- 學位論文
整合神經病變評分量表臨床中文版之信效度建立
Reliability and validity of The Total Neuropathy Score Clinical Chinese Version
摘要
研究背景:癌症病人接受化學治療常引起的周邊神經病變，因症狀表現較不明顯，容易受到醫療團隊和病人忽略。目前，化學治療引起的周邊神經病變的評估工具繁多，但使用上尚未有一致性且偏向主觀評估，因此，臨床醫護人員需要具信效度且囊括主客觀症狀/徵象的評估工具，運用在癌症治療的臨床照護中。 研究目的:建立「整合神經病變評分量表臨床中文版」之信效度。 研究方法:本研究採橫斷式探索性研究，以立意取樣方式依照納入條件和排除條件收案，參與者分為使用神經毒性化學治療癌症病人(100人)以及對照組健康成人(30人)。「整合神經病變評分量表臨床中文版」的信度以內在一致性以及再測信度來測定。效度的測試則進行探索式因素分析、並以斯皮爾曼等級相關係數(Spearman’s rank order correlation coefficient)分別呈現歐洲癌症研究與治療組織生活品質量表-化學治療引起的周邊神經病變(European Organization for Research and Treatment of Cancer quality of life questionnaire-chemotherapy -induced peripheral neuropathy 20)、癌症療法評估/婦癌研究組織-神經毒性次量表(Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity subscale)與「整合神經病變評分量表臨床中文版」之收斂效度，以及癌症病人與健康成人「整合神經病變評分量表臨床中文版」之間的已知群組驗證。 研究結果:「整合神經病變評分量表臨床中文版」的內在一致性Cronbach's α係數為.68，再測信度的測試結果組內相關係數為.98，探索式因素分析結果分成直徑較大與直徑較小的神經纖維兩構面；「整合神經病變評分量表臨床中文版」與EORTC QLQ-CIPN20感覺神經構面和FCAT/GOG-Ntx subscale具有中度相關(r=.537和-.524, p<.01)，EORTC QLQ-CIPN20與運動神經和自律神經構面相關性較低(r=.382和.266, p<.01)；已知群組檢測方面，癌症病人和健康成人兩組平均分數在統計上有顯著差異(95%信賴區間=2.48分-3.70分, t=10.05, df=99, p<.001)。 結論: 「整合神經病變評分量表臨床中文版」在台灣心理計量測試的結果顯示其具信效度，使用方便、快速，且花費少。可提供化學治療之患者評估主觀和客觀上的周邊神經變化，適合使用在台灣臨床照護和研究。
並列摘要
Background: Even with high occurrence, the symptoms of Chemotherapy -induced peripheral neuropathy (CIPN) do not perform significantly, and the existence of CIPN is often overlooked by the healthcare team and patients. Until now, there are many instruments for assessing CIPN, but have no agreement in clinical utilization.The need for an assessment tool with good reliability and validity, including subjective symptoms and objective signs is indispensable. Aim: To verify the reliability and validity of The Total Neuropathy Score Clinical Chinese Version. Patients and methods: This was an exploratory and cross-sectional study that using the purposeful sampling to include the samples. The participants included 100 cancer patients receiving neurotoxicitic chemotherapy and 30 health adults. The reliability of The Total Neuropathy Score Clinical Chinese Version was evaluated by internal consistency reliability and test-retest reliability.The validity of TNSc was evaluated by exploratory factor analysis、convergent validity among Total Neuropathy Score Clinical Chinese Version、EORTC QLQ-CIPN20 and FCAT/GOG-Ntx subscale, and the known-groups validation between the cancer patients and health adults. Result: The internal consistency reliability Cronbach's α was .68 and test-retest reliability ICC was .98. The exploratory factor analysis extracted two factors, which were the larger and the smaller diameter nerve fiber; the correlation between Total Neuropathy Score Clinical Chinese Version、EORTC QLQ-CIPN20 sensory dimension and FCAT/GOG-Ntx subscale were moderate(r=.537 and -.524, p<.01), and the correlation between Total Neuropathy Score Clinical Chinese Version、EORTC QLQ-CIPN20 motor and autonomic dimension is low(r=.382 and.266, p<.01); and the known-groups validation was statistically significant (95% confidence intervals=2.48-3.70, t=10.05, df=99, p<.001). Conclusion: The Total Neuropathy Score Clinical Chinese Version has good reliability and validity. It may be utilized conveniently and rapidly with less cost. It could assess the subjective symptoms and objective signs of CIPN, and is suitable to apply in clinical healthcare and study in Taiwan.
參考文獻
延伸閱讀
- 江欣虹、賴寧生、Hanoch Livneh、葉美玲、蔡宗益（2013）。中文版簡式疾病接受度量表之信效度檢定。志為護理-慈濟護理雜誌，12(1)，66-76。https://www.airitilibrary.com/Article/Detail?DocID=16831624-201302-201403120005-201403120005-66-76
- 陳燕雅（2008）。中文版本疼痛行為量表之建立與信效度檢測〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2008.00048
- 陳淑菁、劉介宇、謝佳容、劉玟宜（2017）。慢性精神病患中文賦能量表之建立及信效度檢驗。精神衛生護理雜誌，12(1)，5-13。https://doi.org/10.6847/TJPMHN.201709_12(1).0001
- 簡淑芬（2008）。中文版安全態度量表之信效度評估與應用-某醫學中心病人安全文化之初探〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2008.00597
- 程維德、李政育（2017）。The clinical efficacy of traditional Chinese medicine in the treatment of peripheral nerve trauma。中國鍼灸學雜誌，5(1)，62-80。https://doi.org/10.6528/CAMS.2017.0006