家屬內化烙印壓力量表應用於精神疾患病人家屬照顧者之再測能力和最小可偵測之變化值

Family Stigma Stress Scale in Family Caregivers of People with Mental Illness: Reproducibility and Minimal Detectable Change

目的：內化烙印相關壓力（stigma-related stress）是值得注意的重大議題。除了病人外，精神疾患病人的家屬照顧者也可能面對內化烙印壓力，而家屬內化烙印壓力量表（Family Stigma Stress Scale; FSSS）可用來測量家屬照顧者的內化烙印壓力。然而，FSSS的再測能力，尤其是最小可偵測之變化值仍未建立。本研究目的為瞭解FSSS於不同時間長度，應用於精神疾患病人家屬照顧者上的再測能力表現。方法：精神疾患病人家屬照顧者在間隔2週到3個月的期間填寫FSSS，用組內相關係數（intraclass correlation coefficient; ICC）並計算最小可偵測之變化值，最後使用最小可偵測之變化值百分比以瞭解再測能力是否符合預期（＜ 30%表示可接受）。結果：精神疾患病人家屬照顧者（n = 197）填寫二次FSSS，間隔時間為2週至3個月；其中112人間隔兩週至1個月內；48人間隔1至2個月；37人間隔2到3個月。FSSS的再測能力是可接受的，不受再測間隔長度影響（ICC = 0.67-0.86）。FSSS總分的最小可偵測之變化值範圍為3.67到4.56。最小可偵測之變化值百分比顯示FSSS總分在各再測間隔的再測能力是可接受或接近可接受的（22.09%-35.36%）。結論：FSSS總分應用於測量精神疾病病人之家屬照顧者的內化烙印壓力時，在三個月內的間隔是可信的。

Objective: Stigma-related stress (or stigma stress) is a critical issue that should be considered by mental health professionals. In addition, stigma stress can occur in the family caregivers of people with mental illness (PWMI), and the Family Stigma Stress Scale (FSSS) can be used to detect the stigma stress for family caregivers. The application of the FSSS, its reproducibility, especially the minimal detectable change (MDC), should be maximized and studied. In this study, we intended to study the reproducibility of the FSSS in family caregivers of PWMI in different durations of test-retest reliability assessments. Methods: We asked family caregivers of PWMI to fill the FSSS in various time from 2 weeks to 3 months. We computed the intra-class correlation coefficient (ICC), and calculated the MDC with the ICC results, to generate MDC%, and finally to determine acceptable reproducibility (＜ 30% indicates acceptable). Results: Family caregivers of PWMI (n = 197) completed the FSSS twice within an interval of 2 weeks to 3 months, 112 completed between 2 weeks and 1 month, 48 between 1 and 2 months, and 37 between 2 and 3 months. The reproducibility of the FSSS was acceptable regardless the lengths of the test-retest intervals (ICC = 0.67 to 0.86). The MDC for the FSSS total score was between 3.67 and 4.56. MDC% revealed that the reproducibility for the FSSS total score was nearly acceptable or acceptable in all different lengths of intervals (MDC% = 22.09% to 35.36%). Conclusion: The FSSS total score is reliable in monitoring the stigma stress in family caregivers of PWMI within an interval of three months.