霍普金斯復健參與度評估量表中文化與初步心理計量特性驗證:以中風個案之職能治療參與度為例

Hopkins rehabilitation Engagement Rating Scale in Chinese version and preliminary psychometric properties verification: The participation of occupational therapy for stroke cases

吳麗君(Li-Chun Wu)

指導教授 ： 呂文賢

中山醫學大學/醫學科技學院/物理治療學系碩士班/碩士(2015年)

https://doi.org/10.6834/CSMU.2015.00035

摘要

背景與目的： Lequerica 等人(2006)於研究中發現，患者在復健治療中參與度愈高，在認知及動作上的功能性改善會更好。所以患者對復健治療之參與度直接影響復健品質與成效。因為國內較少有研究公開提出直接及客觀性的復健參與度測量，因此本研究將Kortte 等人於2007年所發表之Hopkins Rehabilitation Engagement Rating Scale (HRERS) 中文化並進行心理計量特性檢測。
研究方法：將「霍普金斯復健參與量表」翻譯成中文量表後，以住院的中風患者為施測對象。並以此三項評估工具之分數：芙格梅爾評估量表(Fugl-Meyer Assessment Scale)之上肢評估量表、伯格氏平衡量表(Berg Balance Scale)、巴氏量表(Barthel Index, BI)驗證中文版HRERS的預測效度。
研究結果：本量表原本為五個題項，經由項目分析後，刪減題項(一)。四題項之修訂中文版HRERS之Cronbach's α=0.898 - 0.932，顯示此量表具有「良好」之內部一致性。四題項之修訂中文版HRERS亦具有良好之區辨效度(未具有地板或天花板效應)、施測者間信度(ICC=0.65至0.93)及最小可偵測變化值(MDC為3.47-7.46分、MDC%為14% - 31%)。預測效度差(p > 0.05)。
結論：四題項之修訂中文版HRERS具有良好之內部一致性、區辨效度、施測者間信度及最小可偵測變化值，有潛力成為測量病人復健參與度之合適工具。但本研究樣本數少，並有嚴格的個案篩選標準，研究結果難以概化到所有的中風病人身上。後續研究可以招募更多具有不同層級認知功能和門診的受試者以驗證本研究之結果。

關鍵字

中風 ； 參與度 ； 心理計量

並列摘要

Background and Purpose: Lequerica et al.’s research showed that the patients who engaged more in rehabilitation activities would get more improvements in cognition and motion functions. Thus, the patients’ level of engagement in rehabilitation activities influenced the rehabilitation qualities and outcomes straightly. However, little research has suggested any direct and objective instruments to measure the level of engagement in rehabilitation activities in Taiwan. The main purposes of this study were to translate the English version of Hopkins Rehabilitation Engagement Rating Scale (HRERS), published by Kortte et al. in 2007, into Chinese version and verify the psychometric properties of the Chinese HRERS (CHRERS).
Method: We translated the HRERS into Chinese version first, and then applied the CHRERS on 12 in-patients three times during their admission to verify the psychometric properties of the CHRERS. We used the scores of three instruments: Fugl-Meyer Assessment Scale of U/E assessment scale、Berg Balance Scale、Barthel Index(BI) to verify the predictive validity of the CHRERS.
Results: After item analysis, the item 1 in the original scale (5 items) has been deleted. The Cronbach’s α of the revised CHRERS (4 items) was 0.898 to 0.932, that means the scale has “good” internal consistency. The revised CHRERS either has good discriminative validity (no floor or ceiling effect), inter-rater reliability (ICC=0.65 to 0.93), and minimal detectable change (3.47-7.46, MDC% =14% - 31%). The predictive validity of the CHRERS was poor (p＞0.05).
Conclusion: The 4-item CHRERS has sound internal consistency, discriminative validity, inter-rater reliability and minimal detectable change, was a potentially suitable instrument to measure the patients’ level of engagement in rehabilitation activities. The small sample size and rigid inclusion criteria thread the generalization of our results to all stroke patients. Further researches recruiting more participants with more varied levels of cognitive functions and out-patient are warranted to verify our results.

並列關鍵字

stroke ； participation ； psychometric

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