中文版柯恩-曼斯菲尔德激越情绪行为量表的研制

The Cohen-Mansfield Agitation Inventory:development of a Chinese version

目的研制中文版柯恩-曼斯菲尔德激越情绪行为量表(CMAI,简称柯氏量表)的养老院版和社区版,以适合评估香港本土养老院和社区的痴呆症患者的情绪和行为。方法将英文版柯氏量表翻译成中文,然后经精神科专家、中文教师、心理学专家、护理博士等多次修改、回译后,经过质性研究,对28例痴呆症患者进行了非参与性观察,访问了33例患者家属,同时还进行了家属组与专家组座谈,以理解中外痴呆症患者激越情绪行为的异同。然后对189例养老院的痴呆症患者及家属和171例社区痴呆症患者及家属进行问卷调查,以评定工具的信效度。结果中文版养老院用的柯氏量表有21个项目,其信度为0.83;中文版社区用柯氏量表有23个项目,其信度为0.86。结论中文养老院版和社区版柯氏量表有良好的信效度,内容简练,适用于香港本土养老院和社区痴呆症患者情绪和行为的评定。

Objective This study aimed to validate the Cohen-Mansfield Agitation Inventory （CMAI）,an instrument used in the assessment of agitated behaviors in elderly people with dementia,for the Hong Kong Special Administrative Region. Methods Phase 1 of the study was the translation and back-translation of the instrument by experts in the relevant disciplines,including a psychologist,a nurse specialist and a Chinese language teacher. Phase 2 was the patterning of agitated behavior in the local Chinese population. The phenomenon of agitated behavior in afflicted Chinese individuals was explored through nonparticipant observation of nursing home subjects （n=28） and semi-structured interviews of family caregivers in the community （n=33）. The information obtained was grouped into categories of behaviors,and then compared against the items of the CMAI. A total of 189 nursing home residents and 171 community-dwelling elderly people were recruited for the third phase of the study,which tested the psychometric properties of the C-CMAI. Results The content validity index of the CMAI as a result of the expert panel review was 0.86. The inter-rater reliability in 5% of the subjects was 0.82. The validated version of the C-CMAI for nursing home use had 21 items and a Cronhach＇s α of 0.83. The C-CMAI for community use had 23 items and an internal consistency α of 0.86. Conclusion The C-CMAI has been proved to be a valid and reliable instrument to use in the assessment of agitation in people with dementia. Because behavioral presentation between the subsamples （nursing home and community） was not entirely the same,the author recommends clinicians and researchers to use different versions of the instrument according to the setting.