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系統識別號 U0026-2908201318141300
論文名稱(中文) 自閉症嬰幼兒篩檢量表中文版信效度之建立
論文名稱(英文) Development of the Chinese Version of the Baby and Infant Screen for Children aUtIsm Traits, BISCUIT
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 101
學期 2
出版年 102
研究生(中文) 鍾逸霏
研究生(英文) Yi-Fei Chung
電子信箱 fifi0510@yahoo.com.tw
學號 T26994054
學位類別 碩士
語文別 英文
論文頁數 116頁
口試委員 指導教授-徐畢卿
口試委員-劉萌容
口試委員-林玲伊
中文關鍵字 泛自閉症  篩檢  心理計量檢定  自填式嬰幼兒自閉症檢核表 
英文關鍵字 Autism spectrum disorder  Screening tool  Modified The Checklist for Autism in Toddlers (M-CHAT)  Psychometric properties 
學科別分類
中文摘要 自閉症目前為全球關注議題,而自閉症為一終身疾病,多數的家庭都因此產生一連串壓力。國內缺乏具信效度的合適篩檢工具,造成及早發現及早診斷的困難,常錯失黃金治療時期,故本研究擬以Matson(2009a)等人發展出的嬰幼兒自閉症特質篩檢表(Baby and Infant Screen for Children aUtIsm Traits, BISCUIT)進行中文版的信效度檢定,以適合國內使用,並與國際接軌。本研究取樣將採立意取樣,以台北市立聯合醫院婦幼院區之兒童發展療育評估中心為收案地點,研究對象為疑似發展遲緩17-37個月嬰幼兒之主要照顧者為資訊提供者,以會談方式進行問卷調查,問卷分為兩大部分,自填式嬰幼兒自閉症檢核表M-CHAT(Modified The Checklist for Autism in Toddlers)及嬰幼兒自閉症特質篩檢表(Baby and Infant Screen for Children aUtIsm Traits, BISCUIT)會談問卷調查。本研究經人體試驗委員會(IRB) 審查通過後,採知情同意方式由研究者本人向受試者說明後收集資料。資料分析是以國立成功大學提供學生使用SPSS 17.0 for Windows統計軟體進行描述性及推論性統計分析。描述性統計採次數分配(frequency)、百分比、平均值、標準差等方式進行分析;推論性統計信度考驗則採用內部一致性Cronbach’s α等進行分析,效度考驗是建構效度與效標效度,建構效度採探索性因素分析,再以驗證性因素分析驗證與原始量表的適配度,及項目分析檢視題項相關。效標效度部分,是與效標「M-CHAT」及「DSM-IV」一致性,分別是以第一部分的總量表採kappa係數一致性檢定及第一部分之次量表與「DSM-IV」區辨力,採獨立樣本t檢定考驗。
本研究從反譯法(back-translation)進行雙次翻譯、專家檢視、進行團隊討論、前測等嚴謹步驟,後秉持研究倫理的精神進行收案,共計122名。本研究經驗證中文版BISCUIT量表結果,證實本量表具有良好的內在一致性信度、建構效度與效標效度。資料分析結果顯示整體量表的內在一致性信度(Cronbach's Alpha)為0.941,次量表間的Cronbach's Alpha為0.837-0.928之間,皆達0.8以上具有良好的信度。經探索性因素分析確認中文版的適合度,也能獲得「社交互動缺損、重覆行為、溝通障礙」三個因子,支持與原始版BISCUIT涵蓋的三個概念,整體解釋變異量達40.683%,具有良好建構效度。在效標效度的部分與「M-CHAT」及「DSM-IV」能獲得Kappa係數為.858及.62,屬於不錯一致性;次量表中三個次概念在醫師「DSM-IV」診斷有無泛自閉症/自閉症上具顯著差異,能區別出此三個概念,具有區辨效度。在項目分析與驗證性因素分析結果,總量表GFI為0.526,AGFI為0.82,標準化均方根殘差為0.193,次量表GFI為.629-0.887,AGFI為0.558-0.775,標準化均方根殘差0.084-0.111,未獲得良好的整體適配度。
研究結果說明中文版BISCUIT是一個具有良好信效度且可輔助醫師的診斷,可提供為相關專業人員早期篩檢嬰幼兒泛自閉症的工具。未來尚需進一步應用現代測量理論的特性,發展電腦的適性測驗,將量表縮短成簡短且具準確性之篩檢工具,成為快速與正確篩檢適用於臨床之泛自閉症篩檢量表,以利早療各專業團隊建立泛自閉症孩童的完整照護計畫。
英文摘要 Autism spectrum disorder (ASD) is a global issue and early diagnosis for early intervention is crucial. The Baby and Infant Screen for Children aUtIsm Traits (BISCUIT) is a comprehensive assessment battery in American designed to measure autism symptoms as well as associated comorbid psychopathology and problem behavior. Therefore, this study aimed to develop a Chinese version of the Psychometric Properties section of BISCUIT with two-way translation. One hundred twenty-two caregivers were recruited from an early intervention assessment center in the north Taiwan. Results showed that Cronbach's alpha of the BISCUIT were 0.837 to 0.941; three factors were found with exploring factor analysis and supported the original version. In addition, with “M-CHAT” and “DSM-IV” as the criteria, the Kappa coefficients were 0.858 and 0.650, respectively. Based on the above, the study confirmed the Chinese version of the BISCUIT is both reliable and valid, providing a useful aid to diagnosis.
論文目次 中文摘要..I
Development of the Chinese Version of the Baby and Infant Screen for Children aUtIsm Traits, BISCUIT....III
誌謝.....VI
第一章、緒論..............1
第一節、研究背景與重要性....1
第二節、研究目的...........4
第三節、研究問題...........4
第二章、文獻回顧...........6
第一節、自閉症的相關探討....6
第二節、自閉症診斷標準沿革..9
第三節、自閉症早期篩檢診斷的困境與接受早期療育之重要性..15
第四節、現行自閉症相關篩檢工具之探討....16
第五節、BISCUIT量表之介紹..21
第三章、研究方法.......... 22
第一節、研究對象與地點......22
第二節、樣本數估算.........24
第三節、研究工具...........24
第四節、量表翻譯、信效度檢定過程...26
第五節、研究倫理...........29
第六節、資料分析方法........30
第四章、研究結果...........35
第一節、基本人口學資料......36
第二節、研究對象發展現況....39
第三節、信度檢測...........42
第四節、效度檢測...........44
第五章、研究討論...........58
第一節、基本人口學資料......59
第二節、研究對象發展現況....61
第三節、古典測量理論.......63
第四節、現代測量理論.......65
第五節、研究者反思.........68
第六章、結論與建議.........71
第一節、結論..............71
第二節、研究限制...........72
第三節、研究建議與臨床應用...73
第七章、參考文獻............75


表目錄
表2-1、 自閉症篩檢量表比較表 ........17
表3-1、各項資料類型與統計方式.......33
表3-1、各項資料類型與統計方式.......34
表4-1、基本人口學資料..............37
表4-2、發展資料...................40
表4-3、研究對象動作發展項目.........41
表4-4、研究對象語言發展項目.........41
表4-5、研究對象整體發展項目比較......41
表4-6、原始量表各次量表題項.........42
表4-7、中文版量表信度結果...........43
表4-8、中文版與英文版BISCUIT因素負荷量表對照..47
表4-9、驗證性因素分析結果...........49
表4-10、社交互動缺損次量表題項分析...51
表4-11、重覆行為次量表題項分析......52
表4-12、溝通障礙次量表題項分析......53
表4-13、中文版量表與M-CHAT效標效度..55
表4-14、中文版量表與DSM-IV效標效度..56
表4-15、次量表與醫師診斷一致性......57
圖目錄
圖3-1、研究流程圖.................28
圖3-2、收案人數概況...............35
圖4-1、因素陡坡圖.................46
附件目錄
IRB通過證明......................82
受訪者同意書......................84
幼兒自閉症修正檢查表(M-CHAT).......88
嬰幼兒自閉症特質篩檢表(Baby and Infant Screen for Children aUtIsm Traits, BISCUIT).........90
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