The Validity study of the Chinese version Canadian Occupational Performance Measure in people with Schizophrenia in Taiwan
|Keywords:||職能表現;效度;加拿大職能表現測驗;精神分裂症;案主中心;Canadian Occupational Performance Measure(COPM);Validation;Schizophrenia;Client-centered||Issue Date:||2005||Abstract:||
研究背景：台灣地區精神科職能治療臨床常用的評估工具以職能表現要素評估為主，欠缺一個能完整評估職能表現領域、同時具有良好心理計量特性，能供臨床與研究作為療效證據指標的評量工具。加拿大職能表現測驗（Canadian Occupational Performance Measure, COPM）為一評量個案在職能表現領域之問題與變化情形、具有良好信、效度及敏感性的評量工具，被廣泛使用於全球職能治療成效研究。目前台灣已發展中文版，並顯示其應用於精神疾病患者，能有效找出患者之職能表現問題，且具可接受之信度。
研究結果：98位受試者符合收案條件，症狀嚴重程度不同之受試者，其加拿大職能表現測驗結果差異具有統計顯著性（p<.01）；受試者之加拿大職能表現測驗與簡式症狀量表呈中度負相關ρ=-.389∼-.473 (p<0.000)；與職能自我評估能力得分呈低至中度相關ρ=.235∼.420 (p<.05)；與疾病衝擊量表中度負相關ρ=-.285~-.418(p<.05)；與一般自我效能量表中度相關ρ=.404-.461(p<0.000)；與生活品質問卷呈現中度相關ρ=.238~.437(p<.05)；與職能治療綜合評量表相關不顯著。研究結果支持加拿大職能表現測驗有良好的區辨效度及中等的效標關聯效度，可應用於社區精神分裂症患者職能治療學術研究與臨床治療。
Background：The majority of assessments available to measure outcomes in mental health occupational therapy in Taiwan focus on performance components. There remains a need for a valid and reliable outcome measure that assesses the total sphere of occupational performance for the individual client within his/her environment. The Canadian Occupational Performance Measure(COPM) is a generic and individualized measure designed to detect changes in clients’ self perception of occupational performance and satisfaction with performance over time. COPM is widely used worldwide and has been shown to have acceptable psychometric properties. The COPM was translated to Mandarin and tested in Taiwanese clients with psychiatric disorders, the results showed that the COPM can be applied reliably to Taiwanese clients.
Objective：The purpose of the study is to exam validity of the Chinese version of the COPM in clients with schizophrenia.
Methods：102 patients were recruited from the Day care ward and the community psychiatry rehabilitation institute in northen Taiwan. After obtaining their formal consent, each subject was tested on the Mini Mental State Examination and was included in the study if his/her MMSE score were larger than 24. Dermographic and severity information of the subjects were gathered through interview and from chart. The discriminant validity of the COPM was tested by comparing the differences of the COPM scores among groups classified by sysptom severity and onset duration. The assessment tools uesd to test the concurrent validity of COPM including General Self-efficacy Scale（GSE）, modified Chinese Sickness Impact Profile（SIP）, WHOQOL-BREF, Occupational Self Assessment（OSA） and the Comprehensive Occupational Therapy Evaluation Scale（COTES）. All assessments are self-reported by subject except the COTES which was scored by the subjsct’s occupational therapist in three days.
Result：98 subjects who met the criterion completed the COPM and other all questionnaires. The differences in the COPM score between the mild and severe symptom severity of subjects were significant（p<.01）. Spearman correlation coefficients between the scores on the COPM and the Brief Psychiatric Symptom Rating Scale were -.389~ -.473 (p<0.000), with the GSE were .404~ .461 (p<0.000), with the OSA were .235~ .421(p<.05), with the SIP were -.285~ -.418(p<.05), and with the WHOQOL-BREF were .238~.437(p<.05). However, Correlations between the COPM and the COTES were low and nonsignificantly. Evidence gathered supported the discriminiative and criterion-related validity of the Chinese version of the COPM and suggested it is a moderate instrument for use in clinical practice and outcome research in Taiwanese clients with schizophrenic disorders.
|Appears in Collections:||職能治療學系|
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