發展清醒開顱手術之台灣版術中語言測驗：前導性研究

Development of the Taiwanese Version of Intraoperative Linguistic Tests for Awake Craniotomy: A Pilot Study

陳美慧(Mei-Hui Chen) ； 張韡瀚(Wei-Han Chang)

《台灣聽力語言學會雜誌》 45期 (2021/12) Pp. 9-39

https://doi.org/10.6143/JSLHAT.202112_(45).0002

摘要

背景：圖片測驗是清醒開顱手術（awake craniotomy）中常使用於的測驗，用以定位及監測病人的語言功能，其中常被使用的是圖片命名及語意關連測驗。然而這些測驗的圖片都是發展於外國，常受限於文化差異的不同，造成有些圖片無法適用；另外，圖片數量的不足，也可能影響清醒開顱手術的品質。方法：本研究以＂Dénomination d'objet 80＂（DO 80）與「波士頓命名測驗」為圖片命名測驗之藍本；「金字塔和棕櫚樹測驗」（Pyramid and Palm Tree Test）為語意關連測驗的藍本，第一階段經過詞彙蒐集、專家會議討論、繪製圖片、專家效度檢驗及「內在一致性信度」前測分析完成第一版測驗定稿；第二階段對新編測驗進行「內在一致性信度」及「同時效標關連效度」（以中文版波士頓失語症測驗為效標）之信效度檢驗。結果：本研究新編之長庚圖片命名及語意關連測驗皆經過專家效度檢驗，兩測驗皆新編150張圖片（題目），圖片類別各有20及21類。13名腦部病灶在語言區的病人完成「內在一致性信度」前測分析；37名腦部病灶在語言區的病人完成「內在一致性信度」及「同時效標關連效度」分析。命名測驗有良好的內在一致性信度（Cronbach's α = 0.932）及效標關連效度（皮爾森相關係數 = 0.736，p ＜ 0.01），而語意關連測驗亦有良好的內在一致性信度（Cronbach's α = 0.984）及中度關連效度（皮爾森相關係數 = 0.497，p ＜ 0.01）。結論：未來需要更好的研究設計及常模研究，讓這兩種測驗更成熟完備。

關鍵字

清醒開顱手術 ； 術中測驗 ； 命名測驗 ； 語意關連測驗 ； 語言功能定位

並列摘要

Background: Picture tests are often used as intraoperative tasks during awake craniotomy for intraoperative stimulation mapping and linguistic function monitoring. Visual object naming and semantic-association tests are commonly used. However, those tasks developed in the western world are based on cultures and education levels different from Taiwan, which causes insufficiently intraoperative application in Taiwan. Besides, inadequate numbers of the pictures also affect the quality of awake craniotomy. Methods: Using ＂Dénomination d'objet 80＂ (DO 80) and ＂Boston Naming Test＂ as the reference of the visual object naming test, and ＂Pyramid and Palm Tree Test＂ (PPTT) as the reference of the semantic-association test, we developed the novel tests. In the first stage of this study, the first versions of the novel visual object naming and semantic-association tests were constructed through the procedures, including collecting lexicons, meetings of experts, drawing pictures, expert validity assessment, and analysis of pre-test with internal consistency reliability. Using the short-form Boston Diagnostic Aphasia Examination-Chinese (BDAE-C) as the criterion, the reliability and validity of the new tests were analyzed by internal consistency reliability and concurrent, criterion-related validity in the second stage. Results: The novel visual object naming (Chang-Gung visual object naming) and semantic-association (Chang-Gung semantic-association) tests were validated by the expert validity assessment and both contained 150 pictures with 20 and 21 categories respectively. Thirteen patients with brain lesions around speech areas were recruited for analysis of pre-test with internal consistency reliability, while 37 patients with the same inclusion criteria were recruited for analysis of internal consistency reliability and concurrent, criterion-related validity. The naming test had good internal consistency reliability (Cronbach's α = 0.932) and criterion-related validity (Pearson correlation coefficient = 0.736, p ＜ 0.01) while the semantic-association test had good internal consistency reliability (Cronbach's α = 0.984) and medium criterion-related validity (Pearson correlation coefficient = 0.497, p ＜ 0.01). Conclusion: The collection of normative data and further research are needed to improve the first-versions of the novel tests.

並列關鍵字

Awake craniotomy ； Intraoperative test ； Naming test ； Semantic-association test ； Language function mapping

參考文獻

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