精神分裂症－社會功能量表PART2(9/28更新)

以下整理常用於評估精神分裂症者社會功能之量表，包含：
SFS/中文版
SAFE
GAF/GAS/SOFAS/PSP
DAS-II

另新增SAS-SR/SAS-II、SBS

n/s: not stated   n/a: not applicable

Social Functioning Scale (Birchwood, Smith, Cochrane, Wetton, and Copestake, 1990)
描述/施測方式	適用對象
自評社區整合相關能力之問卷 Informant: client or relative Number of items: 791 Time to administer: 20-30 minutes	門診精神分裂症個案(Schizophrenia out-patients)
計分方式	範疇(項目數)
各項目有不同的評分方式，加總後可得到每個範疇的原始分數。換算成標準分數，平均標準分數即代表整體功能表現狀況。(Burns T, Patrick D, 2007)	1.           social engagement/withdrawal(5) 2.           interpersonal behavior(10) 3.           pro-social activities(22) 4.           recreation(15) 5.           independence-competence(13) 6.           independence-performance(13) 7.           employment/occupation(1)
信效度	台灣是否有中文版
＊信度：好的內部一致性、好的施測者間信度、施測者與受試者自評間相關性高(Birchwood, Smith, Cochrane, Wetton, and Copestake, 1990) ＊效度：好的建構效度。(Birchwood, Smith, Cochrane, Wetton, and Copestake, 1990) ＊反應性：在進行家庭治療及社區行動小組介入後，SFS分數有顯著進步(Burns T, Patrick D, 2007) ＊具有敏感度(Birchwood, Smith, Cochrane, Wetton, and Copestake, 1990)	有簡短版的中文社會功能量表 有心理計量研究
理論架構／定義	其評估範疇是參考Hogarty et al (1979)2, Paul & Lentz (1977)3, Stein & Test (1980)4所使用的心理社會介入計畫。另外損傷和失能評估是根據ICIDH之DAS

1)在相關研究中對於此量表的總項目數說法不一，無法確認 employment/occupation有多少項目數

2)Hogarty et al (1979)

a.        resolution of personal and/or environmental problems that directly affected the patient’s performance as a homemaker or as a real or potential wage earner

b.        improving quality of interpersonal relationships

c.        ameliorating social isolation

d.        improving self-care, financial assistance, medication maintenance

3)Paul & Lentz (1977)這是一本書，所以我沒辦法找來看

4)Stein & Test (1980)

a.        how to acquire the material resources

b.        coping skills to meet the demands of community life

c.        motivation to persevere and remain involved with life

d.        freedom from pathologically dependent relationships

e.        support and education of community members who are involved with patients

f.        a supportive system to help the patient with the previous five requirements

Chinese version of Social Functioning Scale 精神病患社會功能量表(宋麗玉, 2001)
描述/施測方式	適用對象
自評問卷，測量個人的社會勝任度與因應生活需要的能力。僅有36題的版本。 Informant: client or relative Number of items: 36 Time to administer: 10 mins	門診與社區復健服務機構之精神疾患者，不包含精神官能症患者、藥物濫用者與老年癡呆症患者
計分方式	範疇(項目數)
除「職業/就業」外，各題分數均在0-3分之間。「職業/就業」最高分為10分，依個案狀況給分	1.           社交/退縮(2) 2.           人際溝通(3) 3.           社會性(6) 4.           娛樂(9) 5.           獨立-能力(5) 6.           獨立-表現(5) 7.           職業/就業(6)
信效度	台灣是否有中文版
＊信度：好的內部一致性，好的照顧者再測信度(宋麗玉, 2001) ＊效度：具有內部建構效度及區辨效度(宋麗玉, 2001) ＊反應性：n/s ＊敏感度：n/s	n/a

Social  Adaptive Functioning  Evaluation (SAFE) (Philip D. Harvey, et al., 1997)
描述/施測方式	適用對象
由觀察者評估社會適應能力的損傷程度 Informant: client or relative Number of items: 17 Time to administer: n/s	Geriatric chronic psychiatric inpatients。可用在有明顯正負性症狀干擾或認知不佳的病人
計分方式	範疇(項目數)
5點量尺－ 0分：no impairment         ｜ 4分：extreme impairment	1.    self-care(7) 2.    social competence and adjustment(7) 3.    miscellaneous skills(impulse control and cooperativeness)(3)
信效度	台灣是否有中文版
＊信度：好的內部一致性、再測信度、施測者間信度(Philip D. Harvey, et al., 1997) ＊效度：具表面效度，好的收斂效度、區辨效度(Philip D. Harvey, et al., 1997) ＊反應性：n/s ＊具敏感度(Philip D. Harvey, et al., 1997)	無
理論架構／定義	n/s 其內容是根據文獻搜尋、面談臨床工作者、與研究適應性功能的專家討論等結果訂定。

Global assessment of functioning(GAF) (Hall RC,1995)
描述/施測方式	適用對象
由觀察者評估個案整體之心理社會功能 Informant: client Number of items:1 Time to administer: n/s	General psychiatry（用於DSM-IV第五軸評估）
計分方式	範疇(項目數)
100點量尺，又分成10個區間。每個區間對於心理症狀嚴重度及社會職能功能表現有不同程度之描述。 1–10( persistent danger)    | 91–100(Superior Functioning) (Burns T, Patrick D, 2007)	1.           Psychological symptoms 2.           Social functioning 3.           Occupational functioning
信效度	台灣是否有中文版
＊信度：有好的施測者間信度(Hilsenroth MJ, et al., 2000)。個案自評和專家評估間相關性高(A. Ramirez, L. Ekselius, M. Ramklint, 2008)。 ＊效度：心理疾患越嚴重，GAF分數越低(Hilsenroth MJ, et al., 2000) ＊反應性：n/s ＊敏感度：n/s	有 尚未找到相關心理計量研究
理論架構／定義	n/s，僅說明由GAS衍伸而來

Global Assessment Scale (GAS) (Endicott J, Spitzer RL, Fleiss JL, Cohen J., 1976)
描述/施測方式	適用對象
為GAF前身，由觀察者評估個案能力損傷程度 Informant: client Number of items:1 Time to administer: n/s	General psychiatry
計分方式	範疇(項目數)
100點量尺，又分成10個區間。每個區間有不同程度損傷之描述。 1–10( most impaired)    | 91–100(healthiest) (Burns T, Patrick D, 2007)	1.           Impairment of daily functioning 2.           Reality testing 3.           Potential for suicide ⁄ violence
信效度	台灣是否有中文版
＊信度：好的施測者間信度(Dworkin RJ., et al., 1990; Thomas Kuhlman, et al., 1991) ＊效度：具有建構效度(Thomas Kuhlman, et al., 1991) ＊反應性：n/s ＊具敏感度(Burns T, Patrick D, 2007)	無
理論架構／定義	n/s，僅說明由Health-Sickness Rating Scale(HSRS)而來

Social and Occupational Functioning Assessment Scale (SOFAS) (Howard H. Goldman, Andrew E. Skodol, and Tamara R. Lave, 1992)
描述/施測方式	適用對象
由GAF衍生而來，觀察者評估個案之社會職能功能表現程度 Informant: client Number of items:1 Time to administer: n/s	General psychiatry
計分方式	範疇(項目數)
100點量尺，又分成10個區間。每個區間對於社會職能功能表現有不同程度之描述。 1–10( most impaired)    | 91–100(healthiest) (Burns T, Patrick D, 2007)	1.           Social functioning 2.           Occupational functioning
信效度	台灣是否有中文版
＊信度：好的施測者間信度(Hilsenroth MJ, et al., 2000) ＊效度：與SCL-90-R global severity index、the Social Adjustment Scale global score、the Inventory of Interpersonal Problems total score有顯著相關(Hilsenroth MJ, et al., 2000) ＊反應性：使用藥物治療8週後，SOFAS可顯示功能的進步。(Burns T, Patrick D, 2007) ＊敏感度：n/s	無
理論架構／定義	n/s，僅說明由GAF而來

Personal  and Social  Performance scale (PSP) (Morosini et al., 2000)
描述/施測方式		適用對象
由觀察者評估個人及社會失能的嚴重程度 Informant: client Number of items:1 Time to administer: 5-10mins		acute symptoms of schizophrenia(Donald L. Patrick, et al., 1997)	community-dwelling outpatients。但對於症狀較輕微的個案使用上會受限 (A.K. Kawata, D.A. Revicki, 2008)
計分方式		範疇(項目數)
100點量尺，又分成10個區間，每個區間有對於失能程度的操作型定義，選擇符合個案之描述。 ‧1-30 = intensive support or supervision needed ‧31-70 = disabilities of various degrees ‧71-90 = mild difficulties ‧91-100 = more than adequate functioning(Burns T, Patrick D, 2007)		1.           socially useful activities, including work and study 2.           personal and social relationships 3.           self-care 4.           disturbing and aggressive behaviors
信效度		台灣是否有中文版
＊信度：好的再測信度及施測者間信度(Donald L. Patrick, et al., 1997) ＊效度：與PANSS中等程度相關、可區辨CGI-S層級(Burns T, Patrick D, 2007) ＊具反應性(Donald L. Patrick, et al., 2009) ＊具敏感度(Burns T, Patrick D, 2007)	＊信度：好的內部一致性(A.K. Kawata, D.A. Revicki, 2008)、好的再測信度(H. Nasrallah, P. Morosini, D.D. Gagnon, 2008) ＊效度：與QLS和CGI-S有高度相關性(A.K. Kawata, D.A. Revicki, 2008)、可區辨CGI-S層級(H. Nasrallah, P. Morosini, D.D. Gagnon, 2008) ＊反應性：n/s ＊敏感度：n/s	無
理論架構／定義		the Boston’s Rehabilitation Center’s approach rehabilitative techniques by Ian Falloon

Positive and Negative Syndrome Scale (PANSS)

Clinical Global Impression-Severity (CGI-S)Positive and Negative Syndrome Scale (PANSS)

Quality of Life Scale(QLS)

World Health Organization Disability Assessment Scale (DASII) World Health Organization
描述/施測方式	適用對象
根據ICF架構所設計之評估量表。分成觀察者評估、個案自評、代理版本，每個版本又有不同項目數之量表。其中又以36項觀察者評估版本提供較完整的資訊，因此介紹此版本為主。 Informant: clients Number of items:36 Time to administer: 20 mins	Used across all diseases, including mental, neurological and addictive disorders
計分方式	範疇(項目數)
記錄個案過去30天在從事日常活動時所遇到的困難程度：none(1), mild(2), moderate(3), severe(4), extreme or cannot do(5)。 單項加總後得每個範疇的分數；再加總得到整體分數，換算成0-100範圍內的分數（0= no disability;100= full disability）	1.           Understanding and communicating(理解與溝通) 2.           Getting around(行動能力) 3.           Self care(自我照顧) 4.           Getting along with others(與人相處) 5.           Household and work activities(生活活動) 6.           Participation in society(社會參與)
信效度	台灣是否有中文版
＊信度：好的內部一致性、再測信度(T. Bedirhan Ustun, et al., 2010) ＊效度：與其他公認之障礙評估工具比較，具有好的同時效度(T. Bedirhan Ustun, et al., 2010) ＊好的反應性(T. Bedirhan Ustun, et al., 2010) ＊敏感度：n/s	有，用在新制身心障礙鑑定 未找到相關文獻資料
理論架構／定義	ICF

Social Adjustment Scale-Self Report(SAS-SR) (Weissman M., Bothwell S., 1976)
描述/施測方式	適用對象
評估個案擔任不同角色時的表現及感受。評估方式分成面談及自評，以下介紹自評版本。 Informant: clients Number of items:42 Time to administer: 15-20mins	Depression
計分方式	範疇(項目數)
評估過去2週的角色功能表現頻率。5點量尺。分數越高，功能越差。 將同一範疇的項目加總取平均得該角色表現分數；將全部項目加總取平均得整體角色表現分數。	Six role areas： 1.           Work 2.           Social and Leisure 3.           Extended Family 4.           Marital 5.           Parental 6.           Family Unit
信效度	台灣是否有中文版
＊信度：intraclass correlations between patient and informant were highly significant(Weissman M., Bothwell S., 1976)；The correlation between self and expert rating is excellent agreement(Pearson’s r=.72, P<.001) (Weissman M., Bothwell S., 1976) ＊效度：n/s ＊具反應性 ＊敏感度：n/s	無
理論架構／定義	Social Adjustment Scale由SSIAM(the structured and scaled interview to assess maladjustment)衍伸而來。 SSIAM將social maladjustment定義為”ineffective performance in the roles and task for which an individual has been socialized…..failure in obtaining satisfaction from performance in these activities….problem of both objective behavior in a given social context and of subjective reactions in that context”。此量表涵蓋了精神治療對於social adjustment的介入目標（reduce the patient’s distress, return his behavior to normal, and smooth his interaction with others），提供臨床結構化之評估工具（Gurland B.J., et al.,1972）。

Social Adjustment Scale-II(SAS-II) (Glazer WM., Aaronson HS., Prusoff BA., and Williams DH., 1980)
描述/施測方式	適用對象
SAS-II以半結構面談的方式評估精神分裂症個案角色功能表現。 Informant: clients Number of items:52 Time to administer: 45-90mins	Schizophrenia
計分方式	範疇(項目數)
評估過去2個月的角色功能表現。5點量尺。分數計算同上。	eight role areas： 1.           Work 2.           Relationship with principal household member 3.           Parental role 4.           Relationship with external family 5.           Social/leisure activities 6.           sexual adjustment 7.           Romantic involvement 8.           Personal well-being(appearance, grooming, ability to care for oneself)
信效度	台灣是否有中文版
＊信度：intra-class correlations between patient and significant others were highly significant(Glazer WM., Aaronson HS., Prusoff BA., and Williams DH., 1980) ＊效度：n/s ＊反應性：n/s ＊敏感度：n/s	無
理論架構／定義	n/s，僅說明此為Schooler與Hogarty(1979)根據SAS修改成適用於精神分裂症個案的量表。

Social Behavior Schedule (Wykes T. and Sturt E., 1986)
描述/施測方式	適用對象
由施測者根據資訊提供者的描述評估個案在過去一個月的行為表現損傷程度 Informant: staff or relative Number of items:21 Time to administer: n/s	General psychiatry
計分方式	範疇(項目數)
5點量尺。 0= normal     | 4 = severe behavioral problems	6 domains: 1.           Communication skills 2.           Behavioural problems 3.           Personal self-care 4.           Occupation 5.           Performance and expectations 6.           Leisure activities
信效度	台灣是否有中文版
＊信度： Mean inter-rater reliability was 94% (range 84–100%) （Wykes T. and Sturt E., 1986） Mean inter-informant reliability was 86% (range 70–99%)（Wykes T. and Sturt E., 1986） Mean test–retest reliability was 83% (range 72–96%)（Wykes T. and Sturt E., 1986） ＊效度：可區辨住在短期精神病房與住在一般住宅設施的病人(Burns T, Patrick D, 2007) ＊反應性不佳(Burns T, Patrick D, 2007) ＊敏感度：n/s	無
理論架構／定義	n/s

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宋麗玉(2001)。具實務應用性之量表發展：精神病患社會功能量表與照顧者負荷量表。行政院國家科學委員會專題研究報告。