School of Nursing, Chang-Gung University, Taoyuan, Taiwan.
Aging Ment Health. 2011 Mar;15(2):243-51. doi: 10.1080/13607860903046511.
Wandering in persons with dementia is perceived as significant due to its prevalence and negative outcomes. However, lack of a validated wandering measure in Taiwan has limited scientific investigation and clinical practice. Therefore, the purpose of this study was to validate the Chinese Revised Algase Wandering Scale-Community Version (CRAWS-CV) in northern Taiwan.
For this cross-sectional study, the sample comprised 180 elders with dementia and their family caregivers (FCs). FCs responded to the CRAWS-CV in interviews with trained research assistants.
The structure of CRAWS-CV was examined by exploratory principal component analysis with varimax rotation. This analysis derived nine factors, explaining 71.48% of variance: eloping behavior (EB), mealtime impulsivity/temporal aspects, getting lost inside the house (GLI), pacing, impulsivity, negative outcomes, random pattern (RANDOM), and getting lost outside. The total scale and subscales showed excellent internal consistency. Good construct validity was shown by significant inter-scale correlation coefficients, and significant correlations between scores on the total CRAWS-CV and its subscales with scores on the Mini-Mental State Examination and Chinese Neuropsychiatric Inventory. The receiver operating characteristic curve showed a cutoff score of 67, with sensitivity and specificity of 83.6% and 76.9%, respectively. CRAWS-CV scores were significantly different for wanderers and non-wanderers. The one-week test-retest reliability using intra-class correlation coefficients (ICCs) showed significant correlations except for the EB and RANDOM subscales. Inter-rater reliability using an ICC was significant and acceptable except for GLI.
This study supports the CRAWS-CV as a valid measure of wandering in community-dwelling elders with dementia in northern Taiwan.
痴呆患者的 wandering 行为被认为具有重要意义,因为其具有普遍性且会产生负面后果。然而,台湾缺乏经过验证的 wandering 测量工具,这限制了科学研究和临床实践。因此,本研究旨在验证台湾北部的中文修订版 Algase 游荡量表-社区版(CRAWS-CV)。
本横断面研究的样本包括 180 名痴呆症老年患者及其家庭照顾者(FC)。FC 通过与受过培训的研究助理进行访谈来回答 CRAWS-CV。
通过最大方差旋转的探索性主成分分析检验了 CRAWS-CV 的结构。该分析得出了九个因素,解释了 71.48%的方差:潜逃行为(EB)、用餐时冲动/时间方面、在屋内迷路(GLI)、踱步、冲动、负面后果、随机模式(RANDOM)和在屋外迷路。总量表和分量表显示出极好的内部一致性。良好的结构效度表现为分量表之间的显著相关性,以及 CRAWS-CV 总分及其分量表与简易精神状态检查和中国神经精神疾病问卷得分之间的显著相关性。受试者工作特征曲线显示,截断值为 67,敏感性和特异性分别为 83.6%和 76.9%。CRAWS-CV 评分在 wanderers 和 non-wanderers 之间存在显著差异。使用组内相关系数(ICC)进行的一周测试-重测信度显示,除了 EB 和 RANDOM 分量表外,其余分量表均具有显著相关性。使用 ICC 进行的评分者间信度是显著且可接受的,除了 GLI 分量表。
本研究支持 CRAWS-CV 作为台湾北部社区居住的痴呆症老年患者 wandering 行为的有效测量工具。