تطابق فرهنگي، روايي و پايايي آزمون دسته بندي كارت‌هاي فعاليت در سالمندان ايراني

Cultural Adaptation, Validity and Reliability of Activity Card Sort Test in Iranian Elders

هدف: سازمان بهداشت جهاني مشاركت را جزء مهمي از روند سالمندي سالم برشمرده است و مشاركت مفهومي مهم در سيستم طبقه‌بندي عملكرد، ناتواني و سلامت (ICF) است. آزمون دسته‌بندي كارت فعاليت، ابزاري جامع براي ارزيابي مشاركت در فعاليت‌هاي ابزاري، اجتماعي و اوقات فراغت است. هدف از اين مطالعه تطابق فرهنگي، سنجش روايي و پايايي نسخهٔ فارسي‌شده تست دسته‌بندي كارت‌هاي فعاليت متناسب با معيارهاي فرهنگي جامعهٔ سالمندان ايراني است. روش‌بررسي: اين مطالعهٔ توصيفي‌تحليلي در شهر تهران و بر اساس نمونه‌گيري در دسترس انجام شد. در مرحلهٔ اول پس از كسب اجازه از سازندهٔ تست، به ايجاد آيتم‌ها پرداخته شد. در مرحلهٔ دوم انتخاب آيتم‌ها به‌منظور انجام روايي محتوي و صوري به اجرا در آمد. سپس در مرحلهٔ سوم، پايايي آزمون با بهره‌گيري از هم‌خواني دروني و پايايي آزمون-باز‌آزمون بررسي شد. يافته‌ها: بر‌اساس نتايج حاصل 86 فعاليت براي نسخهٔ فارسي‌شدهٔ تست دسته‌بندي كارت فعاليت در سالمندان ايراني به دست آمد. ضريب آلفاي كرونباخ براي كل تست 84درصد، همچنين براي فعاليت‌هاي روزمرهٔ كارساز 73درصد، فعاليت‌هاي اوقات فراغت كم‌زحمت80 درصد، فعاليت‌هاي اوقات فراغت پر‌زحمت 71درصد و فعاليت‌هاي اجتماعي 70درصد، مؤيد همساني دروني بالاي اين آزمون است و ثبات از طريق آزمون مجدد 98درصد بود. نتيجه‌گيري: نتايج مطالعهٔ حاضر نشان مي‌دهد كه اين ابزار از روايي و پايايي مناسبي برخوردار است. اين ابزار مي‌تواند به‌عنوان سنجشي مناسب جهت بررسي مشاركت سالمندان ايراني در اختيار متخصصان قرار گيرد.

Objectives: The world Health Organization considered participation as an important role in normal aging .Participation is one of the main concepts of International Classification of Functioning, Disability and Health (ICF). Activity is defined as "the execution of a task or action by an individual" while participation is "the involvement in life situations". Activity Card Sort (ACS) is a comprehensive tool to assess participation in instrumental, leisure and social activities. The main version of ACS includes 80 pictures each representing activities done by the American elderly .being a vital part in human's health and development, participation has become a principal concept in field of occupational therapy. Through participation, humans acquire skills and competency, through which they can communicate with others and with their surroundings in order to achieve their purpose and to give sense to their lives .Occupational therapy focuses on enabling individuals and groups to participate in everyday tasks that are meaningful while engaging them in everyday life with others. The purpose of this study is to investigate the cultural adaptation, validity and reliability of Persian version of ACS according to cultural criteria of Iranian elderly population. Materials & Methods: This descriptive-analytic study was conducted in Tehran using available sampling method. Having acquired the permission of test developer, for item generation process, in the first and second phase, 10 elders through diurnal timing schedule and, 40 elders by activity questionnaire were interviewed respectively. In item selection process, 40 elders participated in Delphi survey in 2 rounds to identify common items in Iranian elders. Finally, two panels consisting of elders and experts reviewed all the items. In The third stage, then, test reliability and test-retest were examined using internal consistency. Results: In item generation process for first phase, 3 items were added to previous comprehensive list of activities and in second phase, 130 activities selected and frequency of each activity was defined. In Delphi survey, items above cut point were selected and finally, after two reviews by elders and experts 86 activities were included in Iranian ACS. Cronbach's alpha values for the Persian ACS was 0.84,for instrumental activities 0.73 ,for low physical demand activities 0.80 ,for high physical demand activities 0.71 and for social activities 0.70,indicating high internal consistency of the instrument. The test-retest correlation was 0.98. Conclusion: cultural adaptation was done in every country with different methods. In present study, all existing and applicable methods with respect to time and geographic limits were carried out in order to collect the best and clearest elder’s activities collection, which reflect appropriate Iranian culture .In current study, Item generation and selection process were combination of methods used in Australian and Hong Kong studies. In order to define the area of activities, one expert panel divided activities into Instrumental (31 activities), low demand leisure (24 activities), high demand leisure (11 activities), and social (20 activities).The results of this study indicate that Iranian ACS has good validity and reliability. The number of Iranian ACS activities (86) is similar to American (89) and Arab version (88) and close to Australian version (82), but it is different from Hong Kong version (65). This tool allows professionals to accurately assess the elderly participation rate.