中文版失智症患者社會功能評估量表之發展

目的：本研究目的在於將國外失智症患者之社會功能評估量表（SF-DEM）進行中文化，並發展出一套符合國人之失智症患者社會功能評估量表。方法：採用橫斷性研究，資料收集期間為2018年5月至2019年3月，研究對象以中部某身心科診所專科醫師診斷出有輕度失智症患者之153位患者與其照顧者作為受試者。統計分析有描述性統計、項目分析、驗證性因素分析、獨立樣本t檢定與內部一致性分析等。結果：在社會功能量表之信度分析，患者與照顧者之Cronbach's α值分別為0.688與0.737，顯示本量表在不同的受試者測試下，其內部一致性依然良好。關於重測信度，其皮爾森相關係數在患者與照顧者之r分別為0.60（p=0.001）與0.64（p=0z.001）。問卷效度採用專家效度與驗證性因素分析（CFA），在驗證性因素分析，顯示社交活動與人際關係這二個構面與假設之測量模式相符，其收斂效度分別為0.91與0.82。最後於本量表中文化完成後，執行一小樣本施測（50個樣本數），同時比較患者與照顧者社會功能之前後差異性，研究發現，經追蹤治療四個月後之患者，其社會功能有顯著之改善（p＜.05）。結論：研究顯示失智者會受家庭與周遭環境之影響，而減少與人際間的互動。如果，失智症患者經常性的參與社交活動，其憂鬱程度會降低，社會功能會提高，如此將可有效延緩失智與罹患憂鬱症的風險。

關鍵字

失智症患者；社會功能評估；信度分析；驗證性因素分析

並列摘要

Purpose: This study aimed to develop an instrument of the Chinese version for evaluating patients' social functions with dementia (SF-DEM) which is suitable for Taiwanese. Methods: A cross-design was used in this study, the data was collected from 2018/05 to 2019/03, and the subject was screened to have mild dementia by a psychiatry clinic in Taichung. There were 153 patients and their caregivers to be screened as qualified samples. Regarding the statistic, it included descriptive statistics, item analysis, confirmation factor analysis (CFA), independent t-test and internal consistent analysis, etc. Results: The reliability analysis of SF-DEM, the value of Cronbach's α is 0.688 and 0.737 to patient and caregiver, respectively. It showed the goodness in the internal consistency of the questionnaire. How about the retest reliability, we used the person correlation coefficient, it was 0.60(p=.001)and 0.64(p=.001)for patient and caregiver? Confirmatory factor analysis (CFA) and expert validation were used for being as questionnaire validity, the CFA was to test the goodness of fit for the hypothetical testing models in the scale. The results of CFA showed that the two scales are for, respectively, its convergent validity was 0.91 and 0.82 for social activity and interpersonal relationship. Moreover, we used this questionnaire to execute a small size questionnaire survey and compare the difference between the pre-test and the post-test in SF-DEM, the result showed that after treatment for four months, the social function of dementia patients had a significant improvement in SF-DEM (p＜.05). Conclusions: This study revealed patients with dementia will be affected by families and environments to decrease their social interactions, and if dementia patients attend social activities, as usual, their anxiety will lower and social function will up, so by this way that can effectively delay the risk tp get dementia and anxiety.