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系統識別號 U0026-2608202015165100
論文名稱(中文) 台灣版在家職能表現評估之跨文化調整
論文名稱(英文) Cross-Cultural Adaptation of the Taiwan Version of the In-Home Occupational Performance Evaluation (I-HOPE-T)
校院名稱 成功大學
系所名稱(中) 職能治療學系
系所名稱(英) Department of Occupational Therapy
學年度 108
學期 2
出版年 109
研究生(中文) 王騰苡
研究生(英文) Teng-Yi Wang
電子信箱 a2552777@gmail.com
學號 T76061013
學位類別 碩士
語文別 中文
論文頁數 114頁
口試委員 指導教授-張玲慧
召集委員-王新台
口試委員-毛慧芬
口試委員-陳柏宗
口試委員-黃百川
中文關鍵字 高齡者  在家活動  居家環境改造  跨文化調整  老化 
英文關鍵字 home modification  cross-cultural adaptation  aging 
學科別分類
中文摘要   居家環境改造可降低環境障礙,以提升高齡者的日常生活表現,進而降低跌倒風險及減少照顧者負擔。然而,目前缺乏適用於我國高齡者之居家環境評估工具,嚴重限制居家環境改造之目標擬定與成效追蹤。在家職能表現評估 (In-Home Occupational Performance Evaluation, I-HOPE) 為以個案為中心的高齡者居家環境評估工具,其兼顧主觀及客觀評估層面,且具有良好的心理計量特性。然而,I-HOPE目前尚無台灣版本,且台美間存有文化與生活型態等差異,本研究之目的為完成台灣版在家職能表現評估 (the Taiwan version of I-HOPE, I-HOPE-T)。
  研究分兩階段:(一)調查I-HOPE應用於台灣高齡者之適用性:共納入54位居住於社區之高齡者,調查對於I-HOPE圖卡之理解程度、活動內容與我國情境之相符度、活動之重要程度,以及其他重要但未被列出之活動,以做為跨文化調整之依據。(二) 翻譯及跨文化調整:依循翻譯標準程序、專家諮詢與調整、前導測試及評估工具確認,完成I-HOPE-T。
  適用性調查結果為:(1) 7張低於理解程度標準(67%)與3張低於文化適應標準(67%)之活動圖卡;(2) 16項重要程度過低(低於2分)之活動與可補充之7項在家活動。跨文化調整結果為:兩次專家諮詢後,4項活動(熨燙衣物、照顧寵物、帳單繳費與聽音樂/廣播〔合併至看電視〕)因重要程度過低、鮮少執行或於不屬在家活動而刪除、4項活動(看電視或聽收音機、進食或飲水、園藝與使用3C產品)因擴大活動範圍而調整及2項活動(運動及宗教儀式)因高齡者經常執行而新增,並修改圖卡26張使能正確且快速理解活動。結果完成I-HOPE-T共42張活動圖卡。
  預期I-HOPE-T具華語及台語版本,可用於台灣高齡者居家環境評估及改造介入之成效評估,將有助於臨床實務之應用,但未來仍需進一步驗證其心理計量特性。
英文摘要 Introduction: The In-Home Occupational Performance Evaluation (I-HOPE) is a reliable and valid tool to evaluate subjective and objective occupational performance and environmental barriers. It is also used to evaluate the needs and effectiveness of home modification. However, given the cultural differences such as lifestyle, family size, and house style, the I-HOPE will need to be adapted for use in Taiwan. This study is to complete a cross-cultural adaption and development of I-HOPE-Taiwan version (I-HOPE-T).

Methods: Two phases were completed: (1) applicability of I-HOPE; (2) translation and cross-cultural adaptation of I-HOPE-T, that included forward translations, synthesis, backward translations, translation correction, adjustment, expert consultation, pilot testing, and expert confirmation.

Results: Fifty-four community-dwelling Taiwanese older adults were recruited. Applicability findings were: (1) seven activity cards not meeting the understandings requirement and three activity cards not meeting the cultural-fit requirement; (2) sixteen activity items deemed not important and seven additional activity items recommended. Expert consultation resulted in: (1) four items deleted (ironing clothes, caring for pets, paying the bills, and listening to music/radio); (2) four items adjusted (watching TV or listening to the radio, eating or drinking, gardening, and using 3C products); (3) two items added (doing exercise and performing religious ceremonies); and (4) pictures or wording of twenty-six activity cards revised. Pilot testing of ten healthy older persons supported the utility of I-HOPE-T. The final results produced 42 cards.

Discussion and Conclusion: I-HOPE-T is translated into Taiwanese Mandarin and Taigi. Future studies can verify its psychometric properties.
論文目次 中文摘要 I
Abstract II
致謝 VI
目錄 VII
圖目錄 IX
表目錄 X

第壹章 緒論 1
第一節 研究背景 1
第二節 研究目的與問題 5

第貳章 文獻回顧 6
第一節 高齡者與環境相關理論 6
第二節 居家環境改造之簡介 10
第三節 居家環境改造之評估 14
第四節 在家職能表現評估之發展與使用 22
第五節 翻譯及跨文化調整之方法學 26

第參章 研究方法 30
第一節 研究設計概述 30
第二節 研究對象及招募方式 31
第三節 研究流程 33
第四節 資料蒐集 36
第五節 資料分析 38

第肆章 研究結果 40
第一節 第一階段「調查I-HOPE應用於台灣高齡者之適用性」 40
第二節 第二階段「翻譯及跨文化調整」 46

第伍章 討論 77
第一節 不同文化情境下新增活動項目之差異 77
第二節 刪除與調整活動項目之文化背景下的考量 81
第三節 調整活動圖卡之異同 84
第四節 針對目標族群進行未經調整之評估工具適用性調查的必要性 89
第五節 研究優勢與限制及未來研究方向 90

第陸章 結論 93

第柒章 參考文獻 94

附錄一、研究倫理審查證明 103
附錄二、I-HOPE研究使用之授權書 104
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