本研究即欲建立中文版「Multidimensional Observation Scale of Elderly Subjects, MOSES」量表（中譯：老年多向度觀察評估量表）之信度與效度。同時亦探討此觀察式量表在長期照護機構老年長者適用性。
研究共有60位長者參與，平均年齡為80.72±8.25歲，其中以女性居多（N＝34，56.7％）。多數未曾入住機構（N＝52，86.7％），而其健康狀態算是良好，共病嚴重度不高，察爾森共病指標 (CCI)中位數為5.00。信度檢測中，評分者間信度Krippendorff's Alpha 為 0.87。MOSES中文版量表的內在一致性，Cronbach’s alpha值在「自我照顧功能」為0.93、「定向感缺損行為」為0.93、「憂鬱/焦慮情緒」為0.92、「激躁行為」為0.92及「社會退縮行為」為0.78。在效度檢驗上，內容效度中的「題項內容效度指標」（I-CVI）之平均值與「量表內容效度指標」（S-CVI）的平均值皆為0.99。效標關聯效度檢測之Pearson’s 相關係數r值，在自我照顧功能」為-0.90、「定向感缺損行為」為-0.86、「憂鬱/焦慮情緒」與簡式老人憂鬱量表間的r值為0.65、與情緒自評量表中的憂鬱（DASS-D）及焦慮（DASS-A）兩個領域之r值分別為0.65及0.53，而與神經精神病徵調查表的「憂鬱/情緒不佳」之r值為0.75，與「焦慮」的r值為0.65；「激躁行為」為0.82，「社會退縮行為」為0.72，上述r值都達統計學上顯著水準。
Thanks to the improvement medical progress and the living standard, the elderly population in Taiwan significantly increased especially in recent year. According to the prediction from the government, in 2018, Taiwan will become the aged society, an elderly population of 14 or more by the definition of the UN. The ageing related issues have attracted the attention by the whole society in Taiwan, and the issues of long-term care specifically for the elderly are most important. In the field of long-term care, functionality is the most important goal in practice and the necessary outcomes in relevant research. In this way, a comprehensive assessment tool with the characteristics of multiple dimensions, sound psychometry, time-saving, and handiness is crucial to provide individual care and research.
The aims of the present study are to translate the Multidimensional Observation Scale of Elderly Subjects, MOSES into traditional Chinese, to examine the reliability and validity, and explore the feasibility of its use in the elderly in the long-term care facility.
A total of 60 older adults were enrolled in the study, the average age of the participants was 80.72±8.25, with female predominant (N＝34, 56.7%), and the majority of them were never institutionalised (N＝52, 86.7%). Most of the enrolled elderly were rather healthy with relatively low (median=5.00) in comorbided severity as indicated by Charlson Comorbidity Index (CCI). In reliability testing, the inter-rater reliability was assessed with Krippendorf's method, and K-alpha was 0.87, indicating a good reliability between raters. The internal validity testing showed the Cronbach's alpha of 0.93 for self-care functioning, 0.93 for disoriented behaviours, depression/anxiety, and irritable behaviour, and 0.78 for withdraw behaviours. We performed content validity and criterion-related validity to examine the construct validity. Content validity was assessed with item-level and scale-level content validity indices (I-CVI and S-CVI). Both I-CVI and S-CVI were 0.99, judged as excellent validity for content validity. The Pearson's r between targeted criterion and self-care functioning was -0.90, and -0.86 for disoriented behaviours. The Pearson's r of self-report criteria and depression/anxiety was 0.65 for Geriatric Depression Scale, 0.65 and 0.53 for DASS-D and DASS-A respectively. The Pearson's r in rater-rated scale was higher, and was 0.75 and 0.65 for NPI-dysphoric and NPI-anxiety respectively. The Pearson's r for the criterion and irritable behaviour was 0.82, and 0.72 for withdraw behaviours.
Based on our results, the MOSES Traditional Chinese version showed good reliability and validity, and was similar to the psychometric properties in the original study. In conclusion, we believed that the MOSES Traditional Chinese version can be a reliable assessment tool for future practice and research in the field of long-term care.