應用系統性文獻回顧檢視世界衛生組織障礙評估量表（WHODAS 2.0）之信效度指標做為台灣新制身心障礙功能評估工具之可行性

To Examine the Assessment Feasibility of WHODAS 2.0 in Taiwan: A System Literatures Review

台灣過去身心障礙鑑定多以醫療觀點的判定為主，但伴隨著全球對障礙定義及觀念的轉變，以疾病為導向的思維模式無法將身心障礙者狀態完整描繪。因此，台灣新制身心障礙鑑定中的功能評估期待以多面向的觀點來了解身心障礙者的失能狀況。並於2012 年將世界衛生組織身心障礙評估量表（World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0）做為功能鑑定評估工具之一，建構一套完整且適用於本土化的身心障礙評估工具，工具本身之信效度尤其重要，因此本研究嘗試應用系統性文獻回顧檢視過去十年中，各國應用WHODAS 2.0 進行信效度指標及其相關研究的概況比較，評析WHODAS 2.0 作為新制身心障礙鑑定工具的適合性。本研究依據自訂的檢索規則共挑選出12 篇文獻，綜合來看，其信度指標內部一致性，數值皆高於0.5；再測信度高於0.2；施測者間信度高於0.7；效度指標中的內容效度及同時效度皆有部分關聯性存在；探索性因素分析所萃取出來之因素為5-7 個不等，而解釋力皆高於55%；在驗證性因素分析上，因素負荷量皆高於0.56，但配適度指標並不完整。由於本文為初探性研究，因此，未來是否將更多本土化的因素納入使得評估工具更具其意義需待後續更多實證性研究釐清。

To enhance the social participation of people with disabilities in Taiwan, the government applies the comprehensive assessment of WHODAS 2.0 to understanding and assessing the limitations in activity and social participation of people with disabilities. Therefore, the purpose of the study is to review the indicators the reliability and validity status of WHODAS 2.0 in the world, and to examine the assessment feasibility in disability evaluation system. A series of keywords are searched, 12 were selected to analysis from 325 articles. The overall results showed the reliability of Cronbach’s α, test-retest and inter-rater reliability in the WHODAS 2.0 were more than 0.5, 0.2 and 0.7, respectively. The content validity and concurrent validity was accepted, the construct validity, the model was explained total variance was more than 55% by the exploratory factor analysis, the factor loading value is more than 0.56, but fit indicators were less accepted in confirmatory factor analysis. The results should be considered as a preliminary study, and the still need more consideration in further study.