嬰幼兒日常職能活動量表之同時效度

Abstract

嬰幼兒每天參與不同的日常職能活動(daily occupation)，其參與日常職能活動的表現是發展的過程也是結果。嬰幼兒日常職能活動量表(Pediatric Daily Occupation Inventory, PDOI)是以嬰幼兒的日常職能活動為評量內容的發展量表。本研究主要探討PDOI的同時效度，以學齡前兒童行為發展量表(Chinese Child Development Inventory, CCDI)作為效標。 本研究對象是台北市35家私立托嬰中心與托兒所中的6~71個月大的嬰幼兒401名。研究過程為請家長先填寫CCDI，後填寫PDOI，先後間隔7~20天。分析時用史比爾曼等級相關(Spearman rank order correlation coefficient, Rho; rs )來檢驗PDOI總分的原始分數與CCDI的7項發展能力與「一般發展」的原始分數的相關程度；以CCDI的「一般發展」的發展商數分出低分組與高分組，以t檢定來看PDOI的百分位數在此兩組間的平均數是否有差異；並採用兩種分組方式各建立一個預期表(expectancy table)，其一為將PDOI總分之原始分數與CCDI「一般發展」之原始分數，以各自的平均數間隔1個標準差為分組的標準，其二為四分位數，目的是獲得各組PDOI預測CCDI各組的機率；進一步驗證是否兩個預期表的一致值(concordant)大於不一致值(discordant)，且gamma值(γ)達顯著。 研究結果發現PDOI總分的原始分數與CCDI的7個發展能力與「一般發展」的發展商數達到顯著高度相關( rs = .737~ .908, p < .01)，顯示PDOI具有很高的同時效度。依據CCDI的「一般發展」之發展商數分出低分組與高分組時，低分組與高分組嬰幼兒在PDOI的百分位數達顯著差異( t = 7.837, p < .001)，表示PDOI能有效得區分發展程度高與低的嬰幼兒。兩個預期表皆顯示：PDOI總分之原始分數與CCDI「一般發展」之原始分數的平均數間隔1個標準差的分組γ值高達 .975 ( p < .001)與以四分位數的分組γ值也高達 .921 ( p < .001)，PDOI與CCDI之間其依相同分組標準的組別其分佈趨勢顯著一致。 從參與日常職能活動的角度評估嬰幼兒的發展，能直接的評估嬰幼兒在生活中的整體發展與需求，瞭解嬰幼兒自我組織整合不同發展能力的適應情形。PDOI將嬰幼兒的發展直接與日常生活結合，反應了嬰幼兒實際參與日常職能活動的情形，使得嬰幼兒發展的評估更具有生活的意義與價值。

Infants and toddlers participate different daily occupations everyday, and their occupational performance is the process and outcome of development. The content of the Pediatric Daily Occupation Inventory (PDOI) is infants’ and toddlers’ daily occupations. This research studied the concurrent validity of PDOI. The criterion was the Chinese Child Development Inventory (CCDI). 401 subjects were 6 ~ 71 month infants and toddlers from 35 private infant-care centers and nurseries in Taipei. The process was that parents filled in CCDI then PDOI during 1~3 weeks. Relationships between the PDOI total raw score with 7 developmental ability raw scores of CCDI and general developmental raw scores were analyzed by Spearman rank order correlation coefficient ( Rho; rs). Independent two samples t test was used to compare the difference of the PDOI percentile between low and high CCDI general development score groups. There were two ways to establich expectancy tables, grouping PDOI total raw scores and general developmental raw scores by grouping units of means with interval one unit standard deviation and quartiles. Expectancy tables showed probilities that each group of PDOI could predict each group of CCDI, and then verified whether each concordant was bigger than discordant, and tested for gamma value (γ). The result revealed that the concurrent validity of PDOI was very high. The PDOI total raw score with 7 developmental ability raw scores of CCDI and general developmental raw scores were correlated significantly (rs = .737~ .908, p < .01). There was significant difference in the PDOI between low and high general development score groups ( t = 7.837, p < .001). This revealed that PDOI could effectively distinguish low and high developmental level infants and toddlers. The expectancy table of mean with interval of a standard deviation was significantly concordant (γ= .975 , p < .001). The expectancy table of interval of a quartiles was significantly concordant with (γ= .921 , p < .001). To evaluate the development through the participation of daily occupations was directly to evaluate infants’ and toddlers’ whole development and need, as well as understood the adaptive situation of their self-organized abilities. PDOI connected infants’ and toddlers’ development and daily living directly, and expressed the true situation of occupation participation. In PDOI, there were more living meanings and values.