中文健康識能評估表的發展與測試

Development and Validation of Mandarin Health Literacy Scale

10.6145/jme.201006_14(2).0005

蔡慈儀(Tzu-I Tsai)；李守義(Shoou-Yih Lee)；蔡憶文(Yi-Wen Tsai)；郭耿南(Ken-N. Kuo)

健康講能 ； 中文量表 ； 量表發展 ； health literacy ； Mandarin Chinese ； scale ； development

Journal of Medical Education

14卷2期（2010 / 06 / 01）

122 - 136

繁體中文

目的：健康識能(health literacy)對醫療照顧系統的結果和花費日益受到重視。除健康識能概念未普及推廣，缺乏適合的評量工具亦是目前對台灣民眾健康識能狀況無法掌握的主因。本文主要是介紹一套中文的健康識能評估表的發展與心理計量結果。方法：我們運用下列步驟發展中文健康識能評估表：專家會議、題庫發展、德菲法審訂、中文適讀測試、及預試後的第一版中文健康識能評估表並進行量表施測調查。結果：最後的量表中包含了50個題目，以隨機抽樣方式完成323位成年民眾量表施測，結果顯示本測量工具內部一致性信度達0.95，幅合性及預測性效度檢驗結果均達統計上顯著差異。結論：這套中文健康識能評估表適用評量台灣一般民眾之健康識讀能力，進一步需要更大量及多樣性的樣本進行檢測和常模建立。

Objectives: A growing body of research has identified health literacy as an important factor that influences the outcomes and costs of health care delivery. Several English and Spanish health literacy measurement tools have been developed and widely used. With the lack of an appropriate and reliable assessment tool in Chinese、our understanding of health 1iteracy and its effects on health and health service utilization in Mandarin Chinese speaking populations has been constrained. The purpose of this study is to describe the development of the Mandarin Health Literacy Scale (MHLS) and to assess its psychometric properties. Methods: We employed several procedures to develop a health literacy measurement tool, including an expert panel, item generation, the Delphi process, readability testing, pilot testing, and field testing. Various different types of analysis, including item response theory analysis, factor analysis, reliability testing and validity testing, were conducted to examine the psychometric qualities of the MHLS. Results: There were 50-items included in the MHLS for the validation study, and 323 subjects completed the questionnaire survey. Results show that the MHLS had good internal reliability (Cronbach's a=0.95). In addition, the results for the convergent and predictive validity were statistically significant. Conclusions: More research is needed to further validate the MHLS using a number of distinct subpopulations of Mandarin Chinese speaking adults and to establish their standard levels of health literacy using the MHLS.

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