精神病患照顧者負荷量表之發展與驗證─以實務應用為取向

Abstract

社會功能關乎精神病患社區復健的潛力與結果，乃是精神醫療的重要一環，因此對於病患社會功能的評量是擬定病患處遇計劃的前置步驟。基於台灣並沒有經過嚴謹且完整信度與效度檢驗的社會功能量表，本研究根據Birchwood等人（1990）的社會功能量表加以修改與縮減，以適合台灣的社會文化情境，並增進實務運用的可能性。研究當中針對301為照顧者、65位病患、43位病患的手足施測；照顧者中有59位於3-4週之後進行再測。樣本來源包括北中南五家精神醫療單位，資料蒐集大多於門診進行。Birchwood等人的量表原有77題，本研究之初版為62題，後經專家審查與預測後修改為54題，以正式施測的資料進行多項信度與效度檢驗，本研究發展出36題的社會功能量表簡短版。這份量表具有良好的鑑別力、內在一致性、在測信度、評量者一致性、區辨效度、與因素效度及聚合建構效度，可適用於台灣地區的社區病患，並有常模提供實務工作者處遇計畫之參考；同時也可應用於未來的相關研究，以增進研究間的比較與研究結果之累積。

Caregiver burden has been an important aspect in psychiatric social work. However, in Taiwan there is a lack of a caregiver burden scale with sound psychometric properties and optimal length to help practitioners identify the caregivers who are most in need. This study aimed at developing a caregiver burden scale of this kind. Data were collected from five psychiatric units or hospitals in northern, central, and southern Taiwan. During outpatient visits, 301 caregivers were in- person interviewed. Among the caregivers, 59 were re-tested 3 to 4 weeks latter. Through comprehensive tests of reliability and validity, a 18-item caregiver burden scale was yielded. This scale has very good psychometric properties including internal reliability, test-retest reliability, factorial validity and convergent validity. With optimal length and norm, this scale is suitable for clinical usage to enhance the consistency and comprehensiveness of assessment. These scales can also be adopted in future studies to ensure measurement validity and make cross-study comparisons possible in the field of psychiatric services.