社區整合量表修訂版於腦中風病人之心理計量測試

Psychometric Testing of the Community Integration Questionnaire-Revised in Patients With Stroke

10.6224/JN.202306_70(3).06

蔡玟純(Wen-Chun TSAI)；孫瑜(Yu SUN)；黃惠娟(Hui-Chuan HUANG)；邱曉彥(Hsiao-Yean CHIU)

中文版社區整合量表修訂版 ； 信度 ； 效度 ； 腦中風 ； community integration questionnaire-revised ； reliability ； validity ； stroke

護理雜誌

70卷3期（2023 / 06 / 01）

37 - 45

繁體中文;英文

背景：腦中風病人重返社區與恢復生產力之評估工具仍缺乏。目的：驗證繁體中文版社區整合量表修訂版於腦中風病人之信效度。方法：採橫斷式研究設計與方便取樣法。在北區某區域教學醫院之神經內科及復健科門診收取具有超過三個月診斷之腦中風病人。資料收集量表包括自擬式人口學資料表、中文版芙蘭切活動量表、中文版歐洲五維健康量表以及繁體中文版社區整合量表修訂版。信度檢定包括內在一致性及再測信度。效度檢定包括聚合效度與關聯校標效度。結果：本研究共收案124位腦中風病人，平均年齡為67.48歲，將近六成為男性，有八成病人為輕度腦中風。18題的繁體中文版社區整合量表修訂版量表與中文版芙蘭切活動量表（r = .49- .83）與歐洲五維健康量表之視覺類比量表達顯著相關（r = .52）。量表內在一致信度高（Cronbach's α = .91），再測信度（組內相關係數）為.99，顯示本量表具有良好信度。結論：健康照護人員可使用此量表作為腦中風病人回歸社區與恢復生產力之評估工具。

Background: No tool is currently available to evaluate the ability of patients with stroke to return to being productive members of their community. Purposes: This study was designed to translate the Community Integration Scale-Revised into traditional Chinese (TC-CIQR) and to verify the reliability and validity of this scale in patients with stroke. Methods: A cross-sectional study design using convenient sampling was adopted in this study. All of the participants were patients undergoing treatment at neurological outpatient clinics and a rehabilitation department of a regional teaching hospital in northern Taiwan. The eligibility criterion was having been diagnosed with stroke for more than three months. The measurement tools used to collect data included an information sheet, the Chinese versions of the Franche Activity Index, EuroQol-5 dimensions, and TC-CIQR. Results: One hundred twenty-four stroke survivors with a mean age of 67.48 years were enrolled as participants. Approximately 60% of the participants were male and over 80% had experienced a stroke of mild severity. The 18- item TC-CIQR yielded strong correlations with the total score of the Franche Activity Index (r = .49 to .83) and CEQ-visual analogue scale (r = .52). The internal consistency of the TC-CIQR (Cronbach's α coefficients = .91) was excellent, and test-retest reliability was .99, indicating the tool has acceptable reliability. Conclusion: The TC-CIQR was shown to have acceptable reliability and validity. Healthcare providers may integrate the TC-CIQR into clinical practice as an effective tool for evaluating the ability of patients with stroke who are undergoing rehabilitation to return to the community.

1. 葉伯壽, B.-S.(2017)。台灣腦中風概況與急性腦梗塞的治療發展。中國統計學報，55(2)，63-66。
   連結：
2. Brott, T.,Adams, H. P., Jr.,Olinger, C. P.,Marler, J. R.,Barsan, W. G.,Biller, J.,Spilker, J.,Holleran, R.,Eberle, R.,Hertzberg, V.(1989).Measurements of acute cerebral infarction: A clinical examination scale.Stroke,20(7),864-870.
3. Callaway, L.,Winkler, D.,Tippett, A.,Herd, N.,Migliorini, C.,Willer, B.(2016).The community integration questionnaire-Revised: Australian normative data and measurement of electronic social networking.Australian Occupational Therapy Journal,63(3),143-153.
4. Chang, T.-J.,Tarn, Y.-H.,Hsieh, C.-L.,Liou, W.-S.,Shaw, J. W.,Chiou, X. G.(2007).Taiwanese version of the EQ-5D: Validation in a representative sample of the Taiwanese population.Journal of the Formosan Medical Association,106(12),1023-1031.
5. Commission on Accreditation of Rehabilitation Facilities. (n.d.). Community integration. Retrieved November 19, 2022, from https://www.carf.org/Programs/ProgramDescriptions/ECS-Community-Integration/
6. Dedding, C.,Cardol, M.,Eyssen, I. C.,Beelen, A.(2004).Validity of the Canadian occupational performance measure: A client-centred outcome measurement.Clinical Rehabilitation,18(6),660-667.
7. Donkor, E. S.(2018).Stroke in the 21st century: A snapshot of the burden, epidemiology, and quality of life.Stroke Research and Treatment
8. Edwards, J. D.,Kapoor, A.,Linkewich, E.,Swartz, R. H.(2018).Return to work after young stroke: A systematic review.International Journal of Stroke,13(3),243-256.
9. Fraga-Maia, H. M. S.,Werneck, G.,Dourado, I.,Fernandes, R. D. C. P.,Brito, L. L.(2015).Translation, adaptation and validation of "community integration questionnaire".Ciência & Saúde Coletiva,20(5),1341-1352.
10. Gerrard, P.,Kazis, L. E.,Ryan, C. M.,Shie, V. L.,Holavanahalli, R.,Lee, A.,Jette, A.,Fauerbach, J. A.,Esselman, P.,Herndon, D.,Schneider, J. C.(2015).Validation of the community integration questionnaire in the adult burn injury population.Quality of Life Research,24(11),2651-2655.
11. Govan, L.,Langhorne, P.,Weir, C. J.(2009).Categorizing stroke prognosis using different stroke scales.Stroke,40(10),3396-3399.
12. Han, J.,Lee, H. I.,Shin, Y.-I.,Son, J. H.,Kim, S.-Y.,Kim, D. Y.,Sohn, M. K.,Lee, J.,Lee, S.-G.,Oh, G.-J.,Lee, Y.-S.,Joo, M. C.,Han, E. Y.,Chang, W. H.,Kim, Y.-H.(2019).Factors influencing return to work after stroke: The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) Study.BMJ Open,9(7),e028673.
13. Holbrook, M.,Skilbeck, C. E.(1983).An activities index for use with stroke patients.Age and Ageing,12(2),166-170.
14. Ioncoli, M.,Berardi, A.,Tofani, M.,Panuccio, F.,Servadio, A.,Valente, D.,Galeoto, G.(2020).Crosscultural validation of the community integration questionnaire-Revised in an Italian population.Occupational Therapy International
15. Katan, M.,Luft, A.(2018).Global burden of stroke.Seminars in Neurology,38(2),208-211.
16. Kratz, A. L.,Chadd, E.,Jensen, M. P.,Kehn, M.,Kroll, T.(2015).An examination of the psychometric properties of the community integration questionnaire (CIQ) in spinal cord injury.The Journal of Spinal Cord Medicine,38(4),446-455.
17. Kyriazos, T. A.(2018).Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general.Psychology,9(8),2207-2230.
18. La Torre, G.,Lia, L.,Francavilla, F.,Chiappetta, M.,De Sio, S.(2022).Factors that facilitate and hinder the return to work after stroke: An overview of systematic reviews.La Medicina del Lavoro,113(3),e2022029.
19. Law, M.,Baptiste, S.,McColl, M.,Opzoomer, A.,Polatajko, H.,Pollock, N.(1990).The Canadian occupational performance measure: An outcome measure for occupational therapy.Canadian Journal of Occupational Therapy,57(2),82-87.
20. Lee, H.-Y.,Hung, M.-C.,Hu, F.-C.,Chang, Y.-Y.,Hsieh, C.-L.,Wang, J.-D.(2013).Estimating quality weights for EQ-5D (EuroQol-5 dimensions) health states with The time trade-off method in Taiwan.Journal of the Formosan Medical Association,112(11),699-706.
21. Lequerica, A. H.,Chiaravalloti, N. D.,Sander, A. M.,Pappadis, M. R.,Arango-Lasprilla, J. C.,Hart, T.,Baños, J. H.,Marquez De La Plata, C. D.,Hammond, F. M.,Sherman, T. E.(2013).The community integration questionnaire: Factor structure across racial/ethnic groups in persons with traumatic brain injury.The Journal of Head Trauma Rehabilitation,28(6),E14-E22.
22. Lin, H.-W.,Li, C.-I.,Lin, F.-J.,Chang, J.-Y.,Gau, C.-S.,Luo, N. A.,Simon Pickard, A. S.,Ramos Goñi, J. M.,Tang, C.-H.,Hsu, C.-N.(2018).Valuation of the EQ-5D-5L in Taiwan.PLOS ONE,13(12),e0209344.
23. Liu, T.-W.,Ng, S. S. M.,Ng, G. Y. F.(2014).Translation and initial validation of the Chinese (Cantonese) version of community integration measure for use in patients with chronic stroke.BioMed Research International
24. McCarthy, M. J.,Lyons, K. S.,Schellinger, J.,Stapleton, K.,Bakas, T.(2020).Interpersonal relationship challenges among stroke survivors and family caregivers.Social Work in Health Care,59(2),91-107.
25. McColl, M. A.,Davies, D.,Carlson, P.,Johnston, J.,Minnes, P.(2001).The community integration measure: Development and preliminary validation.Archives of Physical Medicine and Rehabilitation,82(4),429-434.
26. Pan, A.-W.,Chung, L.,Hsin-Hwei, G.(2003).Reliability and validity of the Canadian occupational performance measure for clients with psychiatric disorders in Taiwan.Occupational Therapy International,10(4),269-277.
27. Rabin, R.,de Charro, F.(2001).EQ-5D: A measure of health status from the EuroQol Group.Annals of Medicine,33(5),337-343.
28. Sander, A. M.,Pappadis, M. R.,Davis, L. C.,Clark, A. N.,Evans, G.,Struchen, M. A.,Mazzei, D. M.(2009).Relationship of race/ethnicity and income to community integration following traumatic brain injury: Investigation in a non-rehabilitation trauma sample.NeuroRehabilitation,24(1),15-27.
29. Schuling, J.,de Haan, R.,Limburg, M.,Groenier, K. H.(1993).The frenchay activities index. Assessment of functional status in stroke patients.Stroke,24(8),1173-1177.
30. The EuroQol Group(1990).EuroQol-A new facility for The measurement of health-re- lated quality of life.Health Policy,16(3),199-208.
31. Thongbupa, S.,Harnirattisai, T.,Muengtaweepongsa, S.(2020).The effects of a family participation program in cognitive rehabilitation on the functional outcomes among acute stroke patients: Preliminary analysis.Science & Technology Asia,25(3),19-28.
32. Tong, Y.,Cheng, Z.,Rajah, G. B.,Duan, H.,Cai, L.,Zhang, N.,Du, H.,Geng, X.,Ding, Y.(2019).High intensity physical rehabilitation later than 24 h post stroke is beneficial in patients: A pilot randomized controlled trial (RCT) study in mild to moderate ischemic stroke.Frontiers in Neurology,10,113.
33. Vyas, M. V.,Hackam, D. G.,Silver, F. L.,Laporte, A.,Kapral, M. K.(2016).Lost productivity in stroke survivors: An econometrics analysis.Neuroepidemiology,47(3-4),164-170.
34. Wang, Y.-C.,Kapellusch, J.,Garg, A.(2014).Important factors influencing the return to work after stroke.Work,47(4),553-559.
35. Willer, B.,Ottenbacher, K. J.,Coad, M. L.(1994).The community integration questionnaire: A comparative examination.American Journal of Physical Medicine & Rehabilitation,73(2),103-111.
36. Willer, B.,Rosenthal, M.,Kreutzer, J. S.,Gordon, W. A.,Rempel, R.(1993).Assessment of community integration following rehabilitation for traumatic brain injury.The Journal of Head Trauma Rehabilitation,8(2),75-87.
37. Wilson, J. T. L.,Hareendran, A.,Grant, M.,Baird, T.,Schulz, U. G. R.,Muir, K. W.,Bone, I.(2002).Improving The assessment of outcomes in stroke: Use of a structured interview to assign grades on the modified Rankin scale.Stroke,33(9),2243-2246.
38. 衛生福利部（2022，6月30日）．110年死因統計結果分析。[Ministry of Health and Welfare, Taiwan, ROC. (2022, June 30). Cause of death statistics, 2021.] https://www.mohw.gov.tw/dl-78424-795221a9-409b-4ce8-ace1-29ac418be9c4.html
39. 衛生福利部中央健保署（2020，4月10日）．急性後期整合照護計畫。[National Health Insurance Administration, Ministry of Health and Welfare, Taiwan, ROC. (2020, April 10). Post-acute care, 2020.] https://www.nhi.gov.tw/Content_List.aspx?n=5A0BB383D955741C&topn=5FE8C9FEAE863B46
40. 薛漪平, I.-P.,謝清麟, C.-L.(1997)。中風患者芙蘭切活動量表效度之再驗證：大台北地區研究。台灣醫學，1(6)，696-702。