簡易視力篩檢表用於65歲以上老人之信度與效度評估

Assessment of the Validity and Reliability of the Simplified Visual Acuity Chart When Administered to Adults 65 Years of Age and Older

10.6288/TJPH2006-25-04-07

張雪會(Hsueh-Hui Chang)；劉靜芸(Jing-Yun Liu)；黃茜莉(Chie-Li Huang)；程景煜(Ching-Yu Cheng)；李中一(Chung-Yi Li)

老人 ； 篩檢 ； 視力清楚 ； 效度 ； 信度 ； elderly ； screening ； visual acuity ； validity ； relability

台灣公共衛生雜誌

25卷4期（2006 / 08 / 01）

303 - 309

繁體中文

目標：對於大規模視力篩檢而言，簡易視力篩檢表因攜帶方便、施測容易而有其使用上的優勢。本研究利用簡易視力篩檢表和傳統E字視力表針對一65歲以上老人樣本進行視力測驗，以評估簡易視力篩檢表的效度與信度。方法：2005年3月初開始收案，針對收案期間首次前來衛生所之65歲以上老人，徵詢其參與研究之意願，獲得新竹縣兩衛生所共38名門診病人，研究樣本同時接受簡易視力篩檢表及E字視力表之檢查（黃金標準），間隔一週後，再回衛生所接受簡易視力篩檢表之複測。計算正確率、敏感度與特異性作為效度指標，另外計算Kappa係數以評估信度。結果：根據簡易視力篩檢表測驗的結果，研究樣本左眼、右眼、與雙眼視力小於0.5之比例分別為52.6%、50.0%、與42.1%，其相對應之正確率分別為0.82、0.84與0.82；敏感度為1.00、0.93與0.91：特異度則是為0.72、0.78與0.78。兩次利用簡易視力篩檢表測驗的結果，左眼、右眼與雙眼的一致性Kappa係數分別為0.79、0.74與0.73。結論：簡易視力篩檢表有不錯的再測信度，但利用簡易視力篩檢表針對老人進行視力篩檢所獲得的視力障礙盛行率將高於E字視力表檢查的結果。

Objective: An enormous potential exists for use of the Simplified Visual Acuity Card (SVAC) in conducting mass eye screening because it can be easily utilized in the field. The purpose of the current study was to compare the SVAC with Snellen's chart in a sample of adults ＞65 years of age. Methods: Thirty-eight elderly adults attending one of two Hsin-Chu County primary health centers in March 2005 volunteered to participate in the study. The SVAC and Snellen's chart were simultaneously administered to the participants, and the SVAC was administered again one week later. The accuracy, sensitivity, specificity, and Kappa coefficient of the SVAC were calculated to assess SVAC validity and reliability. Results: Based on SVAC testing, the prevalence of visual acuity in the study population was determined to be 52.6%, 50.0%, and 42.1% for the left eye, right eye, and both eyes, respectively, consistent with corresponding accuracy rates of 0.82, 0.84, and 0.82, sensitivities of 1.00, 0.93, and 0.91, and specificities of 0.72, 0.78, and 0.78. On the basis of the SVAC test-retest data, the Kappa coefficient was estimated to be 0.79, 0.74, and 0.73 for the left eye, right eye, and both eyes, respectively. Conclusions: The test-retest reliability for the SVAC was satisfactory; however, the prevalence of visual impairment estimated using the SVAC in elderly adults was higher than when tested with Snellen's chart.