『參與和自主衝擊問卷』用於精神障礙者之信效度研究

Psychometric Properties of the Taiwanese Version of the Impact on Participation and Autonomy Questionnaire for People with Mental Illness

王禎笛(Chen-Ti Wang) ； 徐淑婷(Shu-Ting Hsu) ； 凃金堂(Chin-Tang Tu) ； 吳明宜(Ming-Yi Wu)

《復健諮商》 7期 (2014/11) Pp. 43-72

摘要

研究背景與目的：『參與和自主衝擊問卷（the Impact on Participation and Autonomy Questionnaire [IPA]）』為Cardol等人（1999）針對「參與」概念所編製的評估工具，主要在評估慢性障礙者自覺障礙對其參與和自主方面的影響或衝擊。本研究將IPA進行中文化，並以慢性精神病患者為樣本來檢驗其信效度。研究方法：本研究以後向翻譯模式進行IPA的中文化，研究對象為175位台灣南部地區精神復健機構的忠者。本研究檢驗之心理計量有內部一致性、相隔二週再測信度、及建構效度，並分析受試者的障礙程度與認知程度對於『參與和自主衝擊問卷中文版』（IPA-T）評估結果的影響。研究結果：IPA-T中，測量日常生活各項活動的自主性及參與程度者共有25題，可分為室內自主性、居家及社區生活、就業與教育等3個因素結構。內部一致性（Cronbach's α）為.906至.937間，再測信度（ICC）為785至904間。以『WHODAS II 12題白填版』測量個案的障礙程度，以『簡式智能量表團台灣中文版（MMSE-T)』測量個案的認知程度，發現『WHODAS II 12題自填版』得分與IPA-T的「室內自主性」、「店家及社區生活」向度為中度正相關，與「就業與教育」向度為低度正相關，而MMSE-T得分與IPA-T的「室內自主性」、「居家及社區生活」向度呈現低度負相關，與「就業與教育」向度無顯著相關。逐步多元迴歸分析發現，慢性精神病患者的「整體失能情形」對其「自覺參與程度」有中等程度的影響力，但「認知程度」卻不見得會影響其「自覺參與程度」。 研究結論：IPA-T為一頁具信效度的測驗工具，且適用於慢性精神病患者。

關鍵字

參與 ； 自主性 ； 信度 ； 效度 ； 精神障礙者 ； 參與和自主衝擊問卷

並列摘要

Objectives: The Impact on Participation and Autonomy Questionnaire (IPA), which was conceptually based on the ICIDH-2 was developed by Cardol and her colleagues (1999), evaluates the perceived personal impact of chronic disability on participation and autonomy. The purpose of this study was to evaluate the psychometric properties of the Taiwanese version of the IPA (IPA-T) utilizing a sample of people with mental illness. Methods: The IPA was translated into Taiwanese version following the forward-backward translation process. A total of 175 persons from psychiatric rehabilitation institutions in southern Taiwan participated in this study. The internal reliability, 2-week test-retest reliability, and construct validity of the IPA-T were examinated, and the influence of disability and cognitive states to participants' IPA-T results was also analyzed. Results: The IPA-T contains 25 items that assesses participation levels among daily activities, and can be classified into 3 factors: Autonomy Indoors, Domestic and Community Life, as well as Work and Education. Internal reliability (Cronbach's α ranged from .906 to .937) and test-retest reliability of the IPA-T were confirmed for all subscales (ICC ranged from .785 to .904). The WHODAS II 12-item version was used to assess participants' general health and disability condition, and the MMSE-T was used to assess participants' cognitive state. The former was found to have moderate positive correlations with the 'autonomy indoors' and 'domestic and community life' factors, and mild positive correlations with the ‘work and education' factor of IPA-T. The latter was found to have mild negative correlation with the 'autonomy indoors'/'domestic and community life' factors, but no correlation with the 'work and education' factor. Based on step-wise multi-regression analysis, 'general health and disability condition' of individuals with mental illness had moderate power in predicting their 'perceived participation', but not 'cognitive state'. Conclusions: The IPA-T is a reliable and valid instrument for people with mental illness.

並列關鍵字

participation ； autonomy ； reliability ； validity ； mental illness ； the Impact on Participation and Autonomy Questionnaire