精神分裂症研究常用之工具性日常生活活動評估工具之心理計量特性回顧

Independent functioning in daily living requires the ability to perform instrumental activities of daily living (IADL). Limited functions in IADL can profoundly interfere with community integration in patients with schizophrenia. Clinicians need IADL measures with sound psychometric properties in order to know the patient's IADL function accurately and precisely as well as to develop appropriate treatment plans early on. However, there are few IADL measures used in clinical settings and their psychometric properties remain uncertain. This study aimed at compiling and appraising the psychometric properties of the IADL measures that have been commonly used in randomized controlled trial for schizophrenia during the past 10 years (2003~2013). We conducted a comprehensive search of electronic citation databases for Chinese-or-English-language articles on IADL measures and their psychometric properties for patients with schizophrenia. Four frequently used IADL measures were identified, which were the University of California at San Diego Performance-Based Skills Assessment (UPSA), the Independent Living Skills Survey self-report version, the Brief UPSA and the Multnomah Community Ability Scale (MCAS). We found that only the MCAS was reported to have good reliability. With respect to the validity and responsiveness, the results of the 4 IADL measures were either poor or unknown. All of the 4 measures are lacking of the Chinese version and related empirical results, hence they are not applicable in research or clinical settings in Taiwan. Further validations of these measures in patients with schizophrenia are warranted and IADL measures suitable for Taiwanese culture need to be developed.