- 期刊
社區精神病友邁向復元自評表之信效度及其需求之橫斷式研究
A Cross-Sectional Study on the Reliability, Validity and Needs of Journey to Wellness Scale for Psychiatric Disorders in Community
摘要
目的：社區精神病友反映自填日常生活功能評量表（題數86題）填答費時且復健團隊亦難客觀判斷病友之日常生活各項活動執行準確性與落實度。故本研究旨在發展符合病友需求之簡易自評表並分析其結果以提供最適復元計畫。方法：研究樣本取自中部4家社區復健中心共79名病友。邁向復元自評表包括：獨立生活功能、健康維護功能、社會功能、休閒功能、家庭與社會支持系統及職業功能等六類，共12題。評分等級以「完全他助、部分他助、自助、部分助人、完全助人」（1-5分，5個等級）；6：我不想回答這個問題；7：這個問題我目前不適用，無法回答。量表之內容效度由精神醫療、精神復健及臨床研究等專家透過德爾菲法（Delphi method）、焦點團體、1對1深度訪談進行檢核及修訂；量表之信度採再測信度。結果：社區精神病友樣本之平均年齡44.0±11.7歲，平均發病年齡24.6±8.6歲，平均罹病年數19.4±10.5年，思覺失調症佔83.5%，女佔50.6%。自評表各題填答率之「1-5等級」達88.6%-100%，「不想回答」達0.0-3.8%，「不適用」達0.0-7.6%。再測信度（後測減前測分數之一致率）達56%-77%；若加入前後僅差一等級的再測信度可達75%-97%。12項需求中之7項（包括「刷牙」「洗澡」「家事」「服藥」「人際」「家人」「休閒」等）屬低需求；即10%以下分佈於1-2等級（部分他助－完全他助），2項（包括「起床」「工作」等）屬中需求；即10%-20%分佈於1-2等級，3項（包括「交通」「財務」「運動」等）屬高需求；即20%以上分佈於1-2等級。結論：「邁向復元自評表」具有良好信效度，可以精準確知病友的復健需求。建議未來應提供社區病友交通能力、財務管理及運動習慣的強化策略，讓獨立日常生活功能更進階且體適能正向維持。
並列摘要
Purpose. There are as many as 86 questions in the daily life function evaluation scale self-completed by patients with mental illness. Patients reported that it is time-consuming to fill in and answer, and it is difficult for the rehabilitation team to objectively judge the accuracy and implementation of the patients' daily life activities. Therefore, this study aims to develop a simple self-assessment form that meets the needs of patients and analyze its results to provide the most appropriate recovery plan. Methods. The research samples were collected from 79 patients in 4 community rehabilitation centers in central Taiwan. The Self-Assessment Form for Recovery includes six categories: independent living function, health maintenance function, social function, leisure function, family and social support system, and occupational function, with a total of 12 questions. The scoring scale is based on "complete help, partial help, self-help, partial help, and complete help"(1-5 points, 5 levels); 6: I don’t want to answer this question; 7: This question is currently not applicable to me and cannot be answered. The content validity of the scale was checked and revised by experts in psychiatric medicine, mental rehabilitation and clinical research through the Delphi method, focus groups, and 1-to-1 in-depth interviews; the reliability of the scale was tested by using test-retest reliability. Results. The average age of the community psychiatric patient sample was 44.0±11.7, the average age of onset was 24.6±8.6, the average number of years of illness was 19.4±10.5, 83.5% had schizophrenia, and 50.6% were female. The response rates for each question on the self-evaluation form ranged from 88.6% to 100% for "1-5 levels", 0.0-3.8% for "I don't want to answer", and 0.0-7.6% for "Not applicable". The test-retest reliability (consistency rate of post-test minus pre-test scores) reaches 56%-77%; if the difference between before and after is only one level, the test-retest reliability can reach 75%-97%. 7 out of 12 needs (including "brushing teeth" "Bathing", "Hungry", "Taking medicine", "Society", "Family", "Recreation", etc.) are low needs; that is, less than 10% are distributed in levels 1-2 (partial assistance - complete assistance), 2 items (including " "Getting up", "Work", etc.) are in medium demand; that is, 10%-20% are distributed in levels 1-2, and 3 items (including "medical treatment", "finance", "exercise", etc.) are in high demand; that is, more than 20% are distributed in level 1 -2 levels. Conclusion. The "Journey to Wellness Scale" has good reliability and validity, can efficiently and accurately identify the needs, concerns and priorities of patients. It is recommended that in the future, strategies should be provided to strengthen the transportation ability, financial management and exercise habits of community patients, so that independent daily living functions can be more advanced and physical fitness can be positively maintained.