台灣正常中老年人尼爾森修訂版卡片分類測驗之常模研究

Abstract

尼爾森修訂版卡片分類測驗（MCST）改善了威斯康辛卡片分類測驗計分不易以及指導語過於模糊等缺點，是最廣為被使用於執行功能評估的工具之一，然而，目前台灣尚未建立該測驗常模及心理計量資料。本研究目的在評估尼爾森修訂版卡片分類測驗於台灣中老年人使用上之心理計量特性、探討該測驗表現與人口學變項之關係，進一步建立台灣中老年人尼爾森修訂版卡片分類測驗的常模資料。本研究一共收集了台灣地區426位45歲至88歲、教育程度0年至18年的健康中老年人於尼爾森修訂版卡片分類測驗的常模資料，同時收集路徑描繪測驗、彩色路徑描繪測驗、語意流暢性測驗、類同分測驗、矩陣推理分測驗等資料來檢驗尼爾森修訂版卡片分類測驗之效度。其中30位受試者於三個月後進行再測，以檢驗尼爾森修訂版卡片分類測驗之再測信度。本研究結果如下：1. 該測驗與人口學變項之關係上，完成類別總數和年齡呈現負相關與教育程度呈現正相關; 固著型錯誤數與非固著型錯誤數和年齡呈現正相關與教育程度呈現負相關; 但性別與測驗表現的所有分數指標則無顯著相關。2. 心理計量特性方面，該測驗具有.56至.68的再測信度與良好的效度。3. 常模建立方面，本研究以迴歸分析的方式建立校正公式，排除人口學變項對測驗表現的影響，並建立各指標校正分數之百分等級對照表以供參照。綜合上述研究結果，說明MCST於45歲至88歲的健康中老年人使用上有良好的心理計量特性，而本研究提供的常模資料具有代表性與適切性。未來擬以臨床病人為對象，配合神經影像學資料加以佐證，探討MCST在臨床使用上敏感度與特異性之議題，並訂定適當切截點。

The Modified Card Sorting Test（MCST）, a modified version of the Wisconsin Card Sorting Test, proposed by Nelson（1976） is one of the most widely used tests for the evaluation of executive function. However, related studies on the MCST and the normative data for the test are scant in Taiwan. The objectives of this study were to evaluate the reliability and validity of MCST in Taiwanese healthy older adults, collect normative data for MCST in healthy older adults in Taiwan, and to examine the relationship between the test performance and demographic variables. The MCST was administered to 426 healthy individuals aged 45 to 88 years, with education level varied from 0 to 18 years. The Trail Making Test, the Color Trail Test, the Semantic Associated of Verbal Fluency, and Similarity and Matrix Reasoning subtests from the WAIS-III (Chinese version) were also administered to examine the validity of the MCST. Thirty of these 426 participants were retested 3 months later for examining the reliability of the MCST. The results revealed that the complete categories were positively correlated with education, but negatively correlated with age. The perseverative errors and the nonperseverative errors were positively correlated with age, but negatively correlated with education. However, no significant correlation was observed between the index scores and sex. Stability coefficients of the MCST ranged from .56 to .68, and the correlations between the MCST and the criterion validity tests were significant. Regression coefficients derived from demographic variables were used to adjust raw scores, and percentile rank norms for these adjusted scores were established. In conclusion, the MCST showed good test-retest reliability and validity, and the normative data are applicable for the healthy individuals aged from 45 to 88 years. For the effective use of the MCST in clinical settings, further studies of specific clinical populations are required.