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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 胡名霞(Ming-Hsia Hu) | |
dc.contributor.author | Tzu-Hsuan Chen | en |
dc.contributor.author | 陳子瑄 | zh_TW |
dc.date.accessioned | 2021-06-16T10:21:59Z | - |
dc.date.available | 2015-09-24 | |
dc.date.copyright | 2013-09-24 | |
dc.date.issued | 2013 | |
dc.date.submitted | 2013-08-16 | |
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Am J Occup Ther. 2010; 64:547-54. 40.吳英黛。輔具評估專業技術手冊。台北: 金名圖書有限公司; 2007。 41.吳英黛、胡名霞、柴惠敏、吳雪玉、毛慧芬。全國輔具使用現況調查研究。行政院衛生署委託研究報告;2004。 42.李淑貞。國際健康功能與身心障礙分類系統編碼指引。行政院衛生署科技研究97年度成果報告。台北:國立陽明大學ICF暨輔助科技研究中心;2009。 43.胡名霞。長期照護個案行動輔具使用調查報告。物理治療2004; 29:405-20。 44.梁秋萍、周適偉、林聰樺、潘健理、裴育晟、朱岳喬、黎建中、杜國賢、鄧復旦。身心障礙者對於個別化醫療復健輔助器具設計服務需求暨市場供需調查。台灣復健醫誌 2004;31(1):1-10。 45.鄧復旦。身心障礙者對於個別化輔助器具設計服務需求暨市場供需調查。行政院衛生署科技研究發展計畫。台北:長庚紀念醫院林口分院;2001。 46.鍾高基。復健工程/輔助性科技。中華醫學工程學刊 1998; 18(3):147-52。 47.《CNS 15390 身心障礙者輔助器具分類與專門術語》。台北:經濟部標準檢驗局;2010。 48.內政部身心障礙服務入口網。身心障礙者輔具補助基準表及附件-輔具評估報告。取自: http://dpws.moi.gov.tw/ 49.The Wheelchair Skills Program (version 4.1) www.wheelchairskillsprogram.ca/ 50.行政院內政部:內政統計月報。取自: 行政院內政部網站2012.06.20 http://sowf.moi.gov.tw/stat/month/list.htm 51.《建築物無障礙設施設計規範解說手冊》。內政部;2008。 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/60570 | - |
dc.description.abstract | 「輔助器具」(assistive technology devices) 或稱「輔具」是指協助身心障礙者克服生理機能障礙,促進生活自理能力之器具。輔具的使用可提昇、維持或增強失能者的生活功能,補償或預防活動及參與上的受限,增進生活自主性以及降低照顧者的負擔。輔具的應用對象除了身心障礙者,亦包含失能者、銀髮族以及部分短暫傷害後功能減退的個案。所使用的輔具當中,又以行動類輔具使用最多,其中包含了拐杖、輪椅和助行器等項目。
在輔助科技服務(assistive technology service)的架構當中,服務的提供者可包含來自不同輔具相關背景的專業人員,構成輔具服務的多專業團隊服務模式(multidisciplinary team approach)。其中,物理治療師主要的角色包含對於輔具使用者提供直接的輔具使用評估、教育訓練與後續追蹤的服務。 輔具使用評估是內政部2012年輔具補助制度所強調的方向,以滿足身心障礙者的輔具需求,並與「身心障礙者輔具費用補助」需求評估的新制接軌。加強輔具評估的政策,針對輔具需求者,規定於輔具補助申請前須由治療師開立輔具評估報告,以確認個案的功能狀況並藉由輔具評估實際配置個案最需要的輔具項目。對輔具使用者而言,希望達到增進日常功能的目的。對服務體系言,亦可以減少不必要的支出而造成資源的浪費。 輔具評估的重要原則之一是確認使用者實際操作輔具的能力,使其在無障礙環境設計的規範下能夠滿足移行的需求達到獨立自主的日常活動功能,並在面對多數一般常見的社區與居家環境障礙具有克服之能力。然而,目前國內所使用評估報告書內容多以個案之身體狀況與輔具之規格與功能為主,對於個案之日常活動能力以及輔具操作表現是否達到獨立自主的評估較為不足,且缺乏一套標準化且具明確操作型定義的評估工具。因此,本研究將參考國外行動輔具操作技巧功能測試之觀念,發展出一套適用於國內常用的行動輔具之操作技巧功能評估工具。 本研究為一描述性方法學之研究設計(descriptive methodological study design),以三個研究階段進行評估工具之研發。第一階段彙整與參考國外行動輔具操作技巧功能測試之相關文獻,歸納出以操作表現為主(performance based)的行動輔具操作技巧評估項目,並初擬其評估工具的內容與項目。第二階段進行德菲法(Delphi method)專家效度檢測,專家成員包含兩名物理治療、一名職能治療背景的專業學者,以及兩名資深地方輔具中心從業員。專家效度檢測方法為透過問卷收集整合專家們審視本研究初擬結果的評估項目之內容,分別就重要性與適切性進行修正。第三階段則以建構完成的行動輔具使用者操作技巧功能評估工具進行實際施測,以驗證其信度與臨床適用性。實測採方便取樣,樣本來源為新北市輔具資源中心接受輔具評估服務的個案。共徵召9名,包含使用六種行動輔具類(手杖、拐杖、助行器、電動輪椅、手動輪椅或電動代步車)之使用者,各種類至少有一名。實測由一名物理治療師對各受測者進行兩次評估,以驗證評估工具之再測信度(test-retest reliability)。實測過程同時以錄影拍攝記錄,再由另外兩位物理治療師透過觀察錄影帶評分的方式獨立給分,以檢測施測者間信度(inter-rater reliability)與施測者內信度(inter-rater reliability)。 本研究完成發展建構國內第一個整合六種行動輔具操作表現的行動輔具使用者操作技巧功能評估工具及其操作手冊。專家效度檢測的結果顯示,本評估工具內所有九項評估項目內容之重要性與適切性分數以五點式的李克特式量表(Likert scale)評分皆達4分以上,顯示本評估工具有良好的內容效度。實測評估之結果則顯示,操作能力與表現時間總分之再測信度、施測者內與施測者間信度的級內相關係數(ICC)值普遍皆有達到0.8以上的良好信度指標。但唯有操作能力總分之再測信度ICC值為0.78,具中等至良好的再測信度。在臨床適用性方面,本評估工具平均施測時間約為20分鐘,臨床上簡易施測,且可在短時間內完成。此外,評估所使用的設備儀器以及空間場地皆可在大多數的輔具中心或輔具相關服務單位取得,不需特殊或昂貴的設備。 總之,本研究所發展之行動輔具使用者操作技巧功能評估工具具有中等至良好之信效度,且操作方便。可做為臨床服務者、研究者、政策擬定者等輔具服務相關人員輔具評估之工具,並可提供國內輔具評估報告書修改之參考依據。未來研究建議以此評估工具進行較大型的推廣,探討其於輔具介入之成效與成果反應性(responsiveness)等面向之心理計量特性,並進一步建立出本評估工具於操作能力以及各評估項目之表現時間的常模 (norm)。 | zh_TW |
dc.description.abstract | Assistive technology device (ATD) can improve the functional capacities of individuals with disabilities. The use of ATDs ameliorates the problems faced by individuals who have disabilities. Assistive technology has shown not only to compensate and prevent activity limitations and participation restrictions, but also greatly enhances function, independence of daily living, as well as reduce loading on care givers. The users of ATDs include not only people with disability, but also vulnerable elders and injured people. The use of different types of ATDS may depend according to different servility and injury types. Among the various types of ATDs, mobility-related ATDs, such as ambulatory-aids, and wheelchairs are most common of use.
The provision of assistive technology service (ATS) is a multidisciplinary effort, the service providers are usually a multidisciplinary team formed by a group of professionals with assistive technology related backgrounds. From a physical therapist’s point of view, assistive technology service includes the evaluation of fitness and needs of ATDs, and also ATD training and follow up evaluations. In 2012, the ministry of interior has put great emphasized on ATD evaluation while giving out supplementary grant to the disabled ATD users. In order to actually meet the needs of the disabled and also to match the new subsidy policy, therapist’s evaluation is needed to confirm the actual needs and usage conditions of the users. To meet this purpose, there is a need for a standardized set of performance-based tests to evaluate the performance and skills required to use mobility-related ATDs. However, to date in Taiwan, there is no qualitative and quantitative assessment tool available yet to effectively measure the functional performance and ATD skills of those users. Thus, this study aims to develop a performance-based mobility device skills test, the Functional Performance Skills Test (FPST) for mobility aid users. This study is a descriptive methodological study, and will undergo a three-phase development process. Initially, FPST will be developed according to literature review of performance-based related outcome measures of mobility aids. Then the content of FPST will be validated via a two-round Delphi method survey. The Delphi panel is formed by a group of 5 experts experienced in physical and occupational therapy and also service providers in assistive technology center. Lastly, FPST is tested in an assistive technology center by 9 mobility aids users to examine its reliability and applicability. This is the first performance based instrument developed in Taiwan that evaluates the performance skills of a collection of mobility aids including cane, crutch, walker, powered and manual wheelchair and scooter users. The results of this study showed that the current instrument has moderate to high test-retest reliability (ICC=0.78) and excellent inter-rater reliability and inter-rater reliability (both ICCs above 0.8). And the Delphi method validation process also resulted in high content validity of the instrument. As for practicality, we found the test easy to perform and the needs for test setup were minimal. The test is generally feasible in medium-sized clinical settings, and the mean time taken to administer is within 20 minutes. In conclusion, the Functional Performance Skills Test is practical and its measurement properties regarding validity and reliability are moderate to excellent. We recommend this instrument to be used by clinicians and assistive technology service providers. And we also recommend this instrument to be used national wide, and it can also serve as a reference for revision of the current evaluation form officially distributed by the ministry of interior. Further works are needed to determine its responsiveness and effects used in assistive technology training. In addition, development of its scoring norm is also recommended for future studies. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T10:21:59Z (GMT). No. of bitstreams: 1 ntu-102-R00428012-1.pdf: 25156931 bytes, checksum: 64b4636a83d9a3dcaa931ed13d8b7e56 (MD5) Previous issue date: 2013 | en |
dc.description.tableofcontents | 口試委員審定書 I
誌謝 II 中文摘要 III ABSTRACT VI 第一章 前言 1 第一節 研究背景 1 第二節 研究目的 3 第三節 研究重要性 4 第二章 文獻回顧 5 第一節 輔助科技之定義與理論 5 一、輔助科技的定義 5 二、輔助科技的理論 7 第二節 行動輔具對於失能者功能提升的重要性 11 第三節 行動輔具操作表現的結果評量 12 一、行動輔具操作技巧功能測試 12 二、輪椅類輔具操作技巧功能測試 14 第四節 現存輔具使用評估工具之比較與評論 19 第三章 研究方法 21 第一節 研究設計與選樣 21 第二節 Phase 1: 評估工具之設計與開發 22 第三節 Phase 2: 評估工具之效度檢測 24 一、第一回合問卷: 評估內容之重要性評量 24 二、第二回合問卷: 評估項目之適切性評量 25 第四節 Phase 3: 評估工具之信度檢測 26 一、信度檢測之理論基礎 27 二、行動輔具使用者操作技巧功能評估工具度檢測程序 29 第五節 資料分析 31 第四章 研究結果 32 第一節 Phase 1: 評估工具之設計與開發 32 第二節 Phase 2: 評估工具之效度 32 一、行動輔具使用者操作技巧功能評估工具之專家效度檢測結果 32 二、行動輔具使用者操作技巧功能評估工具之修正結果 35 第三節 Phase 3: 評估工具之信度 42 一、行動輔具使用者操作技巧功能評估工具之實測結果 42 二、再測信度 44 三、施測者內信度 45 四、施測者間信度 46 五、行動輔具使用者操作技巧功能評估工具之臨床適用性 47 第五章 討論 48 第一節 行動輔具使用者操作技巧功能評估工具之效度 48 第二節 行動輔具使用者操作技巧功能評估工具之實測結果 51 第三節 行動輔具使用者操作技巧功能評估工具之再測信度 52 第四節 行動輔具使用者操作技巧功能評估工具之施測者間與施測者內信度 56 第五節 行動輔具使用者操作技巧功能評估工具之臨床適用性 58 第六章 結論 60 第七章 研究限制與未來研究建議 61 參考文獻 63 LIST OF TABLES 67 表 1行動輔具操作技巧功能評估工具之心理計量特性整理 67 表 2行動輔具操作技巧功能評估工具之特性整理 68 表 3各專家之簡要專長說明表 69 表 4-1專家效度審查問卷函之結果分析 70 表 4-2專家效度審查問卷函之結果分析(N=5) 71 表5 專家效度審查評估項目之修改建議彙整表 72 表6 各輔具類型之特徵 76 表7 受試者之基本特徵 77 表8 行動輔具使用者操作技巧功能評估工具得分總表(T1) 78 表9 行動輔具使用者操作技巧功能評估工具之再測信度(R1) 79 表10 行動輔具使用者操作技巧功能評估工具各子項之再測信度(R1) 80 表11 行動輔具使用者操作技巧功能評估工具之施測者內信度(R2) 81 表12 行動輔具使用者操作技巧功能評估工具各子項之施測者內信度(R2) 82 表13 行動輔具使用者操作技巧功能評估工具之施測者間信度(R2,R3) 83 表14 行動輔具使用者操作技巧功能評估工具各子項之施測者間信度(R2,R3) 84 LIST OF FIGURES 85 圖1 國際健康功能與身心障礙分類系統 85 圖2 人與科技適配模式 86 圖3 輔助科技結果評估模式 87 圖4 研究流程圖 88 圖5再測信度、施測者內與施測者間信度 89 圖6 評估流程與場地示意圖 90 圖7 各評估項目之操作能力分布情形(N=10) 91 圖8各評估項目之表現時間分布情形(N=10) 92 圖9 施測者一(R1)兩次評估操作能力之相關情形 93 圖10 施測者一(R1)兩次評估表現時間之相關情形 93 圖11 施測者二(R2)兩次評估操作能力之相關情形 94 圖12 施測者二(R2)兩次評估表現時間之相關情形 94 圖13 施測者二(R2)與施測者三(R3)兩者評估操作能力之相關情形 95 圖14 施測者二(R2)與施測者三(R3)兩者評估表現時間之相關情形 95 APPENDIX 96 附錄 1 WSTc 4.1 手動輪椅使用者測試評估表 96 附錄 2 Wheelchair Circuit評估項目與施測方式 98 附錄 3 WUFAc 評估項目與施測方式 100 附錄 4內政部輔具評估報告(編號01) 輪椅及推車 113 附錄 5內政部輔具評估報告(編號02) 電動輪椅與相關配件 119 附錄 6內政部輔具評估報告(編號04) 電動代步車 125 附錄 7內政部輔具評估報告(編號05) 步行輔具 129 附錄 8行動輔具使用者操作技巧功能評估—使用者基本資料 135 附錄 9行動輔具使用者操作技巧功能評估工具—第一版 135 附錄 10 第一回合專家效度審查問卷函 141 附錄 11 第二回合專家效度審查問卷函 152 附錄 12 行動輔具使用者操作技巧功能評估工具—第二版 163 附錄 13行動輔具使用者操作技巧功能評估表 173 附錄 14行動輔具使用者操作技巧功能評估工具—第三版 174 附錄 15台大醫院倫理委員會臨床試驗許可書 184 附錄 16受試者同意書 186 | |
dc.language.iso | zh-TW | |
dc.title | 行動輔具使用者操作技巧功能評估工具之研發 | zh_TW |
dc.title | Development of a Functional Performance Skills Test for Mobility Aids Users | en |
dc.type | Thesis | |
dc.date.schoolyear | 101-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 陸哲駒(Jer-Junn Luh),楊忠一 | |
dc.subject.keyword | 輔具,結果評量,功能,動作技巧,任務表現與分析, | zh_TW |
dc.subject.keyword | assistive device,outcome assessment,function,motor skills,task performance and analysis, | en |
dc.relation.page | 189 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2013-08-16 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
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