角色量表於臺灣精神病患之信度與效度測試

Role Checklist:The Reliability and Validity Study for Taiwanese Psychiatric Patients

在生活中，我們每一個人都扮演著許多角色（配偶、父母、工作者等），經由這些角色，我們支配自己的空間與時問去組織自己的職能行為。研究者提出認知、情緒的障礙會影響並侷限學習，使人們在扮演自己的生活角色上受到限制與障礙。因此，職能治療師要維持個案的功能，就必須了解在他（她）的情境中所要扮演的角色。職能治療師發現角色量表評估的結果，可提高個案對治療活動的參與動機，並增進自我察覺。本篇研究的目的在於檢視台灣版的角色量表信度及建構效度。前後測信度中的29位病患來自於台灣北部地區的一所大學附設醫院之精神科，其診斷類別包括情感性疾病（55.2%、精神官能症（34.4%、及其他（10.3%）。所有的個案在一週內進行再測，收集到的資料使用SAS電腦程式進行Kappa統計分析。另外，效度研究中則包含229位同一醫療機構中的病患，診斷類別包括情感性疾病（62.9%）、精神官能症（7.0%）、精神分裂症（2.6%）、及其他（21.4%）。建構效度使用BIGSTEPS電腦軟體進行羅序模式分析。前後測信度顯示Kappa值在0.30~0.52之間。80%的項目都在可接受的範圍（Kappa > .40）。羅序分析顯示角色量表的所有項目都符合單一建構，並且困難度從最看重到最不看重的項目都落在同一連續性上，最重要的三個角色分別為「家庭成員」、「朋友」、及「照顧者」。最不被看重的角色是「組織成員」。項目分離信度係數為0.98，顯示極佳的內在一致性 ‧ 本研究結果顯示角色量表在前復測信度、內在一致性、及重要性項目的建構效度都表現良好。

We play many roles in our lives. Our spaces and times are arranged and occupational behaviors are organized according to these role. Researchers proposed that cognitive, emotional impairments and restricted learning experience might limit people to practice various roles. Thus, it is necessary to understand client's roles in relation to his or her context for occupational therapists. Occupational therapists found that the test results provide practical information to facilitate clients' motivation in participating the treatment program and their self-awareness. The purpose of the study is to examine the reliability and construct validity of the Role Checklist for Taiwanese clients. Twenty-nine clients were recruited for reliability study from a psychosomatic unit of a university-affiliated hospital in Taiwan. The diagnoses include mood disorders (55.2%), neurotic, stress-related and somatoform disorders (34.4%), and others (10.3%). All clients were tested and retested during one-week interval. Kappa statistics from SAS computer program were used for analyses. The validity study included 229 clients from the same unit as above. The diagnoses include mood disorders (62.9%); neurotic, stress-related and somatoform disorders (7.0%); Schizophrenia (2.6%), and others (21.4%). Rasch measurement model was used to analyze construct validity through BIOSTEPS computer program. Kappa values varied from 0.30 to 0.52 for test-retest reliability study. Eighty percents of these values were at the acceptable level. Rasch analysis indicated that the Role Checklist encompasses a uni-dimensional construct. The three most valued roles were ‘value of being a family member', 'value of being a friend', and 'value of being a caregiver'. Value of organization member role was the least valued role among these subjects. The internal consistency is high as demonstrated by high item separation reliability index. The role checklist was supported of its test-retest reliability as well as construct validity of the value items.