愉悅性活動量表中文版於長照機構住民之信效度初探-以中部長照機構為例

A Preliminary Reliability and Validity of the Chinese Version of the Pleasant Events Schedule (PES) for Long-Term Care Residents: The Case of Long-Term Care Institution in the Central Taiwan

梁峻豪(CHUN-HAO LIANG)

指導教授 ： 何清治

中臺科技大學/管理學院/醫療暨健康產業管理系碩士班/碩士(2018年)

摘要

研究背景：長照機構住民普遍是老年人及失能住民，健康狀態逐漸衰退，人際疏離產生空虛和寂寞，易造成心理疾病如憂鬱症等，而愉悅性活動(pleasant events)可幫助住民改善健康效益。然而，大多數住民缺乏愉悅性活動，與其多從事靜態活動以及身體狀態有關。為了呼應世界衛生組織於2002年提出「活躍老化 (Active Ageing)」的觀念，推動住民從事愉悅性活動，來提升生活品質以減輕憂鬱症狀，找出其中關鍵的影響因素為首要任務。
研究目的：發展愉悅性活動量表中文版(Peasant Events Schedule, PES-CH)，並驗證其應用於臺灣長照機構住民之信度與效度。
研究方法：本研究先以簡易心智狀態問卷調查表(SPMSQ)篩選中部某長期照護機構60位適合住民為對象。PES量表中文版參考Meeks (2009)等人所編製英文版愉悅性活動量表(Pleasant Events Schedule-Nursing Home, PES-NH)，藉由認知行為療法(Cognitive-Behavioral Therapy, CBT)的介入，並進行前後測以檢定其再測信度。作為PES量表中文版的效標關聯效度之量表包括生活品質量表(Quality of life, QoL)、老人憂鬱量表(Geriatric Depression Scale, GDS)、正負向情緒量表 (International Positive and Negative Affect Schedule Short Form, I-PANAS-SF)、日常生活動作(Activities of Daily Living, ADL)。
研究結果：本研究延請5位國內專家學者依研究目的進行表面及內容效度，結果顯示內容效度指標(Content Validity Indicator, CVI)均在0.80以上。在信度方面，量表三項指標(利用、愉悅、頻率)的Cronbach's α分別是0.72、0.84及0.79，再測信度也呈顯著(0.45、0.44、0.65)，顯示PES量表具有可靠的內部一致性及穩定度。在效標關聯效度上，PES量表中文版三項指標(利用、愉悅及頻率)和GDS呈顯著負相關，但和QoL呈顯著正相關。PES量表中文版三個指標利用、愉悅、頻率兩兩均呈顯著正相關，顯示住民在愉悅活動上有利用者、頻率愈多、則愈愉悅。愉悅愈高、生活品質愈好、憂鬱情形愈低。
結論：PES量表中文版對於長照機構是一個可靠有效的憂鬱治療工具，它可幫助社工或相關人員藉由認知行為療法的介入，有效率地評估和改善機構住民的憂鬱狀況。
關鍵字：長照機構、愉悅性活動量表、認知行為療法、信效度、健康促進

關鍵字

長照機構 ； 愉悅性活動量表 ； 認知行為療法 ； 信效度 ； 健康促進

並列摘要

Background: Residents of long-term care facilities are generally elderly and disabled people. Their health condition is gradually decline and interpersonal alienation results in emptiness and loneliness, which is easy to cause psychological diseases such as depression. Pleasant events can help the residents improve their health benefits. However, most residents lack pleasant events, which are related to their more static activities and physical state. In response to the concept of Active Ageing proposed by World Health Organization (WHO) in 2002, it is important to identify key determinants by executing residents doing pleasant events and improving their quality of life to alleviate their depression.
Objective: To develop a Chinese version of Pleasant Event Schedule (PES-CH) scale and examine the reliability and validity of its application to long-term care facility’s residents in Taiwan.
Methods: In this study, a Short Portable Mental Status Questionnaire (SPMSQ) was firstly used to screen 60 suitable residents in a long-term care facility of central Taiwan. PES-CH was referred to the English version of the Pleasant Events Schedule-Nursing Home (PES-NH) prepared by Meeks (2009). With the intervention of Cognitive-Behavioral Therapy (CBT), PES-CH was examined by the test-retest reliability. Criterion related validity is used to demonstrate the accuracy of a measure by comparing PES-CH with Quality of Life scale (QoL), Geriatric Depression Scale (GDS), International Positive and Negative affect Schedule short Form (I-PANAS-SF), and Activities of Daily Living (ADL).
Results: In this study, there are five domestic experts and scholars to verify the surface validity and content validity of PES-CH. Result showed the Content Validity Indicator (CVI) was above 0.8. In terms of reliability, the Cronbach's α of three dimensions (utilization, pleasure, frequency) of PES-CH were 0.72, 0.84 and 0.79 respectively, and the test-retest reliability was significant (0.45, 0.44, 0.65), showing that the PES-CH had reliable internal consistency and stability. In terms of Criterion related validity, there was a significant negative correlation between the three dimensions (utilization, pleasure and frequency) in PES-CH and GDS, but positive correlation with QoL. The three dimensions (utilization, pleasure and frequency) of PES-CH showed the significant positive correlation with each other and indicated that the residents participated in pleasant events, the more the frequency, the more joyful. The higher the joy, the better the quality of life, and the lower the depression situation.
Conclusions: The PES-CH is a reliable and effective depression therapy tool for residents of long-term care institution. PES-CH can help social workers or relevant personnel effectively assess and improve the depression of residents through the intervention of CBT.
Keyword: Long-term Care Facility, Pleasant Events Schedule, Cognitive-Behavioral Therapy, Health Promotion, Reliability and Validity

並列關鍵字

Long-term Care Facility ； Pleasant Events Schedule ； Cognitive-Behavioral Therapy ； Health Promotion ； Reliability and Validity

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