A Forty-year Retrospective of Assessment of Activities of Daily Living

張席熒(Hsi-Ying Chang) ； 謝妤葳(Yu-Wei Hsieh) ； 薛漪平(I-Ping Hsueh) ； 謝清麟(Ching-Lin Hsieh)

《台灣復健醫學雜誌》 34卷2期 (2006/06) Pp. 63-71

https://doi.org/10.6315/2006.34(2)01

摘要

研究背景與目的：日常生活活動(Activities of Daily Living，ADL)功能代表個案自我照顧及生活獨立程度。ADL功能評量之相關議題，包含所依據之理論基礎、評量層面、項目內容、及量表發展或驗證所依據的測驗理論等，由於至今仍未被系統地整合探討，以致相關專業人員難以掌握ADL之評量趨勢。故本文回顧ADL相關議題之發展，以掌握ADL評量之趨勢。方法：參考ADL量表之回顧型文獻及與「復健或ADL測量」相關教科書，以彙整ADL量表；再查證每個ADL量表被期刊論文引用的次數；最後，約以每十年為一時間單位，在每一單位時間中選出ADL量表被期刊論文引用次數最多的前5個量表。結果：共彙整出78個ADL量表（1957-2004年），分成4個時間單位（1957-1970、1971-1980、1981-1990、1991-2004年），故共有20個ADL量表作為本研究之代表性量表，以瞭解ADL評量之發展趨勢。這20個ADL量表之特性如下：（一）大多無特定理論作為量表發展基礎，僅1963年Katz ADL量表及1999年中風影響量表(Stroke Impact Scale)具明確的理論架構作為發展量表之基礎；（二）ADL評量層面來說，在每個時期大多以評量ADL實際表現者居多；（三）ADL所包含的項目內容，早期為評量Basic ADL (BADL)項目居多，之後評量Instrumental ADL (IADL)項目較多，近期則以合併BADL和IADL項目之量表為主；（四）20個ADL量表皆以古典測驗理論發展或驗證之，但1993年後有7個量表使用現代測驗理論驗證或簡化ADL量表。結論：這些結果有助於臨床及研究人員瞭解未來ADL評量之方向。

關鍵字

日常生活活動 ； 日常生活活動評量 ； 心理計量

並列摘要

Background and Purpose: The term activities of daily living (ADL) refers to the basic skills that a person needs in order to carry out the fundamental physical functions of self-care and independent living. In this survey paper, we review the studies on ADL that involve theories of ADL, the concepts and items of measurement, and the test theory developed for ADL assessment. Unfortunately, the issues mentioned above have not been well integrated systematically. With this review, we would like to provide a picture of past and current trends in ADL assessment.
Method: We searched literature reviews and rehabilitation or measurement textbooks for ADL scales. These scales cited lists of references in articles published since 1990. For each stage, we selected 5 articles about ADL based on the most frequently cited references over a period of approximately 10 years.
Result: In this paper, we have selected 20 ADL scales out of 78 as representatives in order to develop a picture of the trends in ADL assessment from 1957 to 2004. We partitioned this period into four stages, 1957-1970, 1971-1980, 1981-1990, and 1991-2004, in order to determine the trends in the different stages. We have made the following observations: (1) Most ADL scales lack theoretical justification, with the exception of the Katz ADL scale, published in 1963, and the Stroke Impact Scale, published in 1999. (2) Measurement of ADL performance has been the main measurement during each stage. (3) Basic ADL (BADL) and Instrumental ADL (IADL) were once used separately as the main measurements during the earlier stages, and recent ADL assessments are composed of both BADL and IADL. (4) These 20 ADL scales were developed or tested with classical test theory; however, modern test theory has been applied to 7 of them since 1993.
Conclusion: These observations may be helpful in understanding the future trends of ADL assessment in both clinical work and research.

並列關鍵字

activities of daily living ； activities of daily living assessment ； psychometrics