| 摘要: | 研究背景：睡眠狀況指標量表目前為依照精神疾病診斷和統計手冊第五版標準發展的失眠篩選工具，然而，此量表尚未被翻譯為繁體中文版本且未有研究針對血液透析病人進行信度及效度探討。
研究目的：翻譯英文版睡眠狀況指標量表為繁體中文版睡眠狀況指標量表與檢視於血液透析病人之信度及效度。
研究方法：本研究為橫斷式研究設計。階段一為依照流程進行問卷翻譯為繁體中文版。階段二則進行問卷測量特質之信效度測試。主要以200名血液透析患者為樣本，進行問卷內在一致性信度評估；利用繁體中文版睡眠狀況指標量表、中文版失眠嚴重程度量表、繁體中文版病人健康問卷-9、繁體中文版廣泛性焦慮量表、中文版國際不寧腿症候群量表及繁體中文版EQ-5D健康生活品質測量問卷等工具進行效度評估。驗證性因素分析用以檢視建構效度。精神疾病診斷與統計手冊第五版作為失眠黃金診斷標準，以接收者操作特徵曲線進行繁體中文版睡眠狀況指標量表敏感度與特異性分析。
結果：男性為61.5%，平均年齡為65.56歲。其中有38%病人經黃金標準診斷為失眠患者。繁體中文版睡眠狀況指標量表信度以Cronbach's alpha分析結果為0.92。專家效度評估結果CVI值為0.88。以驗證性因素分析結果顯示整體模型配適度結果良好，平均變異抽取量值為0.66，組合信度為0.94。繁體中文版睡眠狀況指標量表與中文版失眠嚴重程度量表、繁體中文版病人健康問卷-9、繁體中文版廣泛性焦慮量表、繁體中文版EQ-5D健康生活品質測量問卷文字部分及視覺模擬量表部份具有低度至強度之顯著相關性（r=-0.94, -0.53, -0.38, 0.27及0.30, P皆<0.05）。有失眠、憂鬱及焦慮情形之樣本在繁體中文版睡眠狀況指標量表得分皆顯著較低分。接收者操作特徵曲線結果切分點為16分，敏感度及特異度分別為88.2%及84.7%，曲面下面積為0.91。
結論：繁體中文版睡眠狀況指標量表於血液透析病人具有良好的信度及效度，是一種有效的失眠篩檢工具，可提供臨床醫療人員應用於失眠評估，有助於提早發現疾病並介入治療，促進血液透析族群睡眠健康。
Background: The Sleep Condition Indicator (SCI) is a screening tool created based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). However, the SCI has not been translated into Traditional Chinese version (SCI-TC) and evaluated its measurement properties in patients undergoing hemodialysis.
Purpose: The aim of the study is translating the SCI into traditional Chinese version and evaluating the reliability and validity among patients undergoing hemodialysis.
Methods: This is a cross-sectional study using convenience sampling method. The stage 1 focused on the translation process of the SCI-TC. The stage 2 conducted reliability and validity testing of the SCI-TC. A total of 200 hemodialysis patients was filled out the SCI-TC, Traditional Chinese versions of the Insomnia Severity Index (ISI-C), Patient Health Questionnaire-9 (TCPHQ-9), Generalized Anxiety Disorder Scale-7 (TCGAD-7), International Restless Legs Scale (IRLS-C), and EQ-5D. Confirmatory factor analysis (CFA) was used to test construct validity. The DSM-5 was used as the gold standard for diagnosing insomnia, and receiver operating characteristic (ROC) curves were utilized to analyze the sensitivity and specificity of the SCI-TC.
Results: The mean of age was 65.56 years old, and the percentage of males was 61.5%. Thirty-eight percent of participants were diagnosed with insomnia based on DSM-5 criteria. The internal consistency reliability (Cronbach’s alpha) of SCI-TC was 0.92. The content validity index was 0.88. The CFA findings revealed that the SCI-TC had a good model fit, and the data of average variance extracted and composite reliability were 0.66 and 0.94, respectively. The SCI-TC was significantly associated with the ISI-C, TCPHQ-9, TCGAD-7, TCEQ-5D and TCEQ-VAS (r = -0.94, -0.53, -0.38, 0.27and 0.30, respectively, all P < 0.05). In addition, the ROC curve test indicated that the optimal cut-off point was 16, with the sensitivity, specificity and AUC of 88.2%, 84.7% and 0.91 respectively.
Conclusion: The SCI-TC has good reliability and validity, and can effectively screen insomnia in hemodialysis patients. Our findings present compelling evidence to clinical professionals, supporting the implementation of the SCI as a means of assessing insomnia, facilitating early detection, and providing appropriate interventions to improve sleep health among individuals undergoing hemodialysis. |
