失能者身體功能之評量-失能者與其照顧者看法之比較

Abstract

目標：本文係在比較分析失能者和其家庭照顧者對失能者身體功能的評量，身體功能評量的面向為日常生活活動能力和工具性日常生活活動能力，進而分析影響兩者評量一致性的因素。方法：本研究所使用之資料係來自「建構長期照護體系先導計畫第一年實驗社區前測資料」，分析之樣本僅選取自答的失能者，且又有主要家庭照顧者；計有743位失能者及其照顧者的配對，又資料之分析方法為 Cohen’ s kappa值檢定、配對樣本 T 檢定、及兩組積差相關係數T檢定。結果：失能者和其家庭照顧者對於失能者日常生活活動能力之評量一致性高，而對於工具性日常生活活動能力之評量一致性普通；其次，不論在日常生活活動和工具性日常生活活動能力方面，照顧者傾向低估失能者的能力。另外，配偶照顧者比起非配偶照顧者、同住照顧者比起不同住照顧者、提供較多協助之照顧者比起較少協助之照顧者，有較低的評量一致性。結論：評量失能者身體功能，透過代答者所收集來的資料之品質會受到評量工具之明確性、失能者或代答照顧者的特性、以及兩人關係等因素之影響。

Objectives: The purpose of this paper was to compare the assessment of physical functioning as rated separately by disabled people and their family caregivers. The functional assessment included two major domains: activities of daily living (ADL) and instrumental activities of daily living (IADL). Furthermore, the purpose was to identify the factors that would influence the response agreement between proxy and subject reports for functional assessment. Methods: 743 disabled people and their caregiver’s dyad were selected from The Pilot Program for the Development of Long-Term Care System Baseline Survey. Inter-rater reliability (kappa) and the paired comparison test were employed for the purposes of data analysis. Results: The response agreement was relatively high for ADL assessment, and low for IADL assessment. Family caregivers generally rated a greater level of disability than the disabled people did. For non-spouse caregivers, those caregivers who lived with the disabled, and those who provided more assistance, the response agreement tended to be better than for their counterparts. Conclusions: When assessing the physical functioning of disabled persons, the quality of data collected via their caregivers will be affected by the clarity of the assessment tool, the characteristics of the disabled people and caregivers, as well as the relationship between the disabled people and their caregivers.