肩功能適性量表中文化之項目難易度分析

Background: In language and cultural differences, the question is not explored for the appropriate in Taiwan by using the directly-translated foreign questionnaire to evaluate. The purposes of this study are to discuss the appropriate for using the FLEX-SF Chinese format by direct translation in Taiwan and the deference of items difficulty.
Method: Chinese Item pool (CFLEX-SF) was collected by the objective, standardizing translation process for FLEX-SF. The 227 subjects with shoulder dysfunction who underwent physical therapy completed the CFLEX-SF. To arrange the difficult degree of Items and analysis item calibration difficulty and fit statistic of each item, data was assessed by Rasch-Model computer program WINSTEPS (Mesa Press, Chicago, IL, USA). Internal consistency was assessed using item separation reliability which likes Cronbach alpha (α) coefficient. The Infit and Outfit statistics were used to assess whether item response pattern fits the Rasch model.
Results: The internal consistency is adequate at both times with Cronbach's alpha coefficient at 0.95 and 0.93, test-retest reliability is adequate with interclass correlation coefficient (ICC) at 0.97, correlation coefficient were compared with Physical Component Scale (PCS) and Mental Component Scale (MCS) of the Taiwan's SF-36 questionnaire are rho=0.72 (p＜0.01) and rho=0.35 (p=0.08) respectively. Item 28 has Infit statistics outside this range (＞1.4), indicating that the item maybe have misfit. This item has greater variation in its response pattern which does not match the subject's ability. However, item separation (7.36-7.18) and Item separation reliability (0.98) had not remarkable change through the removal of poorly fitting item. There are obvious differential to compare the item difficulty sequence with FLEX-SF.
Conclusion: The discrepancy between cultural perception and conventionality are existence, can influence the linear, continuous characteristic of IRT questionnaire. In order to adequately assess the condition of Taiwan's patients with shoulder dysfunction, it's necessary to modify appropriately for the CFLEX-SF.