臺灣博碩士論文加值系統

本研究的目的是建立「成人失語症功能性溝通評估工具」的常模並探討失語症相關因子對於「成人失語症功能性溝通評估工具」分數的影響。研究納入30位健康成人及50位失語症個案進行「成人失語症功能性溝通評估工具」的測驗。研究者依據健康成人的功能性溝通數據資料將「成人失語症功能性溝通評估工具」的切截分數訂定為72分，再以失語症個案之「成人失語症功能性溝通評估工具」分數建立該工具的百分等級常模。失語症相關因子分析顯示，失語症嚴重度越嚴重的個案，功能性溝通分數顯著較失語症嚴重度較輕微的個案低，此外，在失語症類型方面也發現說話流暢的失語症個案之功能性溝通分數較說話不流暢失語症個案高。然而，發病時長大於六個月和發病時長小於六個月的失語症個案在功能性溝通分數未達顯著差異。
總結來說，本研究建立的「成人失語症功能性溝通評估工具」可以作為未來評估本土失語症個案功能性溝通能力的對照依據，評估人員能更快速地了解失語症個案在團體中的相對位置，另外，透過失語症相關因子的分析能更深入了解可能影響失語症個案日常溝通的因素。

The purpose of this study was to establish the norm of the "Functional Communication Assessment for Adults with Aphasia" and explore the impact of aphasia-related factors on the scores of the "Functional Communication Assessment for Adults with Aphasia". The study included 30 healthy adults and 50 individuals with aphasia to take the test of the "Functional Communication Assessment for Adults with Aphasia". The researchers set the cut-off score of the "Functional Communication Assessment for Adults with Aphasia" at 72 points based on the functional communication scores of healthy adults, and then established the norm based on the "Functional Communication Assessment for Adults with Aphasia" scores of individuals with aphasia. Results indicated that the functional communication scores of individuals with severe aphasia were significantly lower than those with mild aphasia. In addition, it was also found that the functional communication scores of the fluent aphasia group was significantly higher than the non-fluent aphasia group. However, there was no significant difference on functional communication scores between aphasic adults with an onset period of more than six months and aphasic adults with an onset period of less than six months.
In summary, the norm of "Functional Communication Assessment for Adults with Aphasia" established in this study can be used as a reference for future evaluation of the functional communication ability of individuals with aphasia. Evaluators can more quickly understand the relative position of individuals with aphasia in the group. In addition, through the analysis of aphasia-related factors, we had a deeper understanding of the factors that may affect the daily communication of individuals with aphasia.

中文摘要i
英文摘要ii
目錄iii
圖目錄v
表目錄vi
第一章 緒論1
第一節 研究動機1
第二節 研究目的和研究問題3
第二章 文獻探討5
第一節 溝通組成的要素與功能5
第二節 失語症的功能性溝通8
第三節 失語症溝通障礙的影響面向11
第四節 功能性溝通測驗的重要性15
第五節 國內與國外的功能性溝通評估工具介紹18
第六節 建立常模的必要性27
第三章 研究方法31
第一節 研究對象31
第二節 研究工具39
第三節 研究流程43
第四節 資料分析與統計方法46
第四章 研究結果48
第一節 受試者於「成人失語症功能性溝通評估工具」之表現48
第二節 切截分數和常模數據52
第三節 失語症相關因子對個案於功能性溝通測驗表現之影響54
第五章 討論60
第一節 「成人失語症功能性溝通評估工具」之分數表現60
第二節 失語症相關因子對個案於功能性溝通測驗之表現差異61
第三節 研究限制69
第四節 未來研究方向69
第五節 臨床意義70
第六節 結論71
參考文獻72
附錄82
附錄一 童綜合醫院 人體試驗委員會審查證明書82
附錄二 成人失語症功能性溝通評估工具同意授權使用電子郵件83
附錄三 成人失語症功能性溝通評估工具例題84
圖目錄
圖3-1 健康成人組之施測流程圖45
圖3-2 失語症組之施測流程圖45
圖4-1 不同嚴重度組的失語症個案在功能性溝通測驗總測驗之平均分數55
圖4-2 不同類型的失語症個案在功能性溝通測驗總測驗之平均分數57
圖4-3不同發病時長的失語症個案在功能性溝通測驗總測驗之平均分數59
表目錄
表2-1 美國聽力語言學會成人溝通技巧評估之測驗領域和例題21
表2-2 日常生活溝通能力評估─第三版之測驗領域和例題23
表2-3 功能性溝通活動量表之測驗領域和例題26
表2-4 成人失語症功能性溝通評估工具之分測驗和例題27
表3-1 健康成人組受試者基本資料表33
表3-2 失語症組受試者基本資料表36
表3-3 受試者基本資料摘要表39
表4-1 健康成人組於成人失語症功能性溝通評估工具之描述性統計49
表4-2 失語症組於成人失語症功能性溝通評估工具之描述性統計50
表4-3 失語症成人失語症功能性溝通評估工具的百分等級常模53
表4-4 不同嚴重度組的失語症個案在功能性溝通測驗總測驗和分測驗之平均分數55
表4-5 不同嚴重度的失語症個案在功能性溝通測驗之分數變異數分析摘要表55
表4-6 不同類型的失語症個案在功能性溝通測驗總測驗和分測驗之平均分數57
表4-7 不同發病時長的失語症個案在功能性溝通測驗總測驗和分測驗之平均分數59

吳侑璇（2005）。失語症病患功能性溝通能力之研究［未出版之碩士論文］。國立台北護理健康大學。
吳政達（2001）。教育測驗與統計。高點。
周沛均（2022）。成人失語症功能性溝通評估工具之編制［未出版之碩士論文］。中山醫學大學。
曹真（2010）。失語症多管道溝通篩檢評量工具中文修訂版之研究［未出版之碩士論文］。國立台北護理健康大學。
黃名嘉（2012）。年輕與中老年失語症患者功能性溝通需求及表現之異同：初探［未出版之碩士論文］。國立臺北護理健康大學。
廖宥蓁、曾進興（2008）。失語症患者功能性溝通的需求與表現。台灣復健醫學雜誌，36（2），75-87。
葉重新（2010）。心理與教育測驗。心理。
賴保禎、周文欽、林世華（2000）。心理與教育測驗。空大。
鍾玉梅、李淑娥、張妙鄉（2003）。簡明失語症測驗。心理。
簡茂發（2002）。心理測驗與統計方法。心理。
Aftonomos, L. B., Steele, R. D., Appelbaum, J. S., & Harris, V. M. (2001). Relationships between impairment-level assessments and functional-level assessments in aphasia: Findings from LCC treatment programmes. Aphasiology, 15(10-11), 951-964.
American Speech-Language-Hearing Association. (1990). Functional communication measures project: Advisory report. Rockville, MD: ASHA.
Austin, S.(2021). American Speech-Language-Hearing Association Functional Assessment of Communication Skills. In Encyclopedia of Autism Spectrum Disorders (pp. 180-182). Springer.
Baines, K. A., Heeringa, H. M., & Martin, A. W. (1999). Assessment of Language-related Functional Activities: ALFA: Pro-ed.
Bakheit, A. M. O., Carrington, S., Griffiths, S., & Searle, K. (2005). High scores on the Western Aphasia Battery correlate with good functional communication skills (as measured with the Communicative Effectiveness Index) in aphasic stroke patients. Disability and Rehabilitation, 27(6), 287-291.
Beukelman, D. R., Hux, K., Dietz, A., McKelvey, M., & Weissling, K.(2015). Using visual scene displays as communication support options for people with chronic, severe aphasia: A summary of AAC research and future research directions. Augmentative and Alternative Communication, 31(3), 234-245.
Blomert, L.(1990). What functional assessment can contribute to setting goals for aphasia therapy. Aphasiology, 4(4), 307-320.
Brookshire, R. H., & McNeil, M. R.(2014). Introduction to Neurogenic Communication Disorders. Elsevier Health Sciences.
Brown, G., & Yule, G.(1983). Discourse Analysis. Cambridge university press.
Brown-Schmidt, S., Yoon, S. O., & Ryskin, R. A.(2015). People as contexts in conversation. Psychology of Learning and Motivation, 62(2), 55-59.
Clark, H. H.(1996). Using language. Cambridge university press.
Code, C., & Herrmann, M.(2003). The relevance of emotional and psychosocial factors in aphasia to rehabilitation. Neuropsychological Rehabilitation, 13(1-2), 109-132.
Coppens, P.(2016). Aphasia and Related Neurogenic Communication Disorders. Jones & Bartlett Learning. https://books.google.com.tw/books?id=2J_OCwAAQBAJ
Crockford, C., & Lesser, R.(1994). Assessing functional communication in aphasia: Clinical utility and time demands of three methods. International Journal of Language & Communication Disorders, 29(2), 165-182.
Cruice, M., Worrall, L., Hickson, L., & Murison, R.(2003). Finding a focus for quality of life with aphasia: Social and emotional health, and psychological well-being. Aphasiology, 17(4), 333-353.
Dalemans, R. J., De Witte, L. P., Wade, D. T., & van den Heuvel, W. J. (2010). Social participation through the eyes of people with aphasia. International Journal of Language & Communication Disorders, 45(5), 537-550.
Dalemans, R. J., De Witte, L. P., Wade, D. T., & van den Heuvel, W. J. (2008). A description of social participation in working‐age persons with aphasia: A review of the literature. Aphasiology, 22(10), 1071-1091.
Darrigrand, B., & Mazaux, J.-M.(2000). L'échelle de communication verbale de Bordeaux: une évaluation des compétences communicatives des personnes aphasiques. Glossa, 4-14.
Davidson, B., Howe, T., Worrall, L., Hickson, L., & Togher, L.(2008). Social participation for older people with aphasia: The impact of communication disability on friendships. Topics in Stroke Rehabilitation, 15(4), 325-340.
Davidson, B., Worrall, L., & Hickson, L.(2008). Exploring the interactional dimension of social communication: A collective case study of older people with aphasia. Aphasiology, 22(3), 235-257.
Davidson, B., Worrall, L., & Hickson, L.(2003). Identifying the communication activities of older people with aphasia: Evidence from naturalistic observation. Aphasiology, 17(3), 243-264.
Davidson, B., & Worrall, L. E.(2000). Neurogenic Communication Disorders:A Functional Approach. New York:Thieme.
Dickey, L., Kagan, A., Lindsay, M. P., Fang, J., Rowland, A., & Black, S.(2010). Incidence and profile of inpatient stroke-induced aphasia in Ontario, Canada. Archives of Physical Medicine and Rehabilitation, 91(2), 196-202.
Doedens, W., & Meteyard, L.(2020). Measures of functional, real-world communication for aphasia: A critical review. Aphasiology, 34(4), 492-514.
Doedens, W., & Meteyard, L.(2022). What is functional communication? A theoretical framework for real-world communication applied to aphasia rehabilitation. Neuropsychology Review, 32(4), 937-973.
Engelter, S. T., Gostynski, M., Papa, S., Frei, M., Born, C., Ajdacic-Gross, V., Gutzwiller, F., & Lyrer, P. A.(2006). Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis. Stroke, 37(6), 1379-1384.
Fatimayin, F.(2018). What is communication. National Open University of Nigeria, Lagos.
Flowers, H. L., Skoretz, S. A., Silver, F. L., Rochon, E., Fang, J., Flamand-Roze, C., & Martino, R.(2016). Poststroke aphasia frequency, recovery, and outcomes: a systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 97(12), 2188-2201.
Frattali, C., Thompson, C., Holland, A., Wohl, C., & Ferketic, M. (1995). The American Speech‐Language‐Hearing Association Functional Assessment of Communication Skills for Adults (ASHAFACS)(Vol. null).
Fucetola, R., Connor, L. T., Perry, J., Leo, P., Tucker, F. M., & Corbetta, M. (2006). Aphasia severity, semantics, and depression predict functional communication in acquired aphasia. Aphasiology, 20(5), 449-461.
Galvin, J. E., Roe, C. M., Powlishta, K. K., Coats, M. A., Muich, S. J., Grant, E., Miller, J. P., Storandt, M., & Morris, J. C. (2005). The AD8: a brief informant interview to detect dementia. Neurology, 65(4), 559-564.
Gialanella, B. (2011). Aphasia assessment and functional outcome prediction in patients with aphasia after stroke. Journal of Neurology, 258(2), 343-349.
Goodglass, H., Kaplan, E., & Barresi, B.(2001). BDAE-3: Boston Diagnostic Aphasia Examination–Third Edition: Lippincott Williams & Wilkins Philadelphia, PA.
Harmon, T. G.(2020). Everyday communication challenges in aphasia: Descriptions of experiences and coping strategies. Aphasiology, 34(10), 1270-1290.
Holland, A. L., Fromm, D., & Wozniak, L.(2018). Communication Activities of Daily Living–Third Edition: CADL-3.
Holler, J., Kendrick, K., & Levinson, S. (2017). Processing language in face-to-face conversation: Questions with gestures get faster responses. Psychonomic Bulletin & Review, 25, 1900-1908.
Howe, T. J., Worrall, L. E., & Hickson, L. M. (2008). Observing people with aphasia: Environmental factors that influence their community participation. Aphasiology, 22(6), 618-643.
Irwin, W. H., Wertz, R. T., & Avent, J. R. (2002). Relationships among language impairment, functional communication, and pragmatic performance in aphasia. Aphasiology, 16(8), 823-835.
Johansson, M. B., Carlsson, M., & Sonnander, K.(2012). Communication difficulties and the use of communication strategies: from the perspective of individuals with aphasia. International Journal of Language & Communication Disorders, 47(2), 144-155.
Kertesz, A. (2006). WAB-R: Western aphasia battery-revised: PsychCorp.
Ketterson, T. U., Glueckauf, R. L., Blonder, L. X., Gustafson, D. J., Donovan, N. J., Rodriquez, A. D., Pekich, D., Ley, C., & Gonzalez-Rothi, L. J.(2008). Reliability and validity of the Functional Outcome Questionnaire for Aphasia (FOQ-A). Rehabilitation Psychology, 53(2), 215-233.
Laakso, M.(2014). Aphasia sufferers’ displays of affect in conversation. Research on Language and Social Interaction, 47(4), 404-425.
Laska, A. C., Bartfai, A., Hellblom, A., Murray, V., & Kahan, T. (2007). Clinical and prognostic properties of standardized and functional aphasia assessments. Journal of Rehabilitation Medicine, 39(5), 387-392.
Leavitt, H. J., & Mueller, R. A.(1951). Some effects of feedback on communication. Human Relations, 4(4), 401-410.
Liu, C. K., Chou, M. C., Lai, C. L., & Yang, Y. H. (2009, July11-16). Application of AD-8 to screen very mild dementia in Taiwan. International Conference of Alzheimer’s Disease 2009, Vienna, Austria.
Lomas, J., Pickard, L., Bester, S., Elbard, H., Finlayson, A., & Zoghaib, C. (1989). The communicative effectiveness index: Development and psychometric evaluation of a functional communication measure for adult aphasia. Journal of Speech and Hearing Disorders, 54(1), 113-124.
Mazaux, J. M., Lagadec, T., De Sèze, M. P., Zongo, D., Asselineau, J., Douce, E., ... & Darrigrand, B. (2013). Communication activity in stroke patients with aphasia. Journal of Rehabilitation Medicine, 45(4), 341-346.
Mazaux, J., & Orgogozo, J.(1982). Echelle d’évaluation de l’aphasie adaptée du Boston diagnostic aphasia examination. EAP Editions Psychotechniques, Paris, 5.
McCullough, K. C., McCullough, G. H., Ruark, J. L., & Rainey, J. (2006). Pragmatic performance and functional communication in adults with aphasia. The Journal of Speech and Language Pathology–Applied Behavior Analysis, 1(2), 164-178.
Milroy, L., & Perkins, L.(1992). Repair strategies in aphasic discourse; towards a collaborative model. Clinical Linguistics & Phonetics, 6(1-2), 27-40.
Nasreddine, Z. S., Phillips, N. A., Bedirian, V., Charbonneau, S., Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of American Geriatrics Society, 53, 695-699.
Olsson, C., Arvidsson, P., & Blom Johansson, M. (2019). Relations between executive function, language, and functional communication in severe aphasia. Aphasiology, 33(7), 821-845.
Organization, W. H., & Organization, W. H.(2001). International classification of functioning. Disability and Health (ICF), 28.
Parr, S.(2007). Living with severe aphasia: Tracking social exclusion. Aphasiology, 21(1), 98-123.
Parr, S., Paterson, K., & Pound, C.(2003). Time please! Temporal barriers in aphasia. Aphasia Inside Out, 127-144.
Pearson, J. C., Nelson, P. E., Titsworth, S., & Harter, L.(2017). Human communication. McGraw-Hill Education New York.
Pierce, R. S.(1991). Contextual influences during comprehension in aphasia. Aphasiology, 5(4-5), 379-381.
Plante, E. M., & Beeson, P. M.(2012). Communication and Communication Disorders: A Clinical Introduction. Pearson Education. https://books.google.com.tw/books?id=iT4vAAAAQBAJ
Ramsberger, G.(1994). Functional perspective for assessment and rehabilitation of persons with severe aphasia. Seminars in Speech and Language, 15(1), 1-16.
Rose, M., Mok, Z., & Sekine, K. (2017). Communicative effectiveness of pantomime gesture in people with aphasia. International Journal of Language & Communication Disorders, 52(2), 227-237.
Ross, K. B. (1999). Comparison of impairment and disability measures for assessing severity of, and improvement in, aphasia. Aphasiology, 13(2), 113-124.
Rousseaux, M., Daveluy, W., & Kozlowski, O.(2010). Communication in conversation in stroke patients. Journal of Neurology, 257(7), 1099-1107.
Rousseaux, M., Delacourt, A., Wyrzykowski, N., & Lefeuvre, M. (2003). Test Lillois de Communication (TLC). Ortho Edition.
Schwarz, N.(2007). Cognitive aspects of survey methodology. Applied Cognitive Psychology: The Official Journal of the Society for Applied Research in Memory and Cognition, 21(2), 277-287.
Sekine, K., & Rose, M. L.(2013). The relationship of aphasia type and gesture production in people with aphasia. American Journal of Speech-Language Pathology, 22(4), 662-672.
Simmons-Mackie, N., King, J. M., & Beukelman, D. R.(2013). Supporting communication for adults with acute and chronic aphasia. Paul H. Brookes Pub.
IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.
Tsai, C.F., Lee, W.J., Wang, S.J., Shia, B.C., Nasreddine, Z., & Fuh, J.L. (2012). Psychometrics of the Montreal Cognitive Assessment (MoCA) and its subscales: validation of the Taiwanese version of the MoCA and an item response theory analysis. International Psychogeriatrics, 24(4), 651-658.
Turnbull, J., Lea, D., Parkinson, D., Phillips, P., Francis, B., Webb, S., Bull, V., & Ashby, M.(2010). Oxford advanced learner’s dictionary. International Student’s Edition.
Wade, D., Hewer, R. L., David, R. M., & Enderby, P. M.(1986). Aphasia after stroke: natural history and associated deficits. Journal of Neurology, Neurosurgery & Psychiatry, 49(1), 11-16.
Wallace, S. J., Worrall, L., Rose, T., Le Dorze, G., Cruice, M., Isaksen, J., Kong, A. P. H., Simmons-Mackie, N., Scarinci, N., & Gauvreau, C. A.(2017). Which outcomes are most important to people with aphasia and their families? An international nominal group technique study framed within the ICF. Disability and Rehabilitation, 39(14), 1364-1379.
Weekley, E.(1921). An etymological dictionary of modern English. J. Murray.
Worrall, L., McCooey, R., Davidson, B., Larkins, B., & Hickson, L. (2002). The validity of functional assessments of communication and the Activity/Participation components of the ICIDH-2: do they reflect what really happens in real-life? Journal of Communication Disorders, 35(2), 107-137.
Yang, Y. H., Galvin, J. E., Morris, J. C., Lai, C. L., Chou, M. C., & Liu, C. K. (2011). Application of AD8 questionnaire to screen very mild dementia in Taiwanese. American Journal of Alzheimer's Disease & Other Dementias®, 26(2), 134-138.