运用 Rasch 分析方法研发与验证具文化适宜性的 meaningful activity participation assessment（T-MAPA）繁体中文版。
Developing and validating the Taiwan version of the meaningful activity participation assessment (T-MAPA) with Rasch analysis.
机构信息
Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, 452, Huanqiu Rd., Luzhu Dist, Kaohsiung, Taiwan.
Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089-9003, USA.
出版信息
BMC Geriatr. 2023 Mar 22;23(1):159. doi: 10.1186/s12877-023-03839-9.
BACKGROUND
Meaningful activity participation has shown good predictability for healthy ageing in older adults, and their participation can be assessed using the Meaningful Activity Participation Assessment (MAPA). However, the MAPA has never been validated in any Taiwanese population. Moreover, different cultures may interpret meaningful activity participation differently. This study thus aimed to cross-culturally adapt the MAPA into a Taiwan version (i.e., the T-MAPA) and to investigate the psychometric properties of the T-MAPA in older adults in Taiwan.
METHODS
This study consisted of 3 phases. First, the original MAPA was cross-culturally adapted in 6 stages, including forward, synthesis of, and back translations, cognitive debriefing, expert review, and pilot testing on 18 older adults. Second, a Rasch-Andrich rating scale model was applied to evaluate the psychometric properties (including category function, unidimensionality, item functioning and targeting, and reliability) of the adapted version in a sample of 146 older adults. Lastly, the convergent validity and test-retest reliability were examined on 120 and 49 older adults, respectively.
RESULTS
After cross-cultural adaptation, the first version of the T-MAPA contained 29 items. Optimal category function was obtained by reducing the response categories of the frequency subscale to 4 and retaining a 5-point rating for the meaningfulness subscale. After the removal of 1 misfit item, a 28-item T-MAPA was generated. This version demonstrated unidimensionality, measurement invariance among different subgroups (regarding sex and education), acceptable item targeting (< 1 logit) and negligible floor and ceiling effects (1.37%; 0.68%), high reliability (person reliability coefficient = 0.86; small standard error < 0.5 with large test information > 4), confirmed convergent validity (absolute r = .49-0.54 with psychological well-being, depressive symptoms, and mental and physical health), and excellent test-retest reliability (intraclass correlation coefficient = 0.94).
CONCLUSION
The cross-culturally adapted 28-item T-MAPA is suitable for application to the older population in Taiwan to measure meaningful activity participation. Future examinations of the T-MAPA in other populations with specific clinical features are warranted to extend its utility in practice.
背景
有意义的活动参与已被证明对老年人的健康衰老具有良好的预测性，并且可以使用有意义的活动参与评估（MAPA）来评估他们的参与度。然而，该评估工具从未在任何台湾人群中得到验证。此外，不同的文化可能对有意义的活动参与有不同的解释。因此，本研究旨在将 MAPA 跨文化适应为台湾版本（即 T-MAPA），并调查 T-MAPA 在台湾老年人中的心理测量特性。
方法
本研究包括 3 个阶段。首先，在 6 个阶段中对原始 MAPA 进行跨文化适应，包括前向翻译、综合翻译、反向翻译、认知审校、专家审查和对 18 名老年人进行的试点测试。其次，应用 Rasch-Andrich 评分量表模型评估经适应后的版本在 146 名老年人样本中的心理测量特性（包括类别功能、单维性、项目功能和定位以及可靠性）。最后，在 120 名和 49 名老年人中分别检查了聚合效度和重测信度。
结果
经过跨文化适应，T-MAPA 的第一版包含 29 个项目。通过将频率分量表的响应类别减少到 4 并保留对有意义分量表的 5 点评分，获得了最佳的类别功能。在删除 1 个不适合的项目后，生成了一个包含 28 个项目的 T-MAPA。该版本表现出单维性、不同亚组（性别和教育）之间的测量不变性、可接受的项目定位（<1 对数）和可忽略不计的地板和天花板效应（1.37%；0.68%）、高可靠性（个体可靠性系数=0.86；小标准误差<0.5，具有大测试信息>4）、确认的聚合效度（与心理幸福感、抑郁症状以及精神和身体健康的绝对 r 值分别为 0.49-0.54）和极好的重测信度（组内相关系数=0.94）。
结论
跨文化适应的 28 项 T-MAPA 适用于评估台湾老年人的有意义的活动参与度。未来需要在具有特定临床特征的其他人群中进一步检验 T-MAPA，以扩展其实用性。
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