英國伯明罕大學認知篩檢測驗中文版之建立與確認

The Development and Validation of the Chinese Version of the Birmingham University Cognitive Screen (C-BUCS)

黃馨儀(Hsin-Yi Huang)

指導教授 ： 葉怡玉

國立臺灣大學/理學院/心理學研究所/碩士(2010年)

https://doi.org/10.6342/NTU.2010.10750

摘要

中風常伴隨著認知缺損的問題。文獻指出中風所造成的認知缺損範圍相當廣泛，包含語言、記憶、注意力、和執行功能等。然而長期以來評估工具在臨床上的使用參差不齊。以國內臨床實務而言，目前對中風患者進行認知功能評估時，常使用針對失智症患者設計的評估工具，例如簡易智能評估（Mini-Mental State Examination, MMSE）和認知能力篩檢工具（Cognitive Ability Screening Instrument, CASI），或必須從不同測驗中抽取適當的成份測驗來對患者進行檢測。本研究引進專為中風病人設計的伯明罕大學認知篩檢測驗（Birmingham University Cognitive Screen, BUCS）作為研究工具進而發展中文版C-BUCS，目的在發展一套專為台灣中風患者設計的認知功能評估工具，並初步評估此量表在臨床上之適用性，同時與MMSE和CASI進行比較。本研究共收集100位受試者，以中文為母語且全部完成測驗的受試者共有64人，其中中風患者有33人，正常組有31人。我們以這64個人的資料進行探索性因素分析、建構效度檢定、區辨分析、及單因子變異數分析。由探索性因素分析結果可知中文版BUCS包含五個潛在構念，分別為記憶、語言、注意力偏向、執行功能、和注意力維持，涵蓋了中風患者常見的認知缺損。此外，區辨分析的結果顯示單獨使用MMSE或CASI進行認知功能評估時，對於不同類型的中風患者沒有足夠的區辨力，而C-BUCS則有高度的區辨力，能夠真確地評估中風患者的認知功能。綜合本研究的分析可發現C-BUCS無論在理論上或是臨床上都是一份適當且良好的評估工具，可提供國內學術界和臨床工作者一個完整與客觀的指標。

關鍵字

中風 ； 認知功能 ； 中文化 ； 探索性因素分析 ； 區辨分析

並列摘要

Stroke often accompanies cognitive impairment. Previous studies have found that stroke could cause a variety of cognitive deficits, including language, memory, attention, and executive function. The Birmingham University Cognitive Screen (BUCS) is designed specifically for cognitive evaluation of stroke patients with two important features: vertical alignment of stimuli and inclusion of nonverbal tests. The aim of this research is to develop a Chinese version of BUCS (C-BUCS) and evaluate its applicability in Taiwan’s patient population. Furthermore, we validate Chinese BUCS by examining its construct validity and discriminant validity. We recruited 100 volunteers, with 33 stroke patients and 31 normal controls completing all items, to participate in the study. We examined the construct validity of Chinese BUCS using the comparable subtests in Cognitive Ability Screening Instrument (CASI) and also its latent structure using the exploratory factor analysis. In addition, we conducted discriminant analysis and one-way analysis of variance to investigate whether the C-BUCS can classify sub-groups of participants based on two classification schemes (territory, toast). The results showed that the C-BUCS comprised of five factors, including memory, linguistic ability, attentional bias, executive function, and sustained attention. The correlations with comparable CASI subtests with were all significant. In addition, the results of the discriminant analysis showed that C-BUCS was very sensitive and discriminative, reflecting the cognitive abilities of different sub-groups of participants. C-BUCS appears to be an appropriate assessment tool for clinical evaluation, providing clinicians and researchers an objective indicator to test cognitive abilities of stroke patients.

並列關鍵字

stroke ； cognitive ability ； translation ； exploratory factor analysis ； discriminant analysis

參考文獻

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