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Psychometric study of Chinese version of the Pediatric Volitional Questionnaire for preschoolers in Taiwan
No full text前言：職能治療經由促進個案參與有意願、有目的的職能活動以增進個案的功能。個體動機的低落會成為調適功能（adaptive function）的障礙，阻礙了個案在活動上的參與。動機可提供我們了解孩童的行為在某種情境下產生的可能原因，因此應用到實際臨床治療上時，將增加治療者瞭解及預測行為的能力。文獻回顧中發現，一個具理論基礎、明確定義出項目並且適當地標準化的動機評量工具對職能治療界是重要的。本研究的目的是探討應用中文版的兒童意志量表於台灣學齡前孩童的信、效度品質。
研究方法：研究者根據跨文化翻譯原則將兒童意志量表翻譯完成後，收集北台灣醫療院所、機構、幼稚園中，二至六歲發展正常及發展遲緩的孩童各四十名。分別在兩種情境下觀察孩童執行活動的情形，並予以錄影，再根據錄影帶一一評分。測驗分數以羅序分析模式（Rasch analysis）檢視量表的效度，並以電腦統計軟體SPSS分析其他資料。
結果：本研究結果支持中文版的兒童意志量表之項目具有單一建構效度，與發展測驗具顯著中高度相關，並有良好的內在一致性、前後測信度、及施測者內信度。本研究也比較了正常發展組與發展遲緩組的孩童，在兒童意志量表上的得分，經控制基本資料變項後，發現正常發展組的孩童得分平均明顯地比發展遲緩組的高，結果達到顯著的差異（p<.01）。但孩童的父母親教育程度及家庭經濟狀況等因子，與學齡前孩童的意志功能並沒有達到顯著相關。
結論：兒童意志量表的研究結果證實其為一可信且有效的臨床評估工具，可以提供相關專業人員關於孩童意志活動的臨床判斷、介入計畫及療效進展的擬定與參考。Introduction：Occupational therapy promotes the clients’ functions through engaging them in the purposeful and meaningful occupations. Lack of motivation to participate in occupations would obstuct the individual to perform adaptively. Understanding client’s motivational status provides us a picture of the mechanism which results in certain behaviors. Therefore, clearly defined motivational behaviors could assist clinicians to choose appropriate programs to promote the treatment effect. Literature indicates that an adequate, standardized, and theory-based assessment to evaluate client’s motivational status is important. The purpose of this study is to examine the psychometric properties of the Chinese version of the Pediatric Volitional Questionnaire (PVQ-C) for preschoolers in Taiwan.
Methods: The PVQ-C was translated and back-translated according to scholars’ suggestions. Forty normal preschoolers and 40 preschoolers with developmental delayed were randomly selected from medical institutions and kindergartens of north Taiwan. Subjects were observed and videotaped in 2 situations (school vs. motivational situation). The researcher then rated their performance by watching the videotapes. The data was analyzed using Rasch measurement model and traditional test theory.
Results: The results revealed that all items of the PVQ-C defined a unidimensional construct of volition. The PVQ-C correlated with the developmental test moderately. It also showed that the PVQ-C had acceptable test-retest, intra-rater reliability and internal consistency. The children with developmental delay had significantly lower Rasch score on the PVQ-C as compared with the nomal group when controlled for confounding variables (p<.01).
Conlusion: This study supports that the PVQ-C is a reliable and effective clinical assessment tool, which can provide useful information about the client’s volition status as reference to clinical judgment, intervention program, and progression of treatment.目錄
頁 數
中文摘要 4
英文摘要 5
第一章 緒論 6
第二章 文獻回顧與探討
第一節 動機與行為的關係 7
第二節 職能治療與動機 11
第三節 動機測量 14
第四節 研究問題 17
第三章 研究過程與方法
第一節 研究對象及研究場所 18
第二節 研究工具 18
第三節 研究過程 21
第四節 資料處理與分析 22
第四章 研究結果
第一節 中文版兒童意志量表 25
第二節 研究對象基本人口學特質 25
第三節 中文版兒童意志量表之效度 26
第四節 中文版兒童意志量表的同時效度 28
第五節 中文版兒童意志量表之信度 28
第六節 人口學特質、環境特徵與意志功能的分析 29
第五章 討論
第一節 中文版兒童意志量表的內容 32
第二節 中文版兒童意志量表之效度 33
第三節 中文版兒童意志量表之信度 35
第四節 人口學特質、環境特徵與意志功能的分析 36
第六章 結論與建議
第一節 結論 38
第二節 研究限制 38
第三節 未來研究之建議 39
參考資料
中文部分 41
英文部分 42
圖表目次
表一 各種兒童動機評估之比較 50
表二 第一版PVQ與第二版PVQ的行為指標項目 51
表三 個案基本人口學資料 52
表四 發展遲緩組個案診斷類別分佈 53
表五 兒童意志量表四點計分的分配狀況 54
表六 兒童意志量表改以三點計分的分配狀況 55
表七 兒童意志量表項目的整體適合度 56
表八 兒童意志量表各項目在羅序分析中的轉換分數 57
表九 研究對象在兒童意志量表中的整體反應適合度 58
表十 中文版兒童意志量表、與零歲至六歲兒童發展篩檢量表及學齡前兒童行為檢核表的Spearman相關檢定 59
表十一 施測者內信度 60
表十二 前後測信度 61
表十三 在兒童意志量表得分與人口學及活動特徵的比較 62
圖一 兒童意志量表的四點計分分佈圖 63
圖二 兒童意志量表的改以三點計分分佈圖 64
圖三 項目難度與個案能力的配對圖 65
圖四 項目難度與個案能力在各種得分可能性的配對圖 66
圖五 正常發展個案在項目困難度的表現與先前研究結果比較 67
圖六 全體個案在項目困難度的表現與先前研究結果比較 68
附錄
附錄一 台大醫院倫理委員會臨床研究審核許可證明 69
附錄二 個案受試說明信及同意書 70
附錄三 個案基本人口資料表 72
附錄四 第二版兒童意志量表的部分評分表 76
附錄五 中文版兒童意志量表 7
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