臺灣博碩士論文加值系統

台灣老年人口隨著醫療科技進步與生活水準提高而逐年增加，預估將於2018年將邁入聯合國定義之高齡社會（14％）。而老年人口所衍生的相關問題在近年來也受到國人的密切關注，其中老年長者所特別需要的長期照護議題是所有問題中最為大家所關切。在長期照護實務與研究上，「功能」，是老年長期照護實務中極為重要的目標與相關研究所必須探討的結果。因此，能有一個具多面向、有良好的量尺特性、不耗時且易於使用的評估工具，來對長者進行全面性的評估，是提供高品質的個別性照護，以及進行相關研究至為重要的基石。
本研究即欲建立中文版「Multidimensional Observation Scale of Elderly Subjects, MOSES」量表（中譯：老年多向度觀察評估量表）之信度與效度。同時亦探討此觀察式量表在長期照護機構老年長者適用性。
本研究以方便取樣、採橫斷式調查研究方式，對台灣中部地區老人福利機構住民進行身體、心理與社會性之完整功能性評估。在取得原作者授權後，依循世界衛生組織之翻譯過程的指導原則與步驟進行量表中文化。再以MOSES量表的五大領域，包括評估自我照顧功能、定向感缺損行為、憂鬱/焦慮情緒、激躁行為、與社會退縮行為等；分別以前述五大領域的單一向度評估量表，對機構長者進行評估。探討MOSES全量表及各領域分數與各單一向度評估量表的表現，並進行信效度檢定。
研究共有60位長者參與，平均年齡為80.72±8.25歲，其中以女性居多（N＝34，56.7％）。多數未曾入住機構（N＝52，86.7％），而其健康狀態算是良好，共病嚴重度不高，察爾森共病指標 (CCI)中位數為5.00。信度檢測中，評分者間信度Krippendorff's Alpha 為 0.87。MOSES中文版量表的內在一致性，Cronbach’s alpha值在「自我照顧功能」為0.93、「定向感缺損行為」為0.93、「憂鬱/焦慮情緒」為0.92、「激躁行為」為0.92及「社會退縮行為」為0.78。在效度檢驗上，內容效度中的「題項內容效度指標」（I-CVI）之平均值與「量表內容效度指標」（S-CVI）的平均值皆為0.99。效標關聯效度檢測之Pearson’s 相關係數r值，在自我照顧功能」為-0.90、「定向感缺損行為」為-0.86、「憂鬱/焦慮情緒」與簡式老人憂鬱量表間的r值為0.65、與情緒自評量表中的憂鬱（DASS-D）及焦慮（DASS-A）兩個領域之r值分別為0.65及0.53，而與神經精神病徵調查表的「憂鬱/情緒不佳」之r值為0.75，與「焦慮」的r值為0.65；「激躁行為」為0.82，「社會退縮行為」為0.72，上述r值都達統計學上顯著水準。
研究結果顯示，翻譯後的MOSES中文版量表具有良好的信度與效度，且MOSES中文版量表的量尺表現與原量表之研究結果近似。顯示MOSES量表中文化可供老年長期照護機構使用者進行多面向評估，亦可供相關老年功能性研究作為一可信賴的評估工具。期待MOSES中文量表能提供未來有志於探討機構長者自我照顧、定向感缺損、憂鬱/焦慮情緒、激躁行為及社會退縮行為等相關研究之研究者量表使用之參考。

Thanks to the improvement medical progress and the living standard, the elderly population in Taiwan significantly increased especially in recent year. According to the prediction from the government, in 2018, Taiwan will become the aged society, an elderly population of 14 or more by the definition of the UN. The ageing related issues have attracted the attention by the whole society in Taiwan, and the issues of long-term care specifically for the elderly are most important. In the field of long-term care, functionality is the most important goal in practice and the necessary outcomes in relevant research. In this way, a comprehensive assessment tool with the characteristics of multiple dimensions, sound psychometry, time-saving, and handiness is crucial to provide individual care and research.
The aims of the present study are to translate the Multidimensional Observation Scale of Elderly Subjects, MOSES into traditional Chinese, to examine the reliability and validity, and explore the feasibility of its use in the elderly in the long-term care facility.
A total of 60 older adults were enrolled in the study, the average age of the participants was 80.72±8.25, with female predominant (N＝34, 56.7%), and the majority of them were never institutionalised (N＝52, 86.7%). Most of the enrolled elderly were rather healthy with relatively low (median=5.00) in comorbided severity as indicated by Charlson Comorbidity Index (CCI). In reliability testing, the inter-rater reliability was assessed with Krippendorf's method, and K-alpha was 0.87, indicating a good reliability between raters. The internal validity testing showed the Cronbach's alpha of 0.93 for self-care functioning, 0.93 for disoriented behaviours, depression/anxiety, and irritable behaviour, and 0.78 for withdraw behaviours. We performed content validity and criterion-related validity to examine the construct validity. Content validity was assessed with item-level and scale-level content validity indices (I-CVI and S-CVI). Both I-CVI and S-CVI were 0.99, judged as excellent validity for content validity. The Pearson's r between targeted criterion and self-care functioning was -0.90, and -0.86 for disoriented behaviours. The Pearson's r of self-report criteria and depression/anxiety was 0.65 for Geriatric Depression Scale, 0.65 and 0.53 for DASS-D and DASS-A respectively. The Pearson's r in rater-rated scale was higher, and was 0.75 and 0.65 for NPI-dysphoric and NPI-anxiety respectively. The Pearson's r for the criterion and irritable behaviour was 0.82, and 0.72 for withdraw behaviours.
Based on our results, the MOSES Traditional Chinese version showed good reliability and validity, and was similar to the psychometric properties in the original study. In conclusion, we believed that the MOSES Traditional Chinese version can be a reliable assessment tool for future practice and research in the field of long-term care.

第一章 緒論 1
第一節 研究動機與背景 1
第二節 研究目的 4
第二章 文獻探討 5
第一節 老化與生理、心理與社會功能 5
第二節老年評估工具分類及特質 10
第三節 老年人功能評估工具 13
第三章 研究方法 21
第一節 MOSES 量表中文化過程 22
第二節 研究對象與資料蒐集 25
第三節 研究工具 26
第四節 資料分析與信度、效度檢測方法 34
第四章 研究結果 41
第一節 量表中文化 41
第二節 研究對象人口屬性分布狀況 44
第三節中文版多向度觀察評估量表（MOSES）之信度檢定結果 50
第四節 中文版多向度觀察評估量表(MOSES)之效度檢定結果 51
第五章 討論 55
第一節 完成中文版MOSES 量表翻譯與研究執行過程 56
第二節 檢定中文版MOSES 量表之信度 58
第三節 檢定中文MOSES 量表之效度 61
第四節 研究限制 63
第六章 結論與建議 65
第一節 結論 65
第二節未來研究的建議 66
參考文獻
壹、中文參考文獻 69
貳、外文參考文獻 71
附錄
附錄一、中文版MOSES之CVI分析 81
附錄二、英文版MOSES作者授權同意書 87
附錄三、 老人憂鬱量表（GDS）15題之中文翻譯作者授權同意書 88
附錄四、中文版躁動量表之中文翻譯作者授權同意書 89
附錄五、中文版神經精神病徵調查表之中文翻譯作者授權同意書 90
附錄七、巴氏量表 93
附錄八、簡易心智狀態量表 95
附錄九、簡式老人憂鬱量表 96
附錄十、情緒自評量表 97
附錄十一、Cohen-Mansfield躁動量表 99
附錄十二、中文版神經精神病徵調查表 100
附錄十三、研究團隊邀請機構參與研究之同意書 101
附錄十四、英文版MOSES量表 102
附錄十五、中文化MOSES量表 107

表目錄
表 1、人口學之研究變項操作型定義 34
表 2、MOSES 量表內在一致性（N=10） 43
表 3、基本人口屬性之描述性統計（N= 60） 46
表 4、各量表之描述性統計 48
表 5、MOSES評分者間信度（N=4） 50
表 6、MOSES 量表內在一致性（N=60） 50
表 7 、中文版MOSES之I-CVI分析 51
表 8 、中文版MOSES之S-CVI分析 52
表 9 、MOSES量表與各量表之效標關聯效度 54

圖目錄
圖 1、量表中文化、測試過程圖 24
圖 2、參與收案的流程圖 44

朱育增、吳肖琪、李玉春、賴美淑、譚醒朝（2010）．探討共病測量方法於健保次級資料之應用．台灣公共衛生雜誌，29（3），191-200。
朱國鳳（2017）．怎麼幫老爸老媽申請長照服務？6個步驟，完整呈現申請流程，引自http://www.ilong termcare.com/Article/Detail/976
李世代（2000）．老年人的身心特質（上）．銀髮世紀季刊，4。
呂慧君（2008）．慣用手、健康狀況及情緒狀態之相關性研究（碩士論文）．國立臺灣大學醫學院分子醫學研究所遺傳諮詢組。
邱亨嘉、陳怡君、毛莉雯、蕭世槐、劉宏文、黃明賢（1997）．中文版多元功能評估問卷之信度效度考驗．中華公共衛生雜誌，16（2），119-132。
吳淑瓊、徐慧娟、莊媖智、張明正（1996）．功能評估在估計臺灣社區老人長期照護需要之應用．中華衛誌，15（6），533-544。
林正祥、陳佩含、林惠生（2010）．臺灣老人憂鬱狀態變化及其影響因子．人口學刊，41，67-109。
林怡君、余豎文、張宏哲（2004）．新店地區機構和非機構老人憂鬱情形及相關因素之調查．台灣家庭醫學雜誌，14（2），81—93。
林淑緩、李玲玲、賴思穎、彭少貞（2013）．英國EASY-Care Standard評估工具於台灣老人之應用初探．安泰醫護雜誌，19（4），51-62。
林麗嬋、林一真（2004）．機構用 Cohen-Mansfield 躁動量表中文版之檢定．行政院國家科學委員會專題研究計劃果報告．計畫編號：NSC92-2314-B-010-045。
林麗嬋、吳肖琪、蔡誾誾、張淑卿（2010）．現行長期照護評估工具的問題與因應．長期照護雜誌，14（3），254-265。
林佩欣、林亭妗、陳治中、紀夙芬、陳智光、黃美涓（2014）．長期照護患者簡易全方位評估量表之建立．台灣復健醫學雜誌，42（1），41-50。
陳人豪、嚴崇仁（2003）．老年人之生理變化與檢驗數據判讀．台灣老年學暨老年醫學會，7（3），356-363。
陳人豪、嚴崇仁（2007），老化的生物學與生理改變．當代醫學，34（8），600-608。
張國偉（2011）．誰需要長期照顧？慢性疾病擴張的討論．社區發展季刊，136，426-444。
黃正平（2011）．臨床老年精神醫學-第二版．台北市：合記書局。
葉至誠（2016）．老年社會學．台北：秀威經典。
廖以誠、葉宗烈、柯慧貞、駱重嗚、盧豐華（1995）．老年憂鬱量表中譯版之信、效度初步研究．彰基醫誌，1，11-17。
衛生福利部（2016）．長照政策專區．取自http://1966.mohw.gov.tw/LTC/mp-201.html
衛生福利部社會及家庭署（2017）．106年百歲人瑞人數統計表．取自https://www.sfaa.gov.tw/SFAA/Pages/ashx/File.ashx?FilePath=~/File/Attach/6565/File_170550.pdf
厚生勞働省 (2009). 介護認定審査会委員テキスト. Retrieved Oct 20, 2017 from http://www.mhlw.go.jp/topics/kaigo/nintei/dl/text2009_3.pdf
Alexopoulos, G. S. (2003). Role of executive function in late-life depression. J Clin Psychiatry, 64 Suppl 14, 18-23.
Anton, S. D., Woods, A. J., Ashizawa, T., Barb, D., Buford, T. W., Carter, C. S., . . . Pahor, M. (2015). Successful aging: Advancing the science of physical independence in older adults. Ageing Research Reviews, 24(Pt B), 304-327. doi:10.1016/j.arr.2015.09.005
Barton, A., & Mulley, G. (2003). History of the development of geriatric medicine in the UK. Postgraduate Medical Journal, 79(930), 229–234.
Bech, P. (2005). Social Functioning. CNS Drugs, 19(4), 313-324.
Birren, J. E., & Zarit, J. M. (1985). Concepts of health, behaviour and ageing. In J. E. Birren & J. Livingston (Eds.). Cognition stress and ageing. Englewood Cliffs, NJ: Prentice-Hall.
Bland, J. M., & Altman, D. G. (1997). Statistics notes: Cronbach's alpha. BMJ, 314(7080), 572. doi:10.1136/bmj.314.7080.572
Bravo, G., Dubois, M. F., Hebert, R., De Wals, P., & Messier, L. (2002). A prospective evaluation of the Charlson Comorbidity Index for use in long-term care patients. Journal of the American Geriatrics Society, 50(4), 740-745.
Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35(1), 79-89.
Cohen-Mansfield, J., Marx, M. S., & Rosenthal, A. S. (1989). A description of agitation in a nursing home. The Journals of Gerontology, 44(3), M77-84.
Coleman, P. G., & O'Hanlon, A. (2008). Ageing and Adaptation Handbook of the Clinical Psychology of Ageing (pp. 15-32): John Wiley & Sons, Ltd, Chichester, UK.
Cranton, P. (1976). An Introduction to Criterion-Referenced Measurement. Canadian Journal of Education, 1(4), 83-92. doi:10.2307/1494626
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48(5 Suppl 6), S10-16.
Davenport, E. C., Davison, M. L., Liou, P.-Y., & Love, Q. U. (2015). Reliability, Dimensionality, and Internal Consistency as Defined by Cronbach: Distinct Albeit Related Concepts. Educational Measurement: Issues and Practice, 34(4), 4-9. doi:10.1111/emip.12095
Dunn, V. K., & Sacco, W. P. (1989). Psychometric evaluation of the Geriatric Depression Scale and the Zung Self-Rating Depression Scale using an elderly community sample. Psychology and Aging, 4(1), 125-126.
Ellis, G., Whitehead, M. A., O’Neill, D., Langhorne, P., & Robinson, D. (2011). Comprehensive geriatric assessment for older adults admitted to hospital. The Cochrane Database of Systematic Reviews, 7, CD006211. Advance online publication.
Fratiglioni, L., Wang, H.-X., Ericsson, K., Maytan, M., & Winblad, B. (2000) Influence of social network on occurrence of dementia: a community-based longitudinal study. The Lancet, 355(9212), 1315-1319. doi:10.1016/S0140-6736(00)02113-9
Finkel, S. I., Lyons, J. S., & Anderson, R. L. (1992). Reliability and validity of the Cohen–Mansfield agitation inventory in institutionalized elderly. International Journal of Geriatric Psychiatry, 7(7), 487-490.
Ford, P., & McCormack, B. (1999). Determining older people's need for registered nursing in continuing healthcare: the contribution of the Royal College of Nursing's Older People Assessment Tool. Journal of Clinical Nursing, 8(6), 731-742.
Ford, P. (2004). Nursing assessment and older people: A Royal College of Nursing toolkit. London: Royal College of Nursing.
Fuh, J. L., Liu, C. K., Mega, M. S., Wang, S. J., & Cummings, J. L. (2001). Behavioral disorders and caregivers' reaction in Taiwanese patients with Alzheimer's disease. International Psychogeriatrics, 13(1), 121-128.
Fuller-Iglesias, H., Sellars, B., & Antonucci, T. C. (2008). Resilience in Old Age: Social Relations as a Protective Factor. Research in Human Development, 5(3), 181-193. doi:10.1080/15427600802274043
Granger, C. V., Albrecht, G. L., & Hamilton, B. B. (1979). Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel Index. Archives of Physical Medicine and Rehabilitation, 60(4), 145-154.
Gupta, A. (2008). Measurement scales used in elderly care. (1st ed.). Oxford: UK, Radcliffe Publishing.
Hayes, A. F., & Krippendorff, K. (2007). Answering the call for a standard reliability measure for coding data. Communication Methods and Measures, 1, 77-89.
Helmes, E., Csapo, K. G., & Short, J. A. (1987). Standardization and validation of the Multidimensional Observation Scale for Elderly Subjects (MOSES). The Journal of Gerontology, 42(4), 395-405.
Hertz, J. E., Koren, M. E., Rossetti, J., & Tibbits, K. (2016). Management of Relocation in Cognitively Intact Older Adults. Journal of Gerontological Nursing, 42(11), 14-23. doi:10.3928/00989134-20160901-05
Hooyman, N. R., & Kiyak, H. A. (2011). Social gerontology: A multidisciplinary perspective (9th ed.). Upper Saddle River, NJ: Pearson.
Ishii, S., Weintraub, N., & Mervis, J. R. (2009). Apathy: a common psychiatric syndrome in the elderly. Journal of the American Medical Directors Association, 10(6), 381-393. doi:10.1016/j.jamda.2009.03.007
Juhasz, G., Eszlari, N., Pap, D., & Gonda, X. (2012). Cultural differences in the development and characteristics of depression. Neuropsychopharmacol Hung, 14(4), 259-265.
Kaplan, O. (1952). Psychological Aspects of Aging. The Annals of the American Academy of Political and Social Science, 279, 32-42.
Kim., S. H, Kim., D. H., & Kim., W. S. (2010). Long-term care needs of the elderly in Korea and elderly Long-term care insurance. Social Work in Public Health, 25, 176-184.
Kim, D., Subramanian, S., & Kawachi, I. (2008) Social capital and physical health. In: Kawachi I, Subramanian S, Kim D, editors. Social capital and health (pp. 139-190). Springer.
Kraus, R. G. (2000). Leisure in a changing America: Trends and Issues for the 21st Century. Boston, MA: Allyn and Bacon.
Lawton., M. P., Moss., M., Fulcomer., M., Kleban., M. H. (1982). A research and service oriented multilevel assessment instrument. Journals of Gerontology, 37(1), 91-99.
Lopez-Otin, C., Blasco, M. A., Partridge, L., Serrano, M., & Kroemer, G. (2013). The hallmarks of aging. Cell, 153(6), 1194-1217.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335-343.
Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61-65.
Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., . . . Fratiglioni, L. (2011). Aging with multimorbidity: a systematic review of the literature. Ageing Research Reviews, 10(4), 430-439.
Marshall, E. G., Clarke, B. S., Varatharasan, N., & Andrew, M. K. (2015). A Long-Term Care-Comprehensive Geriatric Assessment (LTC-CGA) Tool: Improving Care for Frail Older Adults? Canadian Geriatrics Journal, 18(1), 2-10. doi:10.5770/cgj.18.122
McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires (3rd ed.). New York: Oxford University Press.
McIntyre, R. S., Cha, D. S., Soczynska, J. K., Woldeyohannes, H. O., Gallaugher, L. A., Kudlow, P., . . . Baskaran, A. (2013). Cognitive deficits and functional outcomes in major depressive disorder: determinants, substrates, and treatment interventions. Depression and Anxiety, 30(6), 515-527. doi:10.1002/da.22063
Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen. (2017). Pflegebedürftigkeit und Pflegebegutachtung- Das neue Begutachtungsinstrument. Retrieved Oct 20, 2017 from https://www.mds-ev.de/themen/pflegebeduerftigkeit-und-pflegebegutachtung/das-neue-begutachtungsinstrument.html
Menec, V. H., Means, R., Keating, N., Parkhurst, G., & Eales, J. (2011). Conceptualizing age-friendly communities. Canadian Journal on Aging, 30(3), 479-493. doi:10.1017/s0714980811000237
Miyoshi K., Morimura Y. (2010) Clinical Manifestations of Neuropsychiatric Disorders. In: Miyoshi K., Morimura Y., Maeda K. (Eds.), Neuropsychiatric Disorders. Springer, Tokyo.
Mody, L., Miller, D. K., McGloin, J. M., Div, M., Freeman, M., Marcantonio, E. R., … Studenski, S. (2008). Recruitment and Retention of Older Adults in Aging Research. Journal of the American Geriatrics Society, 56(12), 2340–2348.
Molton, I. R., & Jensen, M. P. (2010). Aging and disability: biopsychosocial perspectives. Physical Medicine & Rehabilitation Clinics of North America, 21(2), 253-265. doi:10.1016/j.pmr.2009.12.012
Neuendorf, K. A. (2017). The content analysis guidebook (2nd ed), Los Angeles, California: Sage Publications.
Nieuwenhuijsen, K., de Boer, A. G., Verbeek, J. H., Blonk, R. W., & Van Dijk, F. J. (2003). The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems. Occupational and Environmental Medicine, 60 Suppl 1, i77-82.
Nijsten, J. M. H., Leontjevas, R., Pat-El, R., Smalbrugge, M., Koopmans, R., & Gerritsen, D. L. (2017). Apathy: Risk Factor for Mortality in Nursing Home Patients. Journal of the American Geriatrics Society, 65(10), 2182-2189. doi:10.1111/jgs.15007
Onwuameze, O. E., & Paradiso, S. (2014). Social adaptive functioning, apathy, and nondysphoric depression among nursing home-dwelling very old adults. Psychopathology, 47(5), 319-326. doi:10.1159/000360823
Partridge, L., & Mangel, M. (1999). Messages from mortality: the evolution of death rates in the old. Trends in Ecology & Evolution, 14(11), 438-442.
Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23(10), 433-441.
Phillips, C. D., Morris, J. N., Hawes, C., Fries, B. E., Mor, V., Nennstiel, M., & Iannacchione, V. (1997). Association of the Resident Assessment Instrument (RAI) with changes in function, cognition, and psychosocial status. Journal of the American Geriatrics Society, 45(8), 986-993
Philp, I. (1997). Can a medical and social assessment be combined? Journal of the Royal Society of Medicine, 90(Suppl 32), 11-13.
Philip, K. E., Alizad, V., Oates, A., Donkin, D. B., Pitsillides, C., Syddall, S. P., & Philp, I. (2014). Development of EASY-Care, for brief standardized assessment of the health and care needs of older people; with latest information about cross-national acceptability. Journal of the American Medical Directors Association, 15(1), 42-46.
Polit, D. F., & Beck, C. T. (2006). The content validity index: are you sure you know what's being reported? Critique and recommendations. Research in Nursing & Health, 29(5), 489-497. doi:10.1002/nur.20147
Polit, D. F., Beck, C. T., & Owen, S. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459-467. doi:10.1002/nur.20199
Provencher, V., Mortenson, W. B., Tanguay-Garneau, L., Belanger, K., & Dagenais, M. (2014). Challenges and strategies pertaining to recruitment and retention of frail elderly in research studies: a systematic review. Archives of Gerontology and Geriatrics, 59(1), 18-24.
Quinn, T. J., McArthur, K., Ellis, G., & Stott, D. J. (2011). Functional assessment in older people. BMJ, 343. doi:10.1136/bmj.d4681
Richardson, W. S., & Doster, L. M. (2014). Comorbidity and multimorbidity need to be placed in the context of a framework of risk, responsiveness, and vulnerability. Journal of Clinical Epidemiology, 67(3), 244-246.
Rook, K. S., & Charles, S. T. (2017). Close social ties and health in later life: Strengths and vulnerabilities. American Psychologist, 72(6), 567-577. doi:10.1037/amp0000104
Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach's alpha. International Journal of Medical Education, 2, 53-55.
Taylor, J, & Watkinson, D. (2007). Indexing reliability for condition survey data. The Conservator, 30, 49 -62.
Thorsen, S. V., & Bjorner, J. B. (2010). Reliability of the Copenhagen Psychosocial Questionnaire. Scandinavian Journal of Public Health, 38(3_suppl), 25-32. doi:10.1177/1403494809349859
Sansoni J, Marosszeky N, Sansoni E, Fleming G. (2010) Final Report: Effective Assessment of Social Isolation. Centre for Health Service Development, University of Wollongong.
Saxon, S.V., Etten, M. J., & Perkins, E. A. (2010). Physical Change and Aging: A Guide for the Helping Professions (5th ed). New York: Springer.
Seeman, T. E. (1996). Social ties and health: the benefits of social integration. Annals of Epidemiology, 6(5), 442-451.
Seitz, D., Purandare, N., & Conn, D. (2010). Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. International Psychogeriatric, 22(7), 1025-1039.
Selbaek, G., Engedal, K., & Bergh, S. (2013). The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. Journal of the American Medical Directors Association, 14(3), 161-169. doi:10.1016/j.jamda.2012.09.027
Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. In T.L. Brink (Ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165-173). NY: The Haworth Press, Inc.
Simon, A. (1951). Psychological Problems of Aging. California Medicine, 75(2), 73–80.
Soygür, H., Duyan, V., Hasgül, E., Adıbatmaz, M. (2017). Turkish Adaptation Study of Multidimensional Observation Scale For Elderly Subjects. Turkish Journal of Family Medicine and Primary Care. 11(3), 171-185.
Steptoe, A., Deaton, A., & Stone, A. A. (2015). Psychological wellbeing, health and ageing. Lancet, 385(9968), 640–648.
Streiner, D. L. (2003). Starting at the beginning: an introduction to coefficient alpha and internal consistency. Journal of Personality Assessment, 80(1), 99-103. doi:10.1207/s15327752jpa8001_18
Sullivan, G. J., & Williams, C. (2017). Older Adult Transitions into Long-Term Care: A Meta-Synthesis. Journal of Gerontological Nursing, 43(3), 41-49. doi:10.3928/00989134-20161109-07
Volicer, L., Frijters, D. H., & van der Steen, J. T. (2013). Apathy and weight loss in nursing home residents: longitudinal study. Journal of the American Medical Directors Association, 14(6), 417-420.
Ward, K. T., & Reuben, D. B. (2017). Comprehensive geriatric assessment. Retrieved Oct. 20, 2017, from http://www.uptodate.com/contents/3009
Wells, C. S., & Wollack, J. A. (2003). An Instructor's Guide to Understanding Test. Retrieved 29, Dec. 2017, from https://testing.wisc.edu/Reliability.
World Health Organization. (n. d.). Process of translation and adaptation of instruments. Retrieved Oct. 20, 2017, from http://www.who.int/substance_abuse/research_tools/translation/en/
World Health Organization. (2014). Preventing suicide A global imperative. Retrieved Oct 20, 2017 from http://apps.who.int/iris/bitstream/10665/131056/1/9789241564779_eng.pdf?ua=1&ua=1
World Health Organization (2015). Ageing and health. Retrieved Oct 20, 2017, from http://www.who.int/mediacentre/factsheets/fs404/en/
World Health Organization (2016). Mental health and older adults. Retrieved June 20, 2017, from http://www.who.int/mediacentre/factsheets/fs381/en/
World Health Organization (2017). Depression. Retrieved June 20, 2017, from http://www.who.int/mediacentre/factsheets/fs369/en/
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17(1), 37-49.
Yorkston, K. M., Bourgeois, M. S., & Baylor, C. R. (2010). Communication and Aging. Physical Medicine and Rehabilitation Clinics of North America, 21(2), 309-319. doi:10.1016/j.pmr.2009.12.011