中文版醫院出院準備度量表之信效度檢定

Psychometric Testing of the Chinese Version of the Readiness for Hospital Discharge Scale

背景：過去對出院準備服務之評價，鮮少針對病患對自己是否有準備好出院之看法提出評值與探討，且缺少評量工具。目的：驗證中文版醫院出院準備度量表之信度與效度。方法：採橫斷性研究設計，分二階段進行收案，第一階段收集大腸直腸癌和肝癌病患223人，進行探索性因素分析。第二階段收集腦中風病患323人，進行驗證性因素分析。研究工具採Weiss和Piacentine所發展的醫院出院準備度量表。結果：驗證性因素分析結果顯示12題分配於3個次量表：個人狀態、適應能力和預期性支持的模式為量表最佳解釋模式（GFI = .92, AGFI = .88, NFI = .97），且與原量表呈現高度相關（r = .96, p ＜ .001）之效標關聯效度。整體量表內在一致性之Cronbach's α為.89，次量表之α值依序為.73、.90、.89。結論／實務應用：中文版醫院出院準備度量表具有良好效度與信度。本量表可以實際應用於病患對出院準備的評價。

Background: Little has been published in the literature regarding how patients self-evaluate their degree of readiness for hospital discharge. Furthermore, there is currently no self-evaluation tool available in Chinese able to assess the discharge readiness of patients. Purpose: This study was used to psychometrically test the Chinese version of the readiness for hospital discharge scale (RHDS_C). Methods: This study used a cross-sectional design. Two samples were recruited in a two-stage process at two hospitals in Southern Taiwan. Two hundred and twenty-three patients with a diagnosis of either colorectal cancer or hepatic cancer were used to conduct an exploratory factor analysis (EFA) in the first stage of the study. Another 323 patients with a diagnosis of stroke were used conduct a confirmatory factor analysis (CFA). The instrument used was the Readiness for Hospital Discharge Scale (RHDS) developed by Weiss & Piacentine. Results: RHDS_C consists of three subscales: personal status (4 items), coping ability (4 items), and expected support (4 items) adapted from the CFA. The assessed goodness-of-fit index (GFI = .92, AGFI = .88, NFI = .97) indicate the model fit the data well based upon the CFA. Criterion-related validity was supported by the correlation between the original RHDS and the RHDS_C (r = .96, p ＜ .001). The Cronbach's alpha coefficients were .89 for the overall scale and .73, .90, and .89 for the 3 subscales, respectively. Conclusions/Implications for practice: This study confirms the validity of the RHDS_C and suggests this instrument is able to reliably assess the readiness of patients for discharge from the hospital. We recommend the scale be applied in the clinical setting to evaluate the discharge readiness of hospital patients.