簡易檢索 / 詳目顯示

研究生: 施書驊
Shu-Hua, Shih
論文名稱: 以ICF為架構編製之日常生活量表之信、效度研究
Reliabilities and Validities of Scale of Activities of Daily Living developed based on ICF
指導教授: 吳亭芳
Wu, Ting-Fang
學位類別: 碩士
Master
系所名稱: 復健諮商研究所
Graduate Institute of Rehabilitation Counseling
論文出版年: 2010
畢業學年度: 98
語文別: 中文
論文頁數: 107
中文關鍵詞: 信度效度國際健康功能與身心障礙分類系統日常生活活動
英文關鍵詞: reliability, validity, International Classification of Functioning, disability and Health (ICF), activities of daily living (ADL)
論文種類: 學術論文
相關次數: 點閱:414下載:40
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 我國於民國96年「身心障礙者權益保障法」修法時,採用了世界衛生組織頒布的ICF障礙分類系統之「八大身心功能障礙類別」取代原先由醫師診斷的方式做為身心障礙鑑定之依據。為了因應新法之施行,行政院衛生署委託台北醫學大學進行「國際健康功能與身心障礙分類系統(ICF)推動計畫」,以發展適合台灣本土的ICF編碼標準以及鑑定工具。其中自我照顧和居家生活部分之對應工具為「日常生活量表」。但由於該量表甫完成,尚未有信、效度之建立,因此本研究之目的為建立該量表之施測者間信度、再測信度以及效標關聯效度。
    研究者實際施測中風個案,以檢定「日常生活量表」之施測者間信度以及再測信度,並以「巴氏量表」和「工具性日常生活功能」做為效標,考驗「日常生活量表」之效標關聯效度。
    研究結果發現「日常生活量表」的施測者間一致性百分比均介於70%-100%之間(Kappa值介於0.449-1);再測信度之一致性百分比介於73.3%-100%之間(Kappa值介於0.571-1),顯示「日常生活量表」有不錯的施測者間信度及再測信度。效標關聯效度部分,「日常生活量表」的自我照護部分,與巴氏量表及工具性日常生活量表均達顯著相關(Speearman相關係數達0.44-0.835)。但居家生活部分的效度表現則較不理想,未達顯著相關。
    由以上研究結果得知,「日常生活量表」應用於中風個案之評估具有良好的信度,但居家生活領域部分的題目仍須進行修改。未來的研究建議將此量表應用於不同診斷及障礙類的個案別並建立其信、效度,以增進該量表未來的可用性。

    People with Disabilities Rights Protection Act revised in 2007 has adopted ICF as a framework to determinate the eligibility of persons with disabilities in Taiwan. In order to assure a standardized process for eligibility, several scalses were developed to fulfill the pourpose. The “Scale of Activities of Daily Living” was developed as one of scales for disability eligibility. It was developed from the chapter 5 (self-care) and chapter 6 (domestic life) of the part of activities and participate from ICF. The aims of this study are to establish the inter-rater reliability, test-retest reliability and concurrent validity of the “Scale of Activities of Daily Living”. The inter-rater reliability was established from 2 occupational therapists to evaluate the clients at the same time and the test-retest reliability was established to assess the same client twice 2 weeks apart. In addition, the concurrent validity was established to compare the test results of the “Scale of Activities of Daily Living” to that of the “Barthel Index” and “Instrumental Activity of Daily Living”.
    50 stroke patients age between 33 and 90 years from out-patient rehabilitation clinics participated in this study. All the participants were eligible as physical disabilities. Data was analyzed by SPSS 18.0. The results indicated the followings:
    1.The inter-rater reliability of the “Scale of Activities of Daily Living” indicated by the consistence rates of 2 raters were between 0.7-1.00(Kappa=0.449-1).
    2.The test-retest reliability of the “Scale of Activities of Daily Living” indicated by the consistence rates of the first and the second assessments were between 0.73-1.00(Kappa=0.571-1).
    3.The spearman correlation of the “Scale of Activities of Daily Living” and “Barthel Index” were between 0.44-0.835.
    4.The spearman correlation of the “Scale of Activities of Daily Living” and “Instrumental Activity of Daily Living” were 0.312.
    The results explicated the “Scale of Activities of Daily Living” possesses satisfactory inter-rater reliability and test-retest reliability, yet the concurrent validity of domestic life were not good. Further studies should recruit more clients from different diagnosis and disabilities to enhance the usabilities of the “Scale of Activities of Daily Living”.

    中文摘要 I Abstract III 目錄 V 圖次 VIII 表次 IX 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 5 第三節 名詞釋義 6 第二章 文獻回顧 9 第一節 日常生活活動的定義與內涵 9 第二節 常用日常生活量表之評析 12 第三節 ICF臨床上之信度研究 26 第三章 研究方法 31 第一節 研究對象 32 第二節 研究工具 36 第三節 研究步驟 42 第四節 資料分析 45 第四章 研究結果 47 第一節 日常生活量表之信度檢定 47 第二節 日常生活量表之效標關聯效度檢定 55 第三節 現行身心障礙等級與功能表現之相關性 59 第五章 討論 65 第一節 日常生活量表之信度 65 第二節 日常生活量表之效標關聯效度 69 第三節 現行身心障礙等級與功能表現之相關性 71 第四節 受試者日常生活功能表現 73 第五節 研究結論 74 第六節 研究限制及建議 75 參考文獻 77 附錄 84 附錄一 基本資料表 84 附錄二 巴氏量表 85 附錄三 工具性日常生活活動能力量表(IADL) 86 附錄四 日常生活量表 88 附錄五 受試者同意書 99 附錄六 人體研究倫理委員會通過證明函 107

    中文部分
    王顏和、張彧(2005)。脊髓損傷患者生活品質與損傷、功能間關係之 研究。行政院國家科學委員會專題研究成果報告(報告編號:NSC93-2614-B-002-002-),未出版。
    王國羽、鄭清霞、傅從喜、林堤塘、梁鍾廷(2008)。規劃我國在國際健康功能與身心障礙分類系統(ICF)下身心功能障礙者福利與服務需求評估作業前導計畫建議書。行政院國家科學委員會專題研究成果報告(國科會GRB編號:96F1002),未出版。
    身心障礙者權益保障法(2007)。中華民國九十六年七月十一日總統華總一義字第 09600087331號令修正公布。
    吳麗君、高紀惠(1996)。玻巴斯復健護理在中風患者的應用。長庚雜誌,7,75-80。
    吳麗君、高紀惠、馬素華、陳獻宗、潘璦琬(1996)。中風病人施行玻巴斯復健護理方案成效之探討。長庚雜誌,7,1-13。
    吳明隆 (2007)。SPSS操作與應用:問卷統計分析實務。台北市:五南 。
    吳亭芳、林克忠、呂淑貞、胡宜庭、馬海霞、張彧、黃慶鑽、楊聖弘、劉維弘(2009)。新制身心障礙鑑定辦法培訓課程。未出版。
    林昭宏、張靖敏、黃茂雄、劉景寬、林永哲(2001)。初次腦中風患者接受住院復健治療後的追蹤研究。物理治療,26,196-203。
    林昭宏、廖龍仁、黃昭郎、廖小瑤、柴惠敏(2007)。中風病人出院預後功能恢復的追蹤研究-以南投縣社區居民為基礎之初步調查報告。物理治療,27,83-89。
    邱啟潤、許淑敏、吳淑如(2002)。主要照護者負荷、壓力與因應之國內研究文獻回顧。醫護科技學刊,4,273-290。
    郭馨心(2009)。以國際健康功能與身心障礙分類系統對外傷性腦損傷患者進行身心障礙鑑定之初步研究。台北醫學大學,未出版,台北市。
    黃盈翔(2002)。台南市老年人健康功能狀態及其相關因素之探討。國立成功大學公共衛生研究所,未出版,台南市。
    傅士豪(2008)。台灣腦中風病人病發一年內之門診復健利用及其相關因素探討。國立陽明大學物理治療暨輔助科技學系(碩士在職專班),未出版,台北市。
    廖建彰、李采娟、林瑞雄、宋鴻樟(2006)。2000年台灣腦中風發生率與盛行率的城鄉差異。台灣衛誌,25,223-230。
    廖麗君、林昭宏、朱允慧、劉景寬(2002)。功能獨立量表訪談問卷於腦中風病人之信度檢定。物理治療,27,174-182。
    謝清麟(2002)。中風病人健康相關生活品質變化及其影響因子探討:三年追蹤計畫(2)。行政院國家科學委員會專題研究成果報告(報告編號:NSC91-2314-B-002-353-),未出版。
    英文部分
    American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609-639.
    Árnadóttir, G. (1990). The brain and behavior: Assessing cortical dysfunction through activities of daily living. Philadephia: Mosby.
    Árnadóttir, G. (1990). The brain and behavior: Assessing cortical dysfunction through activities of daily living. St. Louis, MO: Mosby.
    Brorsson, B. (1984). Katz Index of independence in ADL: Reliability and validity in short-term care. Scandinavian Journal of Rehabilitation Medicine, 16, 125-132
    Fisher, A. (2003). Assessment of Motor and Process Skills. Development, Standardization, and Administration Manual. (5th ed. Vol. 1). Colorado: Three Star Press Inc.
    Forsberg-Warleby, G. &Nordic, A. M. (2004). Psychological well-being of spouses of stroke patients during the first year after stroke. Clinical Rehabilitation, 18, 430-437.
    Franzen-Dahlin, A., Billing, E., Nasman, P., Martensson, B., Wredling, B.& Murray, V.(2006). Post-stroke depression-effect on the life situation of the significant other. Scandinavian Journal Caring Sciences, 20, 412-416.
    Fricke, J. & Unsworth, C. (1998). Occupational therapists’conceptions of instrumental activities of daily living in relation to evaluation and intervention with older clients. Scandinavian Journal of Occupational Therapy, 5, 180-191.
    Granger, C.V., Dewis, L.S., Peters, N.C., Sherwood, C.C., & Barrett, J.E. (1979). Stroke rehabilitation: Analysis of repeated Barthel index measures. Archives of Physical Medicine and Rehabilitation, 60, 14–7.
    Granger, C.V., Hamilton, B.B., Linacre, J.M., Heinemann, A.W. & Wright, B.D. (1993). Performance profiles of the functional independence measure. American journal of physical medicine & rehabilitation,72, 84-89.
    Hamilton BB, Laughlin JA, Fiedler RC, Granger CV.(1994). Interrater reliability of the 7-level functional independence measure. Scandinavian journal of rehabilitation medicine ,26, 115-119
    Hackett, M. L., Duncan, J. R., Anderson, C. S., Broad, J. B. & Bonita, R. (2000). Health-related quality of life among long-term survivors of stroke. Stroke, 31, 440-447.
    Hartman-Maeir, A., Soroker, N., Ring H., Avni, N. &Katz N.(2007). Activities, participation and satisfaction one-year post stroke. Disability and Rehabilitation, 29, 559-566.
    Hamilton, B. L., Laughlin, J. A., Fiedler, R. C. & Granger, C. V. (1994). Interrater reliability of the 7-level functional independence measure (FIM). Scandinavian Journal of Rehabilitation Medicine, 26, 115-116.
    Hemphill-Pearson, B. J. (Ed.). (1999). Assesssmsnt in occupational therapy mental health: An integrative approach. Thorofare, NJ: Slack.
    Landis, J. R. & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-174.
    Ilika, J. & Hoffman, N. G.(1981). Reliability study of Kohlman evaluation of living skills. Unpublished.
    Ilika, J. & Hoffman, N. G.(1981). Concurrent validity study on the Kohlman evaluation of living skills and the global assessment scale. Unpublished.
    Katz, S., Ford, A. B., Moskowitz, R.W., Jackson, B.A. &Jaffe, M. W. (1963). The index of ADL: A standardized measure of biological and psychosocial function. Journal of American Medical Association, 185, 914-919.
    Katz, S. (1983) Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31, 721-727.
    Khan, F. & Pallant, J. F. (2007). Use of the International Classification of Functioning, Disability and Health (ICF) to identify preliminary comprehensive and brief core sets for multiple sclerosis. Disability and Rehabilitation, 29, 205-213
    Klein, R. M. & Bell, B.(1982). Self-care skills: behavioral measurement with Klein-Bell ADL scale. Archives of physical medicine and rehabilitation, 63, 335-338.
    Kromk, R. A., Ogonowski, J. A., Rice, C. N.& Feldman, H. M. (2005). Reliability in assigning ICF codes to children with special health care needs using a developmentally structured interview. Disability and Rehabilitation, 27, 977-983.
    Lawton, M. P., Moss, M., Fulcomer, M., &Kleban, M.H. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37, 91-99.
    Lawton, M. P., & Brody, E.M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179-186.
    Law, M., &Usher, P. (1988). Validation of the Klien-Bell activities of daily living scale for children. Canadian Journal of Occupational Therapy, 55, 63-68.
    Leonardelli, C. A. (1988). The Milwaukee evaluation of daily living skills: evaluation in long-term psychiatric care. Thorofare, NJ: Slack.
    Lund, M. L., Bernspang, B., & Lexell, J. (2007). Perceived participation and problems in participation are determinants of life satisfaction in people with spinal cord injury. Disability and Rehabilitation, 29, 1417-1422
    Mahoney, F.I. &Barthel, D. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 56-61.
    Mayo, N. E., Wood-Dauphinee, S., Cote, R., Durcam, L. & Carlton, J. (2002). Activity, participation and quality of life 6 months poststroke. Archives Physical Medicine Rehabilitation, 83, 1035-1042.
    McAvoy, E. (1991). The use of ADL indices by occupational therapists. British Journal of Occupational Therapy, 54, 383-385.
    Ogonowski, J. A., Kromk, R. A., Rice, C. N.& Feldman, H. M. (2004). Inter-rater reliability in assigning ICF codes to children with disabilities. Disability and Rehabilitation, 26, 353-361.Ottenbacher, K. J., Mann, W. C., & Granger, C. V. (1994). Interrater agreement and stability of functional assessment in the community-based elderly. Archives of Physical Medicine and Rehabilitation, 75, 1297-1301.
    Pierce, L. L., Finn, M. G., & Steiner, V. (2004). Families dealing with Stroke desire information about self-care needs. Rehabilitation Nursing, 29, 14-17.
    Pohjasvaara, T., Leskela, M., Vatajaa, R., Kalskaa, H., Ylikoskia R., Hietanena, M., Leppavuorid, A., Kastee, M., &Erkinjuntti, E. (2002). Post-stroke depression, executive dysfunction and functional outcome. European Journal of Neurology, 9, 269–275
    Robinson-Smith, G., Johnston, M., & Allen, J. (2000). Self-care, self-efficacy, quality of life and depression after stroke. Archives of Physical Medicine and Rehabilitation, 81, 460-464.
    Rogers, J. C.& Holm, M.B. (1988). Performance assessment of self-care skills (3.1).Pittsburgh, Pa: unpublished.
    Schulz, R. C., Tompkins, C.A., Wood, D. &Decker, S. (1987). The social psychology of caregiving: physical and psychological costs of providing support to the disabled. Journal Applied Social Psychology, 17, 401–428.
    Soberg, H. L., Finest, A., Roise, O.& Bautz-Holter, E. (2008). Identification and comparison of rehabilitation goals after multiple injuries: An ICF analysis of the patients’ physiotherapists’ and other allied professions’ reported goals. Journal of Rehabilitation Medicine, 40, 340-346.
    Soberg, H. L., Sandvik, L.& Ostensjo, S. (2008). Reliability and application of the ICF in coding problems, resources and goals of person with multiple injuries. Disability and Rehabilitation, 30, 98-106.
    Stallone, R. A., Dyken, M. L., Fang, H. C. H., Heyman, A., Seltser, R., & Stamler, J. (1992). Epidemiology for stroke facilities planning. Stroke, 3, 360-371.
    Starrost, K., Geyh, S., Trautwein, A., Grunow, J., Ceballos-Baumann, A., Prosiegel, M., Stucki, G.,& Cieza, A.(2008). Interrater reliability of the extended ICF core set for stroke applied by physical therapists. Physical Therapy, 88, 841-851
    Stier-Jarmer, M., Grill, E., Ewert, T., Bartholomeyczik, S., Finger, M., Mokrusch, M.,Kostanjsek, N., & Stucki, G. (2005). ICF Core Set for patients with neurological conditions in early post-acute rehabilitation facilities. Disability and Rehabilitation, 27, 389-395
    Sveen, U., Bautz-Holter, E., Dring,K. M., Wyller, T. B., & Laake, K. (1999). Association between impairments, self-care ability and social activities 1 year after stroke. Disability and Rehabilitation, 21, 372-377.
    Trombly, C. A.,& Radomski, M. V. (2001). Occupational therapy of physical dysfunction. (5th ed.).Baltimore. Williams & Wilkins.
    Wade, D. T., Skilbeck, C.E.& Langton, H. R. (1983). Predicting Barthel ADL Score at 6 months after an acute stroke. Archives of Physical Medicine Rehabilitation, 64, 24-28.
    World Health Organization. (2001). International Classification of Functioning, Disability and Health. Geneva: Author.
    World Health Organization. (2010 ,July 24). Stroke, cerebrovascular accident. Retrieved July 24, 2010, from, http://www.who.int/topics/cerebrovascular_accident/en/
    Xiong. T.& Hartley, S. (2008). Challenges in linking health-status outcome measures and clinical assessment tools to the ICF. Advances in Physiotherapy, 10, 152-156.

    下載圖示
    QR CODE