日常生活评定量表III中文版在精神分裂症患者中的结构效度
Construct Validity of the Chinese Version of the Activities of Daily Living Rating Scale III in Patients with Schizophrenia.
作者信息
Chiu En-Chi, Lee Yen, Lai Kuan-Yu, Kuo Chian-Jue, Lee Shu-Chun, Hsieh Ching-Lin
机构信息
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Educational Psychology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
出版信息
PLoS One. 2015 Jun 29;10(6):e0130702. doi: 10.1371/journal.pone.0130702. eCollection 2015.
BACKGROUND
The Chinese version of the Activities of Daily Living Rating Scale III (ADLRS-III), which has 10 domains, is commonly used for assessing activities of daily living (ADL) in patients with schizophrenia. However, construct validity (i.e., unidimensionality) for each domain of the ADLRS-III is unknown, limiting the explanations of the test results.
PURPOSE
This main purpose of this study was to examine unidimensionality of each domain in the ADLRS-III. We also examined internal consistency and ceiling/floor effects in patients with schizophrenia.
METHODS
From occupational therapy records, we obtained 304 self-report data of the ADLRS-III. Confirmatory factor analysis (CFA) was conducted to examine the 10 one-factor structures. If a domain showed an insufficient model fit, exploratory factor analysis (EFA) was performed to investigate the factor structure and choose one factor representing the original construct. Internal consistency was examined using Cronbach's alpha (α). Ceiling and floor effects were determined by the percentage of patients with the maximum and minimum scores in each domain, respectively.
RESULTS
CFA analyses showed that 4 domains (i.e., leisure, picture recognition, literacy ability, communication tools use) had sufficient model fits. These 4 domains had acceptable internal consistency (α = 0.79-0.87) and no ceiling/floor effects, except the leisure domain which had a ceiling effect. The other 6 domains showed insufficient model fits. The EFA results showed that these 6 domains were two-factor structures.
CONCLUSION
The results supported unidimensional constructs of the leisure, picture recognition, literacy ability, and communication tool uses domains. The sum scores of these 4 domains can be used to represent their respective domain-specific functions. Regarding the 6 domains with insufficient model fits, we have explained the two factors of each domain and chosen one factor to represent its original construct. Future users may use the items from the chosen factors to assess domain-specific functions in patients with schizophrenia.
背景
中文版日常生活活动评定量表III（ADLRS-III）共有10个领域，常用于评估精神分裂症患者的日常生活活动（ADL）。然而，ADLRS-III各领域的结构效度（即单维度性）尚不清楚，这限制了对测试结果的解释。
目的
本研究的主要目的是检验ADLRS-III各领域的单维度性。我们还研究了精神分裂症患者的内部一致性以及天花板/地板效应。
方法
从职业治疗记录中，我们获取了304份ADLRS-III的自我报告数据。进行验证性因子分析（CFA）以检验10个单因子结构。如果某个领域显示模型拟合不足，则进行探索性因子分析（EFA）以研究因子结构并选择一个代表原始结构的因子。使用克朗巴哈系数（α）检验内部一致性。天花板效应和地板效应分别由每个领域中获得最高分和最低分的患者百分比确定。
结果
CFA分析表明，4个领域（即休闲、图片识别、识字能力、通讯工具使用）具有足够的模型拟合度。这4个领域具有可接受的内部一致性（α = 0.79 - 0.87），且无天花板/地板效应，但休闲领域存在天花板效应。其他6个领域显示模型拟合不足。EFA结果表明，这6个领域为双因子结构。
结论
结果支持休闲、图片识别、识字能力和通讯工具使用领域的单维度结构。这4个领域的总分可用于代表其各自特定领域的功能。对于模型拟合不足的6个领域，我们解释了每个领域的两个因子，并选择了一个因子来代表其原始结构。未来的使用者可以使用所选因子中的项目来评估精神分裂症患者的特定领域功能。
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