中文版「職能自我評估」之心理計量品質研究 --以台灣精神分裂症個案為例

Psychometric Study of Occupational Self Assessment – Chinese version for patients with schizophrenia in Taiwan

王淑敏(Shu-Ming Wang)

指導教授 ： 潘璦琬

國立臺灣大學/醫學院/職能治療研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.02428

摘要

摘要
精神科職能治療的領域中，重視個案在職能領域方面的實際功能表現，但較缺乏有效的評估工具來評量，然而有效的評估工具是療效驗證非常重要的一環，因此本文採用依據「人類職能模式」及「案主中心」概念發展而來的「職能自我評估(Occupational Self Assessment, OSA)」，探討其心理計量特性。
本研究按標準將「職能自我評估」翻譯成中文版後進行資料收集。共有93位來自台北縣兩家區域醫院之日間病房及門診的精神分裂症個案參與研究。其中51位於兩週內進行「職能自我評估」的再測。研究之資料以羅序模式（Rasch measurement model）進行「職能自我評估」建構效度之分析；與「加拿大職能表現測驗」以項目符合度的百分比，及斯皮爾曼相關（Spearman’s correlation）探討受試者的羅序分數與「加拿大職能表現測驗」操作能力及滿意度平均分數間之相關，進行同時效度之檢驗；並以加權Kappa值進行再測信度之分析。
分析結果顯示「職能自我評估」具有良好的建構效度，可分為四個次量表分別為「職能勝任」、「環境衝擊」、「職能勝任重要性」、以及「環境衝擊重要性」。與「加拿大職能表現測驗」項目相關的數目達73％，且受試者在「職能勝任」及「環境衝擊」分量表的羅序分數，與「加拿大職能表現測驗」操作能力和滿意度的平均分數，均有顯著的相關，顯示量表具有良好的同時效度。再測信度在四個分量表中，分別有86%、75%、86%、及100%的項目加權Kappa值在0.4以上，代表具中等程度的穩定性。
由本研究結果可得知中文版的「職能自我評估」量表具有良好的心理計量特性，可作為精神科職能治療有效的臨床評估工具。
關鍵字：人類職能模式、案主中心、精神分裂症、職能自我評估

關鍵字

人類職能模式 ； 職能自我評估 ； 案主中心 ； 精神分裂症

並列摘要

Abstract
Functional performances were emphasized on the occupational therapy in mental health. However, lacking of standardized evaluation tools was noticed.The Occupational Self Assessment (OSA) was developed based on the model of human occupation and client- center intervention. The purpose of this study was to examine the psychometric properities of Chinese version of OSA.
OSA was translated into Mandarin by research members before testing. 93 patients diagnosed as schizophrenia were recruited from 2 community hospitals (either from day care program or outpatient department) in northern Taiwan. 51 of the subjects were accepted the retest of OSA within 2 weeks.
Rasch measurement model was selected to examine the construct validity. Items matching percentage of COPM and OSA and Spearman’s correlation between subjects Rasch score as well as COPM performance score and satisfaction score were used to examine the concurrent validity. Weighted Kappa was used to examine test- retest reliability.
The results of Rasch model measurement revealed that OSA had good construct validity. There were 73% items matched between OSA and COPM. Besides, moderate correlation was noted between Rasch score as well as COPM performance mean score and satisfaction mean score, which was suggested that OSA had moderate concurrent validity. Weighted kappa in 75% to 100% items of four subscales was up to 0.4, which was suggested that OSA had moderate test-retest reliability.
The research findings suggested that OSA had good psychometric properties, and can be applied in clinic to be a valid and reliable assessment tool.
Key words: OSA, model of human occupation, client center, schizophrenia

並列關鍵字

OSA ； client center ； model of human occupation ； schizophrenia

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