台灣版慢性病照護評估問卷之發展與驗證

Development and validation of the Taiwanese Version of the Assessment of Chronic Illness Care Questionnaire

10.6288/TJPH.202106_40(3).109098

黃紀諺(Chi-Yen Huang)；周盈邑(Ying-Yi Chou)；楊銘欽(Ming-Chin Yang)；董鈺琪(Yu-Chi Tung)

慢性病照護評估 ； 效度 ； 信度 ； 慢性病照護模式 ； assessment of chronic illness care ； validity ； reliability ； chronic care model

台灣公共衛生雜誌

40卷3期（2021 / 06 / 28）

294 - 305

繁體中文

目標：慢性病照護評估（Assessment of Chronic Illness Care, ACIC）問卷為國際上常用於評估醫療機構慢性病照護之品質或整合程度，但尚未使用於台灣，故本研究目的為翻譯慢性病照護評估問卷，並驗證台灣版ACIC問卷，作為測量台灣慢性病照護品質之評估工具。方法：依世界衛生組織建議之問卷發展流程進行問卷翻譯，我們於2019年7月至2020年2月之間完成ACIC問卷翻譯，郵寄ACIC問卷給56家診所之所有377位醫療人員，並以內容效度指標值（content validity index, CVI）、驗證性因素分析（confirmatory factor analysis, CFA）及Cronbach's α進行信效度檢定。結果：有效問卷共251份，回收率66.6％。經檢測專家效度全數題目之CVI均達0.8以上，刪除原量表其中13題後，配適度指標為0.89，卡方自由度比為1.78，標準化均方根殘差值為0.04，及近似均方根誤差為0.06，驗證性因素分析結果為一可接受之模型。內在一致性檢定之Cronbach's α值為0.897－0.946，顯示題目間有內在一致性。結論：21題台灣版ACIC問卷具有效度和信度，可以作為評估台灣慢性病照護品質的工具。

Objectives: The Assessment of Chronic Illness Care (ACIC) questionnaire is widely used to assess the quality or integration of services in medical institutions. However, it has not yet been used in Taiwan. Thus, this study translated the ACIC questionnaire and validated the Taiwanese version of this questionnaire to measure the quality of chronic care in Taiwan. Methods: The translation process was based on the World Health Organization's ＂Process of Translation and Adaptation of Instruments.＂ We translated the ACIC questionnaire between July 2019 and February 2020 and distributed it by mail to 377 medical personnel employed at 56 clinics. The content validity index (CVI), confirmatory factor analysis (CFA), and Cronbach's α values were used to assess its reliability and validity. Results: The number of valid questionnaires returned was 251, and the response rate was 66.6%; the CVI was 0.8 or higher for all questions. After 13 items were eliminated, CFA revealed a favorable index of fit (0.89), with a chi-square to degree of freedom ratio, standardized root mean square residual, and root mean square error of approximation of= 1.78, 0.04, and 0.06, respectively. The Cronbach's α values (0.897-0.946) indicated acceptable internal consistency. Conclusions: The 21-item Taiwanese version of the ACIC questionnaire has satisfactory validity and reliability and can be used to evaluate the quality of chronic care in Taiwan.

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