愉悅性活動量表中文版於長照機構住民之信效度初探

A Preliminary Reliability and Validity Study of the Chinese Version of the Pleasant Events Schedule for Residents of Long-term care Institutions

目的：長照機構住民普遍是老年人及失能住民，健康狀態逐漸衰退，人際疏離產生空虛和寂寞，易造成心理疾病如憂鬱症等，而愉悅性活動（Pleasant Events）可幫助住民改善健康效益。發展愉悅性活動量表（Peasant Events Schedule, PES）中文版，並驗證其應用於臺灣長照機構住民之信度與效度。方法：本研究先以簡易心智狀態問卷調查表（SPMSQ）篩選中部某長期照護機構60位適合住民為對象。PES中文版參考Meeks等人（2009）所編製英文版愉悅性活動量表。藉由認知行為療法的介入，並進行前後測以檢定其再測信度。PES中文版的效標關聯效度之量表包括生活品質量表、老人憂鬱量表、正負向情緒量表、日常生活動作表。結果：PES中文版內容效度指標（Content Validity Indicator, CVI）均在0.8以上。PES中文版三項指標（利用、愉悅、頻率）Cronbach's α分別是0.72、0.84及0.79，再測信度亦呈顯著，顯示具有可靠的內部一致性及穩定度。在效標關聯效度上，PES中文版三項指標和老人憂鬱呈顯著負相關，但和生活品質呈顯著正相關。PES中文版三個指標中兩兩均呈顯著正相關，顯示住民在愉悅活動上有利用者、頻率愈多、則愈愉悅。愉悅愈高、生活品質愈好、憂鬱愈低。結論：PES中文版對於長照機構是一個可靠有效的認知行為治療工具，可幫助醫療人員藉由認知行為療法的介入，有效率地評估和改善住民的心理健康狀況。

Purposes: Residents of long-term care institutions are generally the older people and people with disabilities. Their health status is gradually declining, and interpersonal alienation leads to emptiness and loneliness, easily resulting in psychological disorders such as depression. Pleasant events can help residents improve their health status. Therefore, this study aimed to develop the Chinese version of the Pleasant Events Schedule (PES-CH), and verify its reliability and validity in residents of long-term care institutions in Taiwan. Methods: The Short Portable Mental Status Questionnaire (SPMSQ) was used to screen 60 suitable residents of a long-term care institution in Central Taiwan. The PES-CH drew references from the English version of the PES developed by Meeks et al. Through the intervention of cognitive behavioral therapy, pre-testing and post-testing were used to determine its test-retest reliability. The measures of criterion-related validity of the PES-CH include Quality of Life (QoL), Geriatric Depression Scale (GDS), Positive and Negative Affect Schedule (PANAS), and Activities of Daily Living (ADL).Results: The content validity index of the PES-CH was above 0.8. Cronbach's α of the three indices, utilization, pleasure, and frequency of PES-CH were 0.72, 0.84 and 0.79, respectively. Moreover, the test-retest reliability was significant, which indicated that PES-CH has reliable internal consistency and stability. In terms of criterion-related validity, the three indices of the PES-CH were significantly negatively correlated with geriatric depression, however, significantly positively correlated with QoL. The pairwise correlation of these three indices was significantly positively correlated. This indicated that the residents have participated in pleasant events, and the higher the frequency, the greater the pleasure, and the higher the pleasure, the better the QoL, and the lower the depression. Conclusions: PES-CH is a reliable and effective cognitive behavioral therapy tool for long-term care institutions, employed by medical personnel to efficiently assess and improve the mental health of the residents.