自覺環境障礙量表在台灣於社區老年人的適用性

The Utility of the Perceived Environmental Barriers in Community for the Community-dwelling Elderly in Taiwan

10.6315/2015.43(3)02

連偉志(Wei‐Chih Lien)；官大紳(Ta‐Shen Kuan)；張哲豪(Jer‐Hao Chang)；郭乃文(Nai‐Wen Guo)

自覺環境障礙 ； ROC曲線 ； 老年人 ； perceived environmental barriers ； receiver operating characteristic curve ； elderly

台灣復健醫學雜誌

43卷3期（2015 / 09 / 01）

149 - 158

繁體中文

目的：本研究目的在提供自覺環境障礙量表使用在老年人合理的分數分界點以供臨床上量測環境因素使用。方法：本研究以200位居住在社區認知功能正常的老年人為研究對象，環境因素部分使用自覺環境障礙量表施測，利用receiver operating characteristic曲線(ROC 曲線)並依居住在社區的老年人功能獨立與否(評估工具是照護需求層級量表，Hierarchy of the Care Required)來找出預測功能獨立之最適切點以供臨床上使用。結果：本研究發現自覺環境障礙量表-台灣版「物理和結構」構面分數及總分對照護需求層級量表基本日常生活活動獨立具有可接受的區辨能力(area under curve 分別為0.751 及0.737)。自覺環境障礙量表-台灣版「物理和結構」構面分數及總分對工具性日常生活活動獨立具有好的區辨能力(area under curve 分別為0.839 及0.826)。取自覺環境障礙量表-台灣版總分之分界點於總分7 分可合理預估患者的基本日常生活活動是獨立的，其敏感度是0.797，特異度是0.546。分數分界點位於總分4分，則可合理預估其工具性日常生活活動獨立的，其敏感度是0.899，特異度是0.637。結論：自覺環境障礙量表－台灣版對居住在社區的老年人的基本日常生活活動及工具性日常生活活動是否具備獨立功能，具有可接受的區辨能力。

Background and Purpose: The purpose of this study was to find out the cut-off point of the Perceived Environmental Barriers in Community according to basic activity of daily living (BADL) and instrumental activity of daily living (IADL) independence in community-dwelling elderly in Taiwan. Methods: In this study, 200 community-dwelling elderly were sampled and administered with the Perceived Environmental Barriers in Community and Hierarchy of the Care Required (HCR). Receiver operating characteristic curves were used to find out the cut-off points of the Perceived Environmental Barriers in Community. Results: We found that the Physical/Structural domain and total score of the Perceived Environmental Barriers in Community demonstrated acceptable discrimination with regard to the independence of the BADL domain of the HCR (the areas under the curve were 0.751 and 0.737, respectively) and excellent discrimination was demonstrated with regard to the independence of the IADL domain of the HCR (the areas under the curve were 0.839 and 0.826, respectively). We also found that the cut off point was 7 in the BADL independence (sensitivity 0.797 and specificity 0.546) and the cutoff point was 4 in the IADL independence (sensitivity 0.899 and specificity 0.637). Conclusions: The results showed that the cut-off points of the Perceived Environmental Barriers in Community had acceptable discrimination with regard to the independence of BADL and IADL in a sample of community-dwelling elderly in Taiwan.