精神病患社會功能量表之發展與驗證——以實務應用為取向

社會功能關乎精神病患社區復健的潛力與結果，乃是精神醫療的重要一環，因此對於病患社會功能的評量是擬定病患處遇計劃的前置步驟。基於台灣並沒有經過嚴謹且完整信度與效度檢驗的社會功能量表，本研究根據Birchwood等人（1990）的社會功能量表加以修改與縮減，以適合台灣的社會文化情境，並增進實務運用的可行性。研究當中針對301位照顧者、65位病患、43位病患的手足施測；照顧者中有59位於3-4週之後進行再測。樣本來源包括北中南五家精神醫療單位，資料蒐集大多於門診進行。Birchwood等人的量表原有77題，本研究之初版為62題，後經專家審查與預測後修改為54題，以正式施測的資料進行多項信度與效度檢驗，本研究發展出36題的社會功能量表簡短版。這份量表具有良好的鑑別力、內在一致性、再測信度、評量者一致性、區辨效度、與因素效度及聚合建構效度，可適用於台灣地區的社區病患，並有常模提供實務工作者處遇計畫之參考；同時也可應用於未來的相關研究，以增進研究間的比較與研究結果之累積。

This study aimed to develop a social functioning scale with optimal length for practice usage. Based on the scale developed by Birchwood et al. (1990), a 77-item scale was modified and shortened into 54 items in accord with the culture of Taiwanese life style and experts' reviews. Data were collected from five psychiatric units or hospitals in Taiwan. During outpatient visit, 301 caregivers and 65 patients were in-person interviewed. Fifty-nine caregivers were re-tested 3 to 4 weeks latter. Also, 43 siblings of the patients self-administered the social functioning scale. Through comprehensive tests, the final version of social functioning scale contains 36 items. This scale has very good psychometric properties including internal reliability, test re-test reliability, inter-rater reliability, factorial and convergent construct validity and discriminant validity. With optimal length and norm, this scale can be used to enhance clinical assessment. These scales can also be adopted in future studies to ensure measurement validity and make cross-study comparisons possible in the field of psychiatric services.