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    Please use this identifier to cite or link to this item: http://asiair.asia.edu.tw/ir/handle/310904400/110960


    Title: 「老年多向度觀察評估量表」中文化及信度與效度研究
    Authors: 施盈君
    Contributors: 健康產業管理學系長期照護組
    Keywords: 老年多向度觀察評估量表、MOSES中文量表、老年功能性評、Multidimensional Observation Scale of Elderly Subjects (MOSES)、MOSES Traditional Chinese version、Geriatric Assessment
    Date: 2018
    Issue Date: 2018-06-14 14:36:39 (UTC+8)
    Publisher: 亞洲大學
    Abstract: 台灣老年人口隨著醫療科技進步與生活水準提高而逐年增加,預估將於2018年將邁入聯合國定義之高齡社會(14%)。而老年人口所衍生的相關問題在近年來也受到國人的密切關注,其中老年長者所特別需要的長期照護議題是所有問題中最為大家所關切。在長期照護實務與研究上,「功能」,是老年長期照護實務中極為重要的目標與相關研究所必須探討的結果。因此,能有一個具多面向、有良好的量尺特性、不耗時且易於使用的評估工具,來對長者進行全面性的評估,是提供高品質的個別性照護,以及進行相關研究至為重要的基石。
    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。
    本研究以方便取樣、採橫斷式調查研究方式,對台灣中部地區老人福利機構住民進行身體、心理與社會性之完整功能性評估。在取得原作者授權後,依循世界衛生組織之翻譯過程的指導原則與步驟進行量表中文化。再以MOSES量表的五大領域,包括評估自我照顧功能、定向感缺損行為、憂鬱/焦慮情緒、激躁行為、與社會退縮行為等;分別以前述五大領域的單一向度評估量表,對機構長者進行評估。探討MOSES全量表及各領域分數與各單一向度評估量表的表現,並進行信效度檢定。
    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。
    研究結果顯示,翻譯後的MOSES中文版量表具有良好的信度與效度,且MOSES中文版量表的量尺表現與原量表之研究結果近似。顯示MOSES量表中文化可供老年長期照護機構使用者進行多面向評估,亦可供相關老年功能性研究作為一可信賴的評估工具。期待MOSES中文量表能提供未來有志於探討機構長者自我照顧、定向感缺損、憂鬱/焦慮情緒、激躁行為及社會退縮行為等相關研究之研究者量表使用之參考。

    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.
    Appears in Collections:[健康產業管理學系] 博碩士論文

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