改良版「職能復健評估綜合評量表」於思覺失調症病人之心理計量特性

目的：改良版「職能復健評估綜合評量表」（Modified Comprehensive Occupational Rehabilitation Evaluation Scale, M-CORES）為北市3家社區精神復健機構例行使用的評量表，評估思覺失調症病人整體功能。本研究目的為驗證其心理計量特性：內在一致性、施測者間信度與建構效度。方法：蒐集3家社區精復機構2017/01-03例行使用M-CORES的評估紀錄，其中1家社區精復機構30位個案再由另1位治療師進行相同評估。研究者蒐集彙整後進行分析。結果：彙整181份M-CORES紀錄；研究顯示施測者間信度（組內相關係數範圍0.71-0.94）良好，多數評估面向內在一致性（0.76-0.87）在接受範圍內；驗證型因素分析顯示多數指標的適配度仍不足（卡方值=2.07、漸進誤差均方根=0.09、比較適配度指標=0.75、標準化均方根殘差=0.10）。結論：M-CORES有可接受的內在一致性及良好的施測者間信度，但建構效度不理想。研究者建議刪修評量項目以改善M-CORES之建構效度。

關鍵字

思覺失調症；改良版職能復健評估綜合評量表；社區精神復健機構；信度；效度

並列摘要

Objective: The Modified Comprehensive Occupational Rehabilitation Evaluation Scale (MCORES) is a routine scale used in three community psychiatric rehabilitation institutions in Taipei for evaluating the general function of schizophrenia patients. We aimed to examine the internal consistency, inter-rater reliability, and construct validity of the M-CORES in schizophrenia patients. Methods: The records of M-CORES assessments at the three community psychiatric rehabilitation institutions during 2017/01-2017/03 were collected. Another therapist was invited to assess 30 cases of one of the institutes using the M-CORES. The data were then integrated and analyzed. Results: A total of 181 records of M-CORES were completed by three occupational therapists. The M-CORES exhibited good inter-rater reliability (intraclass correlation coefficient = 0.71-0.94) and acceptable internal consistency (0.76-0.87) in most domains assessed (instrumental activities of daily living, leisure, work, and social function). Confirmatory factor analysis showed that the M-CORES had insufficient goodness of fit (x /df = 2.07, root mean square error of approximation = 0.09, comparative fit index = 0.75, and standardized root-mean-square residual = 0.10). Conclusion: The M-CORES had good inter-rater reliability and acceptable internal consistency but insufficient construct validity. A revision is needed to improve the construct validity.

並列關鍵字

schizophrenia ； modified comprehensive occupational rehabilitation evaluation scale (M-CORES) ； institution of community psychiatric rehabilitation ； reliability ； validity

參考文獻

姚開屏。從心理計量的觀點看測量工具的發展。職能治療學會雜誌1996；14(1)：v-xxi。

吳希文，楊銘欽。精神分裂症病患三種社區精神復健模式之醫療利用分析。臺灣職能治療研究與實務雜誌2012；8(1)：1-14。

劉麗婷，池昭芬，顏維貞等。有效能職能治療師特質之探討。職能治療學會雜誌 2005；23：114-27。

Joseph J, Kremen WS, Franz CE, et al. Predictors of current functioning and functional decline in schizophrenia. Schizophr Res 2017; 188: 158-64.

Hobart J, Lamping D, Thompson A. Evaluating neurological outcome measures: the bare essentials. J Neurol Neurosurg Psychiatry 1996; 60(2): 127-30.

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