中文版家庭照顧者給藥管理困擾量表之發展與信效度評估

Development and validation of the Family Caregiver Medication Administration Hassle Scale-Chinese version (FCMAHS-CH)

10.6288/TJPH.202004_39(2).108098

顧德璉(TE-LIEN KU)；吳淑英(SHU-YING WU)；蘇億玲(YI-LIN SU)；賴嘉敏(CHIA-MING LAI)；季瑋珠(WEI-CHU CHIE)

家庭照顧者 ； 給藥管理 ； 困擾 ； 信度 ； 效度 ； family caregiver ； medication administration ； hassle ； reliability ； validity

台灣公共衛生雜誌

39卷2期（2020 / 04 / 24）

216 - 230

繁體中文

目標：本研究旨在發展一份適合評估台灣家庭照顧者給藥管理相關心理負荷之測量工具，並測試其信、效度。方法：本研究採橫斷面研究設計，分為三個階段，首先透過雙向翻譯及專家內容效度進行中文版家庭照顧者給藥管理困擾量表編制；接著邀請本國籍家庭照顧者及醫療專業人員共15名進行前驅研究；最後以138名本國籍家庭照顧者為研究對象進行量表施測，並於兩週後以便利取樣方式從原本138名個案中選取30名進行後測。結果：中文版家庭照顧者給藥管理困擾量表包含：「資訊取得／資訊分享」、「給藥時間安排」、「安全性議題」、「藥品領取/處方箋管理」四構面，共計24題，可解釋總變異量為65.76%。量表具備良好內容效度，心理計量分析顯示量表具備良好內在一致性信度、再測信度、建構效度、區辨效度及已知組比較效度。結論：中文版家庭照顧者給藥管理困擾量表具有良好信、效度，可應用於評估國內家庭照顧者族群給藥管理照顧工作之心理負荷，亦可作為衛生教育介入方案之需求評估工具。

Objectives: The aim of this study was to develop a Chinese version of the Family Caregiver Medication Administration Hassle Scale (FCMAHS-CH) and examine its psychometric properties, reliability, and validity for Taiwanese caregivers. Methods: A cross-sectional methodological design was executed in three phases. First, the original English version of the FCMAHS was translated into Chinese through a two-way translation process, and an expert panel was then convened to evaluate the content validity. Second, a pilot study was conducted with 15 Taiwanese family caregivers and health care professionals to test the readability of the FCMAHS-CH. Finally, a sample of 138 Taiwanese adult family caregivers completed the FCMAHS-CH, and 30 of the participants were retested after 2 weeks. Results: The FCMAHS-CH contained 24 items classified into the following four domains: information acquisition and sharing, medication scheduling, safety issues, and prescription filling and management. The overall scale with four domains explained 65.76% of the total variance. The scale had acceptable content validity; psychometric analysis demonstrated high internal consistency and test-retest reliability as well as good construct, discriminant, and known-group-comparison validity. Conclusions: The FCMAHS-CH can be used to assess medication administration-related stressors among Taiwanese family caregivers. The scale has well established reliability and validity, thus providing a new tool for future practice and research into family caregiving in Taiwan.

1. 莊昭華, CH,林漢斯, HS,陳書毓, SY,許雅娟, YC,謝蕙萓, HI(2017)。社區中老年人用藥安全知識、態度和行為之探討。台灣家庭醫學雜誌，27，89-101。
   連結：
2. Anthonie, E,Moret, L,Renault, A,Sbille, V,Hardouin, JB(2014).Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures.Health Qual Life Outcomes,12,2.
3. Arlt, S,Linder, R,Rösler, A,von Renteln-Kruse, W(2008).Adherence to medication in patients with dementia: predictors and strategies for improvement.Drugs Aging,25,1033-1047.
4. Conway, JM,Huffcutt, AI(2003).A review and evaluation of exploratory factor analysis practices in organizational research.Organ Res Meth,6,147-168.
5. George, J,Phun, YT,Bailey, MJ,Kong, DC,Stewart, K(2004).Development and validation of the medication regimen complexity index.Ann Pharmacother,38,1369-1376.
6. Gillespie, R,Mullan, J,Harrison, L(2014).Managing medications: the role of informal caregivers of older adults and people living with dementia. A review of the literature.J Clin Nurs,23,3296-3308.
7. Hair, JF,Black, WC,Babin, BJ,Anderson, RE(2014).Multivariate Data Analysis.Harlow:Pearson.
8. Jyrkka, J,Enlund, H,Korhonen, MJ,Sulkava, R,Hartikainen, S(2009).Polypharmacy status as an indicator of mortality in an elderly population.Drugs Aging,26,1039-1048.
9. Kao, HF,Lynn, MR(2009).Use of measurement of medication administration hassles with Mexican American family caregivers.J Clin Nurs,18,2596-2603.
10. Kuliś, D,Bottomley, A,Velikova, G,Greimel, E,Koller, M(2017).EORTC Quality of Life Group Translation Procedure.Brussels:Eortc Quality of Life Group.
11. Lazarus, RS,DeLongis, A(1983).Psychological stress and coping in aging.Am Psychol,38,245-254.
12. Look, KA,Stone, JA(2018).Medication management activities performed by informal caregivers of older adults.Res Social Adm Pharm,14,418-426.
13. Polit, DF,Beck, CT(2006).The content validity index: are you sure you know what’s being reported? Critique and recommendations.Res Nurs Health,29,489-497.
14. Polit, DF,Beck, CT,Owen, SV(2007).Is the CV Ian acceptable indicator of content validity? Appraisal and recommendations.Res Nurs Health,30,459-467.
15. Ranelli, PL,Aaversa, SL(1994).Medication-related stressors among family caregivers.Am J Hosp Pharm,51,75-79.
16. Reinhard, SC,Levine, C,Samis, S(2012).Home Alone: Family Caregivers Providing Complex Chronic Care.Washinton, DC:AARP Public Policy Insititute.
17. Smith, F,Francis, SA,Gray, N,Denham, M,Graffy, J(2003).A multi-centre survey among informal carers who manage medication for older care recipients: problems experienced and development of services.Health Soc Care Community,11,138-145.
18. Travis, SS,Bernard, MA,McAuley, WJ,Thornton, M,Kole, T(2003).Development of the family caregiver medication administration hassle scale.Gerontologist,43,360-368.
19. Travis, SS,Bethea, LS,Winn, P(2000).Medication administration hassles reported by family caregivers of dependent elderly persons.J Gerontol A Biol Sci Med Sci,55,M412-M417.
20. Travis, SS,McAuley, WJ,Dmochowski, J,Bernard, MA,Kao, HF,Greene, R(2007).Factors associated with medication hassles experienced by family caregivers of older adults.Patient Educ Couns,66,51-57.
21. 內政部統計處：人口年齡分配。https://www.moi.gov.tw/files/site_stuff/321/2/year/year.html。引用2019/08/01。Department of Statistics, Ministry of the Interior, R.O.C. (Taiwan). Population by age. Available at: https://www.moi.gov.tw/files/site_stuff/321/2/year/year.html. Accessed August 1, 2019.
22. 王雅靜, YC,曾恩娣, ET,王美雰, MF,王淑敏, SM,韓慧美, HM(2013)。提升居家老年病人用藥安全。長期照護雜誌，17，41-56。
23. 桃園市政府衛生局：巴氏量表。 https://www.tycg.gov.tw/uploaddowndoc?file=health37/201607292151562.pdf&filedisplay=%E3%80%8C%E5%B7%B4%E6%B0%8F%E9%87%8F%E8%A1%A8%E3%80%8D.pdf&flag=doc。引用2019/08/01。Department of Health, Taoyuan City Government. Barthel Index. Available at: https://www.tycg.gov.tw/uploaddowndoc?file=health37/201607292151562.pdf&filedisplay=%E3%80%8C%E5%B7%B4%E6%B0%8F%E9%87%8F%E8%A1%A8%E3%80%8D.pdf&flag=doc. Accessed August 1, 2019. [In Chinese]
24. 國家發展委員會：中華民國人口推估（2018至2065年）。https://www.ndc.gov.tw/Content_List.aspx?n=84223C65B6F94D72。引用2019/08/01。National Development Council. Population projections report in Taiwan, 2018-2065. Available at: https://www.ndc.gov.tw/Content_List.aspx?n=84223C65B6F94D72. Accessed August 1, 2019. [In Chinese]
25. 張煥禎, HC,許世昌, SC,簡珍宜, CI,陳淑怡, SI,陳韻宜, YY,許詩典, ST(2011)。居家照護老年個案用藥安全與適當性之現況分析。領導護理，12，24-31。
26. 陳秀娟, HC,陳美伶, ML(2004)。癌症病患家屬照顧者照顧工作之探討。長庚護理，15，258-270。
27. 蔡文正, WC(2009)。民眾對中醫藥的認知度、信賴度、使用度及其相關因素之探討。中醫藥年報，27，153-224。

1. 顧徳璉,吳淑英(2023)。藥事照顧的新藍海：論家庭照顧者給藥管理工作與相關支持策略。長期照護雜誌，26(1)，89-101。
2. 張弘潔(2022)。兒童公共衛生的新目標：將兒童納入所有政策。台灣公共衛生雜誌，41(1)，4-6。