本研究旨在修編精神疾病患者之日常生活功能評量表第四版，目的：為確認評量表具有信度與效度，並符合現代生活功能之需求。方法：研究對象分 2 組，對照組為健康無疾病者 60 人，另一為病例組，取自某精神專科醫院及附設精神復健機構的精神病患者 182人。人口學資料 2 組除了教育年相差 1 年多之外，其他條件均未有顯著差異。結果：本量表經 16 位資深專家評定符合內容效度；於信度方面，病例組與對照組之 Cronbach’s α 分別為 .519~.938 與 .619~.915，顯示其具備可接受至良好的測驗穩定性。同時，兩組於 2週重複測量分數之相關係數介於 .704~.932 與 .618~.904，顯示此工具具備可接受至良好的再測信度。從量表總分之差異性考驗，對照組 89.24 分；病例組 64.83 分，顯示本量表具有良好公眾群體效度；於效標關聯效度方面，結果顯示 ADLRS-IV 與 ADLRS-III 總分之相關係數為 .818，支持 ADLRS-IV 可提供與舊版同等有效的日常生活功能分數，ADLRS-IV 具有良好的效標關聯效度。由於 ADLRS-III 採用 70 分為正常標準的分數，且本研究結果顯示超過 95% 的對照組分數超過此標準，故 ADLRS-IV 亦採用 70 分為正常標準，將70 分以上者視為正常，並進一步分為優、良與可三個等級；並將 70 分視為障礙標準，並分為輕、中、重與極度 4 個等級，以便與臨床經驗及觀察結合。結論：本量表具有良好的信效度，評量等級可作為臨床上擬定精神病人治療計畫之依據。

This study aimed to develop the Activities of Daily Living Rating Scale, 4th edition (ADLRS-IV). Objectives: To modify the content of the scale from its previous edition in order

to better reflect the current standards of people’s daily life and functioning and to establish validity and reliability of the ADLRS-IV. Methods: We recruited 60 healthy participants

without diagnoses as the control group; the test group consisted of 182 participants with psychiatric disorders from a regional psychiatric center and community-based rehab programs.

Demographic data showed no significant differences between the two groups except for a one-year difference in education level. Results: The scale was evaluated by 16 content

experts and was deemed to meet content validity. Cronbach’s α was between .519 and .928 for the test group and between .619 and .915 for the control group, indicating acceptable to

good internal consistency reliability. The test-retest administration with a two-week interval revealed correlation coefficients between .704 and .932 for the test group and between .618

and .904 for the control group, indicating acceptable to good test-retest reliability. The mean total score of the ADLRS-IV for the control group was 89.24 and for the test group was 64.83, suggesting the tool’s capability to distinguish between diagnostic and healthy groups (known-groups validity). Criterion-related validity was supported through the high correlation (r=.818) between the scores of ADLRS-IV and ADLRS-III, indicating the revised tool has a comparable level of test accuracy as its precursor. Adopting the cutoff score of 70 previously established by the ADLRS-III, the ADLRS-IV yielded 95% of the control group who exceeded the cutoff. To enhance clinical practicality of the ADLRS-IV, we further calibrated the test scores into seven levels: three “normal” levels above the cutoff of 70 (excellent, good, and acceptable) and four “disabling” levels below the cutoff (mild , moderate, severe, and very severe). Conclusion: The ADLRS-IV has good reliability and validity and can help determine the degree of a client’s functional disability and, as a result, develop a suitable intervention plan.