前言: WHO制定的「2017-2025 年全球失智症行動計畫」，針對第二大行動領域「增進大眾對失智症之認識及友善態度」，訂出到 2025 年，全球的各個國家將至少有一項有效且針對提升公眾失智症意識的社會運動的目標，但相關評估指標僅著重在過程面，並未實際反映大眾對失智症的認識及友善態度，因此本研究欲建立結果面的測量指標－失智症之認識及友善態度問卷調查，此測量工具除了可用於台灣的「失智症防治照護政策綱領暨行動方案2.0」第二大行動領域的調查，未來也可提供作為全球失智症行動計畫新增結果指標之依據。
目的: 1. 翻譯失智症態度量表(Dementia Attitude Scale, DAS)中文版，並驗證其信效度 2. 參考既有文獻，結合失智症知識與態度量表，建立失智症之認識及友善態度問卷調查 (Dementia Awareness and Friendliness Survey, DAFS)中文版，並驗證其信效度 3. 建立失智症之認識及友善態度問卷調查之短版 (Dementia Awareness and Friendliness Survey-Short Form, DAFS-s)，並驗證其信效度。
方法: 研究一: 本研究參照Beaton於2000年提出的翻譯步驟與流程，將DAS原量表由英文經過前翻譯、回覆翻譯與團體討論，翻譯成中文，接著由專家進行量表的內容效度審查，並招募38人進行前驅測試後調整題目。另採方便取樣選取大學生與金融行員共236人作為正式收案樣本，利用古典測驗理論(CTT)分析計算量表中各題目之校正項目總分相關、刪除該題後的內部一致性係數(Cronbach’s α)與鑑別度等指標，進行量表的初步評估以刪減適切性不足的題目。然後以探索性因素分析檢視量表之建構效度，與進行量表構面命名；信度檢定則包含內部一致性及兩週後的再測信度。 研究二: 本研究合併DAS中文版和失智症知識評估量表短版 (DKAS-s)，作為失智症之認識及友善態度問卷調查初版之題目 ，共計33題，之後採方便取樣招募大學生與金融行員共300人進行預試，逐題進行CTT和試題反應理論(IRT)之分析，計算校正項目總分相關與刪除該題後的Cronbach’s α，最終刪除10題、保留23題為DAFS長版。另外調查400名金融行員作為正式收案樣本，以驗證問卷之信效度，並以CTT 和IRT分析建立DAFS短版問卷，比較DAFS長版與短版的結果。
結果: 研究一: DAS翻譯後的量表內容經5位專家檢定後，評定量表的內容效度指數介於0.94-1.00之間，皆達標準。透過項目分析後量化的指標，由原版20題刪除違反3個以上指標的題目，形成17題的DAS中文版，並透過主成分分析萃取出3個因素，依據態度三元理論，分別命名為「認知」、「情感」、「行為」。樣本的推論性結果顯示，大學生對失智症的態度平均分數顯著的高於金融行員。整體量表Cronbach’s α值為0.83。兩週後的再測信度ICC值為0.78。 研究二: 本研究採用雙因素部分給分模型來分析DAFS的信效度，研究結果支持問卷分為兩個構面：失智症認識與失智症態度，呈現良好的模型適配度。23題中大多數題目的infit MNSQ指標均介於0.7-1.3之間，大多數題目提供的測驗訊息量超過整體測驗訊息量的平均值。根據受試者能力及試題難度對照圖，題目的難度範圍主要落在-2到2 logits之間，顯示試題難度可以涵蓋大部分受試者在失智症態度的能力範圍，並涵蓋部分受試者在失智症認識的能力範圍。差異試題功能分析(DIF)顯示大部分題目在性別、職業和失智症接觸經驗具相等之意涵。區辨效度顯示DAFS與歐洲健康識能問卷調查沒有相關。DAFS的試題區分信度係數(ISR)為0.99，失智症認識與失智症態度的受試者區分信度係數 (PSR)分別為0.67和0.82，整體的Cronbach’s α值為0.83。接著以正式樣本資料選取指標結果較佳的10題作為短版問卷(DAFS-s)題目：短版保留了長版42.14%的測驗訊息量。 DAFS-s的題目難度範圍主要落在-2到2 logits之間，與長版範圍大致相同。DAFS-s的ISR為0.98，失智症認識與失智症態度的PSR分別為0.51和0.79，整體的Cronbach’s α值為0.70。效標關聯效度分析顯示DAFS長版與短版問卷的試題難度相關性係數為1，受試者能力估計值的相關性係數均大於0.97，顯示兩者呈現高度相關。
結論: 本研究所發展與驗證的三個與失智友善相關的測量工具包含：(1) 失智症態度量表 (2) 失智症之認識及友善態度問卷調查 (23題長版) (3) 失智症之認識及友善態度問卷調查之短版(10題)，統計分析均呈現出良好的信效度證據，有助於了解非醫療專業人員的受試者對於失智症的認識程度與友善態度。

The WHO proposed the Global action plan on the public health response to dementia 2017-2025 with the second action area on dementia awareness and friendly attitudes. Yet currently there is no tool to evaluate the outcomes of dementia awareness and friendliness among the general populations. This study aimed to develop the Dementia Awareness and Friendliness Survey (DAFS) and its short form for outcome evaluation. This study combined the Shortened Dementia Knowledge Assessment Scale (DKAS-s) and the Chinese version of the Dementia Attitude Scale (DAS-TC) which was translated into Chinese through this study to form the initial DAFS. First, the 23-items DAFS was developed based on results from item analyses and item response theory
analyses using data collected from the first convenient sample (N=236). Second, the psychometric properties of the DAFS were validated and the Dementia Awareness and Friendliness Survey-Short Form (DAFS-s) was developed by another sample of bank staff (N= 400). Two-dimensional partial credit model was used to assess the model-data fit, and results exhibited good fit with two dimensions of the DAFS: dementia knowledge and dementia attitude. Subsequently, 10 questions with better statistical performance were selected as the short form DAFS-s. The three dementia-friendly measurements developed and validated in this study include:(1) DAS-TC (2) DAFS (23 item) (3) DAFS-s (10 item), and all showed good validity and reliability. The three tools will help us to understand dementia awareness and friendly attitudes in general populations without medical backgrounds.

Key words: Dementia awareness, Dementia attitudes, Scale development, Item response theory

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