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研究生:陳嘉容
研究生(外文):Chia-Jung Chen
論文名稱:台灣版青少年吸菸依賴量表之心理計量測試
論文名稱(外文):Psychometric Testing of The Cigarette Dependence Questionnaires on a Taiwanese Adolescent Sample
指導教授:黃芷苓黃芷苓引用關係
指導教授(外文):Chih-Ling Huang
學位類別:碩士
校院名稱:長榮大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:132
中文關鍵詞:吸菸依賴青少年效度信度
外文關鍵詞:cigarette dependenceadolescentvalidityreliability
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台灣地區在1994年高中生吸菸率10.7%,到了2005年是13.99%,青少年吸菸率有逐年上升的趨勢,大多數的吸菸青少年到了成人時期仍會持續吸菸,其主要造成原因是尼古丁依賴。但目前國內缺乏青少年吸菸依賴量表之檢測工具,因此無法針對青少年進行吸菸依賴評估。本研究選用兩個國外常用的青少年吸菸依賴量表在台灣進行翻譯和測試,Dimensions of Tobacco Dependence Scale(DTDS)及Hooked On Nicotine Checklist(HONC)量表,藉此了解這些量表在國內吸菸青少年的適用性。本研究設計為橫斷之描述性研究,採立意取樣,研究對象為中、南部九所高中職學校的吸菸學生,有效樣本共293位。效度評估方面,DTDS與HONC量表的專家內容效度指標值,分別為0.92與1。另外,採用吸菸依賴之重要生理指標,呼出一氧化碳、唾液的古丁尼濃度以及Fagerstrom Test of Nicotine Dependence (FTND)量表,做為效標關聯效度的檢定,結果DTDS、HONC量表與呼氣一氧化碳之相關,分別為.13 (p<.05)、.09;與唾液古丁尼之相關,分別為.31 (p<.01)、.23 (p<.01);與FTND量表之相關,分別為.57 (p<.01)、.59 (p<.01)。建構效度是進行吸菸依賴量表之探索性因素分析,結果DTDS量表是二個因素結構,可解釋36.57%的變異量,HONC量表則是一個因素結構,可解釋35%的變異量。信度評估方面,是進行內在一致性檢測,由於DTDS量表為連續性分數,其Cronbach alpha為0.95,HONC採二分計分,其KR-20為0.84。因此DTDS及HONC量表在國內進行的測試結果,都呈現不錯的信效度,未來研究可以使用這二個量表進行國內青少年吸菸依賴的評估。
The smoking rate of Taiwanese adolescents is gradually increasing, which reached 10.7% and 13.99% among the Taiwanese senior high school students in 1994 and 2005 respectively. As teenagers begin smoking, most of them continue smoking in adulthood. Nicotine dependence is the main reason in the maintenance of smoking from adolescent into adulthood. The instruments for measuring cigarette dependence in adolescents are not available in Taiwan so that cigarette dependence of adolescent smokers could not be assessed. The aims of the study are to translate and to test two worldwide used questionnaires, Dimensions of Tobacco Dependence Scale (DTDS) and Hooked on Nicotine Checklist (HONC). The results can help us to understand whether these scales can be appropriately used to assess cigarette dependence of adolescent smokers in Taiwanese. This study is a descriptive and cross-sectional study using the purposive sampling. The student smokers were recruited from nine senior high schools and vocational high schools in the middle and southern Taiwan. The effective sample size is 293. The content validity index of the Chinese version of the DTDS and the HONC are 0.92 and 1, respectively. The important biomarkers (expired carbon monoxide, CO and saliva cotinine) and the Fagerstrom Test of Nicotine Dependence (FTND) are used to examine the criterion-related validity. The correlation coefficients of the DTDS and the HONC and expired CO are .13 (p <.05) and .09. The correlation coefficients of the DTDS and the HONC and saliva cotinine are .31(p <.01) and .23 (p <.01). The correlation coefficients of the DTDS and the HONC and FTND scale are .57 (p <.01) and .59 (p<.01). The internal structure of the DTDS was first examined using EFA with promax rotation. Two factors emerged from the factor analysis that accounted for 36.57% of the variance. One factor of the HONC was determined by factor analysis, accounting for 35% of the variance. The internal consistency is evaluated by reliability coefficient. The items of the DTDS are continuous variables. The Cronbach’s alpha of the DTDS is 0.95. The items of the HONC was dichotomous variables. The Kuder-Richardson coefficient (KR-20) is 0.84. The results demonstrated that the Chinese version of the DTDS and the HONC have good reliability and validity. Future research can use these scales to assess cigarette dependence of adolescent smokers in Taiwan.
第一章 緒論....................................................................................................1
第一節 研究背景與動機............................................................................1
第二節 研究目的........................................................................................3
第貳章 文獻查證............................................................................................4
第一節 青少年吸菸依賴的概念................................................................4
第二節 青少年吸菸依賴之測量工具......................................................10
第三節 吸菸依賴的生理指標..................................................................19
第叄章 研究方法..........................................................................................23
第一節 研究對象......................................................................................23
第二節 研究設計......................................................................................25
第三節 研究工具......................................................................................26
第四節 研究倫理......................................................................................29
第五節 資料收集......................................................................................31
第六節 資料分析方法..............................................................................32
第肆章 研究結果..........................................................................................37
第一節 研究對象之描述性統計..............................................................37
第二節 量表效度......................................................................................41
第三節 量表信度......................................................................................48
第伍章 討論..................................................................................................50
第一節 研究對象之人口學變項及量表得分之分佈特性....................50
第二節 與國外DTDS及HONC量表之效度比較..............................56
第三節 與國外DTDS及HONC量表之信度比較..............................62
第陸章 結論與建議......................................................................................64
第一節 結論............................................................................................64
第二節 限制與建議................................................................................65
參考文獻........................................................................................................66
表....................................................................................................................82
表一 研究對象人口學基本資料..................................................................82
表二 研究對象之吸菸經驗..........................................................................84
表三 研究對象之吸菸背景資料..................................................................85
表四 DTDS量表之同意比例.......................................................................86
表五 HONC量表之同意比例......................................................................88
表六 FTND量表之各題回答情形...............................................................89
表七 DTDS量表之專家建議修改後題目...................................................90
表八 DTDS量表之社會性項目分析...........................................................91
表九 DTDS量表之感官性項目分析...........................................................92
表十 DTDS量表之情感性項目分析...........................................................93
表十一 DTDS量表之生理性項目分析.......................................................94
表十二 DTDS量表之收斂效度與區別效度...............................................96
表十三 原始計分之DTDS量表2-5因子個數的因素負荷量......................98
表十四 修正後計分之DTDS量表2-5因子個數的因素負荷量................101
表十五 DTDS量表之因素分析................................................................104
表十六DTDS量表之各因素間相關.........................................................106
表十七 HONC量表之項目分析...............................................................107
表十八 HONC量表1-3因子個數的因素負荷量....................................108
表十九 HONC量表之因素分析...............................................................109
圖..................................................................................................................110
圖一 青少年吸菸依賴量表之發展與測試................................................110
圖二 DTDS量表之陡坡圖.........................................................................111
圖三 HONC量表之陡坡圖........................................................................112
附件..............................................................................................................113
附件一 FTND量表.....................................................................................113
附件二 基本資料........................................................................................114
附件三 DTDS量表.....................................................................................116
附件四 HONC量表....................................................................................118
附件五 吸菸經歷........................................................................................119
附件六 一氧化碳濃度測量儀的使用方式................................................120
附件七 唾液收集方法與步驟....................................................................121
附件八 優良臨床試驗規範訓練結業證書................................................122
附件九 同意臨床試驗證明書....................................................................123
附件十 家長及學生同意書........................................................................124
附件十一 DTDS量表原作者允用同意書.................................................127
附件十二 HONC量表原作者允用同意書................................................128
附件十三 英文量表翻譯成中文對等性之專家效度評分表....................129
附件十四 DTDS量表之專家評分結果.....................................................130
附件十五 HONC量表之專家評分結果....................................................132
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