酒精依賴嚴重度量表中文版之信效度建構研究

Abstract

酒精依賴嚴重度量表（Severity of the Dependence Scale for Alcohol，SDS-A）是一個用以評估個案酒精依賴嚴重程度的簡短五題量表，本研究目的為建構中文版酒精依賴嚴重度量表之信與效度。 本研究自99年2月至6月間進行，樣本是以北部某醫院之酒藥癮病房戒酒個案及北部某勒戒機構之安非他命個案為研究對象，採橫斷式的方便取樣，共計100位。信度採內部一致性信度與再測信度進行，效度採建構效度，並以酒精使用疾患確認測驗作為效標關聯效度。每位加入本研究的個案皆由1位精神科專科醫師以MINI國際神經精神科面談診斷進行會談，確認個案是否有酒精依賴的診斷，並將診斷的結果與酒精依賴嚴重度量表進行相關性分析，決定量表最佳切分點。 結果顯示，酒精依賴嚴重度量表於信度方面，內部一致信度Chronbach’s alpha值為0.92，再測信度皮爾森相關係數為0.90。效度方面，利用主成分因素分析求出量表的建構效度，結果得到單一因素，解釋變異量為79.11%。酒精使用疾患確認測驗之效標關聯效度皮爾森相關係數為0.88；在ROC區線下面積為97.8% (95%CI=.934,1.022)，最適合的切分點為4分，敏感度為96.6，特異度為95.8。 中文版酒精依賴嚴重度量表於本研究中結果顯示有不錯的信度與效度，建議未來能將此量表推廣到醫療院所或社區使用，並作為常規的檢測工具，藉以早期篩檢個案是否有酒精依賴嚴重的問題。

The Severity of the Dependence Scale for Alcohol (SDS-A) is a short five-item scale to evaluate alcohol dependence case. The aim of study was to construct the reliability and validity of the Chinese version of Severity of Dependence Scale for Alcohol. This study was a cross-sectional survey with convenience sampling. The data were collected from February to June 2010. The sample were one hundred cases, including the alcohol dependence detoxication patients from the addiction ward in a hospital and the amphetamine users in a prison in Taipei area. The reliability test of the SDS-A included internal consistency reliability and test-retest reliability. Alcohol use Disorders Identification Test (AUDIT) was use to test the criterion-related construct validity of the SDS-A. Each case was assessed by a psychiatrists using Mini International Neuropsychiatric Interview (MINI) to diagnose alcohol dependence. The results of MINI diagnosis was the analyzed its correlation with SDS-A to determine the best cut-off point of SDS-A. The internal consistency reliability of SDS-A was fair, with the Chronbach's alpha being 0.92. The test-retest Pearson’s correlation coefficient of SDS-A was 0.90. In terms of validity, principal components analysis (PCA) was use to test the construct validity of SDS-A and a single factor was obtained, with the explained of SDS-A variance being 79.11%. AUDIT was use to test the criterion-related validity of SDS-A, with the Pearson's correlation coefficient being 0.88. The area under the ROC curve was 97.8% (95% CI =. 934, 1.022), and the most appropriate cut-off point was score of 4 or above, with sensitivity being 96.6 and the specificity being 95.8. The results showed that the Chinese version of Severity Dependence Scale for Alcohol had fair reliability and validity. It is suggested that this scale can be extensively used in medical institutions and communities. SDS-A can be used as a routine screening tool for early diagnosis and screening of alcohol dependency problems.