日常執行功能行為量表之發展與其因素結構及信效度研究

Development of the Daily Executive Behaviors Scale: Five-Factor Solution, Reliability, and Validity

吳玉欣(Yu-Hsin Wu) ； 余麗樺(Li-Fa Yu) ； 陳靖(Ching Chen) ； 郭乃文(Nai-Wen Guo)

《臨床心理學刊》 4卷2期 (2009/12) Pp. 86-94

https://doi.org/10.6550/ACP.200912_4(2).0002

摘要

目的：近年學者以使用評估執行功能缺損問卷之方式來標記患者行為表現層次之監控問題，以彌補傳統診間施行神經心理測驗之不足。因此本研究發展適用於本土使用的日常執行功能行為量表，並檢驗本量表之因素結構與信效度，以協助臨床工作者瞭解患者執行功能障礙之行為表徵。方法：本研究整理國外的執行功能異常問卷、本研究之研究團隊之臨床行為觀察、照顧者之抱怨等資料編製初步量表，經過專家評估修改後，收集179位腦傷與非腦傷患者資料進行因素分析，得到五個因素，另加入100位失智症、腦損傷患者與正常受試資料進行信效度與量表適用性考驗。結果：日常執行功能行為量表共21題，其中包括：因素一「動機控制因素」、因素二「計畫性因素」、因素三「情緒監控因素」、因素四「社交抑制因素」和因素五「環境互動監控因素」等五個因素。本量表與其各因素之內部一致性良好且可以有效區辨臨床組與正常組之表現差異。結論：本量表共包含五個因素，具有良好的信效度，並呈現額葉損傷、非額葉損傷與失智症等不同臨床診斷組之表現，為適用於臨床使用之日常執行功能行為量表。

關鍵字

日常執行功能行為 ； 額葉損傷

並列摘要

Objective: The executive dysfunction exhibited in brain-damaged patients is a severe sequela. However, current neuropsychological tests cannot assess executive dysfunction completely due to its various manifestations. The purposes of this study were to develop an executive behavior scale for screening unusual behaviors that would accompany dysexecutive syndromes and to examine the factor structure, reliability and validity of the scale.Method: The initial items were constructed based on authors' clinical observations, reviews of relevant literature, and contents on the dysexecutive scale. A panel of experts was then asked to evaluate the content coverage, complexity, clarity and relevance of the items. The items were further trimmed by conducting item analysis and factor analysis on response data of 179 subjects rated by their caregivers. One hundred subject data were added to further assess the reliability and validity of the scale.Resulst: The final executive behavior scale consisted of 21 items. The five factors extracted from the scale were as follows: motivation control, planning, emotion control, inhibition of social interaction, and environment monitor. The Cronbach's alpha coefficient of the scale was .91, which indicated good internal consistency. Furthermore, the scale was shown to be able to discriminate between the frontal-damaged, nonfrontal-damaged, dementia, and normal subjects.Conclusion: The five-factor executive behavior scale appears to possess good reliability and validity. It could be used in assessing executive dysfunction in clinical population in Taiwan.

並列關鍵字

daily executive behaviour ； frontal-damaged

參考文獻

郭乃文（2003）。「以Cohen認知神經心理學概念探討注意力功能測量研究」。台北：台灣大學心理學研究所博士論文。

Alexander, G. E., Delong, M. R., Strick, P. L.（1986）.Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9, 357-381.

Anderson, S. W., Damasio, H., Tranel, D.（1990）.Neuropsychological impairments associated with lesions caused by tumor or stroke. Archives of Neurology, 47, 397-405.

Ardila, A.（2008）. On the evolutionary origins of executive functions. Brain and Cognition, 68, 92-99.

Baddeley, A., Sala, S. D., Papagno, C., Spinnler, H. （1997）. Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. Neuropsychology, 11, 187-194.