簡易檢索 / 詳目顯示

研究生: 高玉芬
Yu-Fen,Kao
論文名稱: 酒精依賴嚴重度量表中文版之信效度建構研究
The Reliability and Validity of Chinese Version of Severity of Dependence Scale for Alcohol (SDS-A[ch]) Study
指導教授: 李景美
Lee, Ching-Mei
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2010
畢業學年度: 98
語文別: 中文
論文頁數: 87
中文關鍵詞: 酒精依賴嚴重度量表信度效度ROC曲線
英文關鍵詞: Alcohol, Severity of Dependence Scale, Reliability, Validity, ROC curve
論文種類: 學術論文
相關次數: 點閱:346下載:49
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 酒精依賴嚴重度量表(Severity of the Dependence Scale for Alcohol,SDS-A)是一個用以評估個案酒精依賴嚴重程度的簡短五題量表,本研究目的為建構中文版酒精依賴嚴重度量表之信與效度。
    本研究自99年2月至6月間進行,樣本是以北部某醫院之酒藥癮病房戒酒個案及北部某勒戒機構之安非他命個案為研究對象,採橫斷式的方便取樣,共計100位。信度採內部一致性信度與再測信度進行,效度採建構效度,並以酒精使用疾患確認測驗作為效標關聯效度。每位加入本研究的個案皆由1位精神科專科醫師以MINI國際神經精神科面談診斷進行會談,確認個案是否有酒精依賴的診斷,並將診斷的結果與酒精依賴嚴重度量表進行相關性分析,決定量表最佳切分點。
    結果顯示,酒精依賴嚴重度量表於信度方面,內部一致信度Chronbach’s alpha值為0.92,再測信度皮爾森相關係數為0.90。效度方面,利用主成分因素分析求出量表的建構效度,結果得到單一因素,解釋變異量為79.11%。酒精使用疾患確認測驗之效標關聯效度皮爾森相關係數為0.88;在ROC區線下面積為97.8% (95%CI=.934,1.022),最適合的切分點為4分,敏感度為96.6,特異度為95.8。
    中文版酒精依賴嚴重度量表於本研究中結果顯示有不錯的信度與效度,建議未來能將此量表推廣到醫療院所或社區使用,並作為常規的檢測工具,藉以早期篩檢個案是否有酒精依賴嚴重的問題。

    The Severity of the Dependence Scale for Alcohol (SDS-A) is a short five-item scale to evaluate alcohol dependence case. The aim of study was to construct the reliability and validity of the Chinese version of Severity of Dependence Scale for Alcohol.
    This study was a cross-sectional survey with convenience sampling. The data were collected from February to June 2010. The sample were one hundred cases, including the alcohol dependence detoxication patients from the addiction ward in a hospital and the amphetamine users in a prison in Taipei area. The reliability test of the SDS-A included internal consistency reliability and test-retest reliability. Alcohol use Disorders Identification Test (AUDIT) was use to test the criterion-related construct validity of the SDS-A. Each case was assessed by a psychiatrists using Mini International Neuropsychiatric Interview (MINI) to diagnose alcohol dependence. The results of MINI diagnosis was the analyzed its correlation with SDS-A to determine the best cut-off point of SDS-A.
    The internal consistency reliability of SDS-A was fair, with the Chronbach's alpha being 0.92. The test-retest Pearson’s correlation coefficient of SDS-A was 0.90. In terms of validity, principal components analysis (PCA) was use to test the construct validity of SDS-A and a single factor was obtained, with the explained of SDS-A variance being 79.11%. AUDIT was use to test the criterion-related validity of SDS-A, with the Pearson's correlation coefficient being 0.88. The area under the ROC curve was 97.8% (95% CI =. 934, 1.022), and the most appropriate cut-off point was score of 4 or above, with sensitivity being 96.6 and the specificity being 95.8.
    The results showed that the Chinese version of Severity Dependence Scale for Alcohol had fair reliability and validity. It is suggested that this scale can be extensively used in medical institutions and communities. SDS-A can be used as a routine screening tool for early diagnosis and screening of alcohol dependency problems.

    中文摘要………………………………………………………… I 英文摘要………………………………………………………… II 致謝……………………………………………………………… III 目錄……………………………………………………………… IV 表目錄…………………………………………………………… V 圖目錄…………………………………………………………… VI 第一章 背景 第一節 研究動機……………………………………………… 1 第二節 研究目的與問題……………………………………… 6 第三節 名詞界定……………………………………………… 6 第二章 文獻探討 第一節 酒精依賴的定義……………………………………… 8 第二節 酒精依賴造成的影響………………………………… 12 第三節 酒精依賴常見篩選工具……………………………… 16 第四節 酒精依賴嚴重度量表之信度與效度………………… 21 第五節 接收操作特徵曲線…………………………………… 27 第三章 研究方法 第一節 研究對象……………………………………………… 32 第二節 研究工具……………………………………………… 32 第三節 研究步驟……………………………………………… 35 第四節 資料處理與分析……………………………………… 37 第四章 研究結果 第一節 社會人口學變項資料………………………………… 39 第二節 研究工具結果分佈趨勢……………………………… 41 第三節 信度建構……………………………………………… 50 第四節 效度建構……………………………………………… 51 第五節 ROC curve與最佳切分點…………………………… 53 第五章 討論 第一節 量表之信度建構……………………………………… 55 第二節 量表之效度建構……………………………………… 55 第三節 ROC curve與最佳切分點…………………………… 57 第六章 結論與建議 第一節 結論…………………………………………………… 58 第二節 建議…………………………………………………… 58 第三節 研究限制……………………………………………… 60 參考文獻…………………………………………………… 61 附錄一 安非他命研究人體試驗委員會同意函…… 70 附錄二 安非他命研究同意書……………………… 71 附錄三 酒癮研究人體試驗委員會同意函………… 77 附錄四 酒癮研究同意書…………………………… 78 附錄五 酒精依賴嚴重度量表授權同意證明……… 82 附錄六 酒精使用疾患確認測驗授權同意證明…… 83 附錄七 MINI台灣版使用同意書…………………… 84 附錄八 酒精依賴嚴重度量表……………………… 85 附錄九 酒精使用疾患確認測驗…………………… 86 附錄十 MINI台灣版(酒精濫用和依賴)…………… 87 表 目 錄 表2-1 DSM-IV與ICD-10對酒精依賴的定義比較……………… 11 表4-1 社會人口學資料………………………………………… 40 表4-2 酒精依賴嚴重度量表前測與後測分數分佈…………… 43 表4-3 酒精依賴嚴重度量表前測與後測總分分佈…………… 44 表4-4 酒精使用疾患確認測驗各題得分分佈………………… 46 表4-5 酒精使用疾患確認測驗總分分佈……………………… 48 表4-6 MINI國際神經精神科面談診斷之酒精依賴診斷症狀分佈 49 表4-7 MINI國際神經精神科面談診斷之酒精依賴診斷項目數… 50 表4-8 酒精依賴嚴重度量表再測信度………………………… 51 表4-9 KMO與Bartlett’s檢定…………………………………… 52 表4-10 解釋總變異量…………………………………………… 52 表4-11 酒精依賴嚴重度量表各題因素負荷量………………………52 表4-12 酒精依賴嚴重度量表與酒精依賴診斷之敏感度、特異度與切分點…54 圖 目 錄 圖2-1 不同篩檢測驗在ROC曲線上的表現………………………… 29 圖4-1 ROC curve於酒精依賴嚴重度量表……………………… 53

    中文
    孔繁鐘(2007)。第四版精神疾病診斷準則手冊。台北:合記。
    中華民國內政部全球資訊網。2010年3月7日。取自:
    http://www.moi.gov.tw/。
    行政院衛生署(2003)。酒癮防治手冊:台北。
    交通安全路口網。交通安全統計資訊。2010年1月7日。取自:
    http://168.motc.gov.tw/GIPSite/wSite/ct?xItem=28576&ctNode=1389&mp=1。
    伍希文、張景勳、羅慶徽(2006)。胎兒酒精症候群。基層醫學,
    21(8),211-213。
    李宇宙(2001)。MINI國際神經精神科面談診斷簡介。MINI台灣版
    2.1.0。台北市:台灣精神醫學會發行。
    李燕鳴、白璐(2000)。飲酒相關交通事故之醫療花費及死亡率情況
    分析。台灣家醫誌,10,148-161。
    吳潮聰(2001)。不醉才上道。台北:元氣齋。
    邱皓政(2001)。社會與行為科學的量化研究與統計分析(第三版)。台北:五南。
    邱皓政(2006)。量化研究與統計分析(第三版)。台北:五南。
    胡海國、林信男(1996)。ICD-10精神與行為障礙之分類。台北:中
    華民國醫學會。
    姚開屏(1996)。從心理計量學的觀點看測量工具之發展。職能治療
    學會雜誌,14(1),5-18。
    郭千哲(1994)。應用於臺灣地區基層醫療場所的酗酒篩檢問卷之設
    計與發展。未出版碩士論文,國立臺灣大學,臺北市。
    郭千哲(2005)。基層醫療診所的酒癮盛行率。台灣精神醫學,19(2),137-147。
    郭耿南(2007)。2005年國民健康訪問暨藥物濫用調查結果報告NO.2
    。台北:國家衛生研究院。
    陳俊興、黃名琪、沈武典(2006)。某綜合醫院問題性飲酒者之改變
    動機調查。台灣精神醫學,20(3),201-211。
    陳秋瑩、王增勇、林美薰、楊翠娟、宋鴻樟(2006)。原鄉的家庭暴
    力及受暴婦女求助行為之探討-比較原漢之差異。臺灣公共衛生
    雜誌,25(1),65-74。
    陳喬琪(1994)。成癮的定義是什麼。台灣精神醫學,8,67-68。
    葉紅秀(1996)。認識酒精濫用問題。臨床醫學,38(3),159-168。
    彭懷真(1999)。酒是現代組織的大挑戰。管理雜誌,302,98-99。謝菊英、蔡春美、管少彬(2004)。挑戰成癮觀點:減害治療模式。
    台北:張老師文化。
    警政統計通報(2010)。2010年6月30日。取自:
    http://www.npa.gov.tw/NPAGip/wSite/ct?xItem=51635&ctNode=11393&mp=1。
    蘇佳欣(1997)。怎樣飲酒最健康。台北:星辰。
    劉麗珠(1988)。酗酒問題及其對家庭功能影響之研究。未出版碩士
    論文,私立東海大學,臺中市。

    英文
    Aertgeerts, B., Buntinx, F., Bande-Knops, J., Vandermeulen, C., Roelants, M., Ansoms, S., & Fevery, J. (2000). The value of CAGE, CUGE, and AUDIT in screening for alcohol abuse and dependence among college freshmen. Alcoholism, Clinical and Experimental Research , 24(1), 53-57.
    Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The Alcohol Use Disorders Identification Test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol , 56(4), 423-432.
    Carran, D. T., & Scott, K. G. (1992). Risk assessment in preschool children: Research implications for the early detection of educational handicaps. Topics in Early Childhood Special Education, 12(2), 196-211.
    Chen, C. H., Chen, W. J., & Cheng, A. T. (2004). Prevalence and identification of alcohol use disorders among nonpsychiatric inpatients in one general hospital. General Hospital Psychiatry, 26(3), 219-225.
    Chen, V. C., Chen, H., Lin, T. Y., Chou, H. H., Lai, T. J., Ferri, C. P., & Gossop, M. (2008). Severity of heroin dependence in Taiwan: Reliability and validity of the Chinese version of the Severity of Dependence Scale (SDS[Ch]). Addictive Behaviors, 33(12), 1590-1593.
    Cheng, A. T. (1995). Mental illness and suicide. A case-control study in east Taiwan. Archives of general psychiatry, 52(7), 594-603.
    Cherpitel, C. J. (1995). Analysis of cut points for screening instruments for alcohol problems in the emergency room. Journal of Studies on Alcohol, 56(6), 695-700.
    Coleman, D. H., Straus, M. A. (1986). Marital power, conflict, and violence in a nationally representative sample of American couples. Violence and Victims, 1(2), 141-157.
    Davidson, K. M. (1995). The diagnosis of depression in alcohol dependence: Changes in diagnosis with drinking status. British Journal of Psychiatry, 166 (2), 199-204.
    de las Cuevas, C., Sanz, E. J., de la Fuente, J. A., Padilla, J., & Berenguer, J. C. (2000). The Severity of Dependence Scale (SDS) as screening test for benzodiazepine dependence: SDS validation study. Addiction, 95(2), 245-250.
    Ferri, C. P., Marsden, J., Araujo, M., Laranjeira, R. Gossop, M. (2000). Validity and reliability of the Severity of Dependence Scale (SDS) in a Brazilian sample of drug users. Drug and Alcohol Review, 19, 451-455.
    Gayford, J.J. (1975) Wife battering: A preliminary survey of 100 cases.British medical journal, 1(5951), 194-197.
    Glascoe, F.P., Byrne, K. E., Ashford, L. G., Johnson, K.L., Chang, B., & Strickland, B. (1992). Accuracy of the Denver-II in Developmental Screening. Pediatrics, 89(6 Pt 2), 1221-1225.
    Glascoe, F.P., Martin, E.D., & Hunphrey, S. (1990). A comparative review of developmental screening tests. Pediatrics, 86(4), 547-554.
    Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., & Strang, J. (1995). The Severity of Dependence Scale (SDS): Psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90(5), 607-614.
    Gossop, M., Marsden, J., & Stewart, D. (2002). Dual dependence: Assessment of dependence upon alcohol and illicit drugs, and the relationship of alcohol dependence among drug misusers to patterns of drinking, illicit drug use and health problems. Addiction, 97(2), 169-178.
    Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, S. P., Dufour, M. C., & Pickering, R. P. (2004). The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002. Drug and Alcohol Dependence, 74(3), 223-234.
    Green, D. M., & Swets, J. A. (1974). Signal detection theory and psychophysics. New York: Krieger.
    Greiner, M., & Gardner, I. A. (2000). Epidemiologic issues in the validation of veterinary diagnosis tests. Preventive Veterinary Medicine, 45(1-2), 3-22.
    Hanley, J. A., & McNeil, B. J. (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 143(1), 29-36.
    Harrison, C. A., & Abou Saleh, M. T. (2002). Psychiatric disorders and substance misuse: Psychopathology. In G. H. Rassool (Eds), Dual Diagnosis: substance misuse and psychiatric disorders (pp.43-57). United Kingdom: Blackwell Science Ltd.
    Haynes, R. B., Sacket, D.L., Guyatt, G. H., & Tugwell, P. (2006). Clinical Epidemiology: How to do clinical practice research (3rd ed). Philadelphia, PA: Lippincott Williams & Wilkins.
    Hides, L., Dawe, S., Young, R. M., & Kavanagh, D. J. (2007). The reliability and validity of the Severity of Dependence Scale for detecting cannabis dependence in psychosis. Addiction, 102(1), 35-40.
    Hulley, S. B., Cummings, S. R. (Eds.). (1988). Designing Clinical Research. Baltimore, MD: Williams & Wilkins.
    Hulley, S. B., Cumming, S. R., Browner, W. S., Grady, D., Hearst, N., & Newman, T. B. (2001). Designing clinical research: An epidemiology approaches (2nd ed).Philadelphia, PA: Lippincott Williams & Wilkins.
    Humeniuk, R., Ali, R., Babor, T. F., Farrell, M.,Formigoni, M. L., Jittiwutikarn, J., de Lacerda, R. B., Ling, W., Marsden, J., Monteiro, M., Nhiwatiwa, S., Pal, H., Poznyak, V., & Simon, S. (2008). Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST). Addiction, 103(6), 1039-1047.
    Hwu, H. G., Yeh, E. K., Chang, L. Y. (1989). Prevalence of psychiatric disorders in taiwan defined by the chinese diagnostic interview schedule. Acta Psychiatrica Scandinavica, 79(2), 136-47.
    Kadri, N., Agoub, M., El Gnaoui, S., Alami, KhM., Hergueta, T., & Moussaoui, D. (2005). Moroccan colloquial Arabic version of the Mini International Neuropsychiatric Interview (MINI): Qualitative and quantitative validation. European Psychiatry , 20(2), 193-195.
    Kaye, S., & Darke, S. (2002). Determining a diagnostic cut-off on the Severity of Dependence Scale (SDS) for cocaine dependence. Addiction, 97(6), 727-731.
    Lang, T. A., & Secic, M. (1997). How to report Statistics in Medicine: annotated guidelines for authors, editor, and reviewers. Philadelphia, PA: American College of Physicians.
    Lawrinson, P., Copeland, J., Gerber, S., & Gilmour, S. (2007). Determining a cut-off on the Severity of Dependence Scale (SDS) for alcohol dependence. Addictive Behaviors, 32(7), 1474-1479.
    Lecrubier, Y., Sheehan, D., Weiller, E., Amorim, P.,Bonora, I., Sheehan, K.H., Janavs, J., & Dunbar, G. (1997) . The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: Reliability and validity according to the CIDI. European Child & Adolescent Psychiatry , 12(5), 224-231.
    Lin, T. (1953). A study of the incidence of mental disorders in Chinese and other cultures. Psychiatry, 16(4), 313-336.
    Marshal, M. P. (2003). For better or for worse ? The effects of alcohol use on marital functioning. Clinical Psychology Review, 23(7), 959-997.
    Martin, G., Copeland, J., Gates, P., & Gilmour, S. (2006). The Severity of Dependence Scale (SDS) in an adolescent population of cannabis users: Reliability, validity and diagnostic cut-off. Drug and Alcohol Dependence, 83(1), 90-93.
    Meisels, S. J. (1989). Can developmental screening tests identify children who are developmentally at risk? Pediatrics, 83(4), 578-585.
    Otsubo, T., Tanaka, K., Koda, R., Shinoda, J., Sano, N., Tanaka, S., Aoyama, H., Mimura, M., & Kamijima, K. (2005). Reliability and validity of Japanese version of the Mini-International Neuropsychiatric Interview. Psychiatry and Clinical Neurosciences, 59(5), 517-526.
    Pokorny, A. D., Miller, B. A., & Kaplan, H. B. (1972). The brief MAST: A shortened version of the Michigan Alcoholism Screening Test. The American Journal of Psychiatry, 129(3), 342-345.
    Roberts, A. R. (1987). Psychosocial characteristics of batterers: A study of 234 men charged with domestic violence offences. Journal of Family Violence, 2(1), 81-93.
    Roy, A. (1985). Suicide and psychiatric patients. Psychiatric Clinics of North America, 8(2), 227-241.
    Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption--II. Addiction, 88(6), 791-804.
    Selzer, M. L.(1971). The Michigan alcoholism screening test: The quest for a new diagnostic instrument. The American journal of psychiatry, 127(12), 1653-8.
    Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G.C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl. 20), 22-33.
    Stibler, H., Borg, S., Joustra, M. (1986). Micro anion exchange chromatography of carbohydrate-deficient transferrin in serum in relation to alcohol consumption (Swedish Patent 8400587-5). Alcoholism, Clinical and Experimental Research, 10(5), 535-544.
    Topp, L., & Mattick, R. P. (1997). Choosing a cut-off on the Severity of Dependence Scale (SDS) for amphetamine users. Addiction, 92(7), 839-845.
    Walker, L. E.(1984). The battered women syndrome. New York:
    Springer.
    World Health Organization: Global status report on alcohol. Geneva: World Health Organization, 1999.
    World Health Organization: Global status report on alcohol. Geneva: World Health Organization, 2002.
    Wu, A., Chanarin, I., & Levi, A. J. (1974). Macrocytosis of chronic alcoholism. Lancet, 1(7862), 829-831.

    下載圖示
    QR CODE