| Summary: | 碩士 === 中山醫學大學 === 醫學檢驗暨生物技術學系碩士班 === 104 === Background: Chu’s Activities of Daily Living Rating Scale, third edition (the ADLRS-III) is widely used to assess activities of daily living in mental health clinics in Taiwan. However, the test-retest reliability and the minimal detectable change (MDC) of this scale have not been validated in patients with schizophrenia, limiting the explanation and applicability of this measure.
Purpose: The purpose of this study was to verify the test-retest reliability, MDC, and responsiveness of the ADLRS-III.
Method: A total of 50 patients with schizophrenia in a psychiatric day-care rehabilitation institution were evaluated by a trained therapist with the ADLRS-III twice, two weeks apart. The intra-class correlation coefficient (ICC) was employed both to verify the test-retest reliability of the ADLRS-III and to calculate the standard error of measurement (SEM) and MDC. In addition, a total of 50 sub-acute patients with schizophrenia were evaluated with the ADLRS-III twice (on the 7th day and 42nd days after admission to the acute ward) to estimate the responsiveness of the ADLRS-III, including group-level responsiveness: effect size d, a standardized response mean and paired t test; and individual-level responsiveness: the percentage of those whose difference scores between the 7th and 42nd days exceeded the MDC.
Results: The ICC for the ADLRS-III was 0.94, representing high test-retest reliability. The SEM for the ADLRS-III was 4.6, and the MDC95 was 12.8 (20.3% of mean score), indicating acceptable measurement error. In terms of group-level responsiveness, the ES was 0.45, representing a low effect; the SRM was 1.16, representing a high effect. The t-test result was statistically significant ( t=8.125, p ＜ .001). In terms of individual-level responsiveness, the percentage of patients whose difference scores between test and retest sessions exceeded the MDC was 16%.
Recommendations and Conclusions: The results of this study show that the ADLRS-III has good test-retest reliability in patients with schizophrenia, and the MDC value is helpful to clinicians and researchers in interpreting the difference score of the ADLRS-III between consecutive sessions and in making decisions. In terms of group-level responsiveness, the effect ranged from low to high based on various indexes. The individual-level responsiveness appeared to be low.
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