A Study on the Reliability and Validity of the Korean Version of Internalized Stigma of Mental Illness Scale (K-ISMI) / 신경정신의학

OBJECTIVES: The Internalized Stigma of Mental Illness (ISMI) scale designed to measure the subjective experience of stigma with sub-scales measuring Alienation, Stereotype Endorsement, Perceived Discrimination, Stigma Resistance, and Social withdrawal. The purpose of this study was to examine the reliability and validity of the Korean version of ISMI. METHODS: The subjects were 194 schizophrenic patients and 205 peoples with depressive disorder. K-ISMI, CES-D (The Center for Epidemiologic Studies Depression Scale) and Self Esteem scale were performed. RESULTS: Results showed that the ISMI had high internal consistence and split-half reliabilities. The internal consistency coefficients (Cronbach alpha) of each subscale ranged from .83 to .93. The validity of the ISMI was investigated by principal axis factoring analysis, yielding 5 factors of alienation, perceived discrimination, negative stereotype, stigma resistance, devaluation and social withdrawal. 5 subscales explained 60.67% of total variance. Concurrent validity was supported by comparisons against scales measuring related constructs. As expected, the ISMI had positive correlations with CES-D, and it had negative correlation with self-esteem scale. Subsidiary analysis showed that schizophrenic patients showed higher internalized stigma than depressed patients. CONCLUSION: Overall, the findings support the utility of ISMI as a tool to evaluate internalized stigma of persons with mental illness. Interventions that can lessen internalized stigma may well hasten the recovery process in individuals with mental illness.

A Study on the Reliability and Validity of Seoul-Instrumental Activities of Daily Living(S-IADL) / 신경정신의학

OBJECTIVES: Seoul-Instrumental Activities of Daily Living (S-IADL) was developed to assess elderly person's instrumental everyday activities. This study aims to develop standardized IADL assessment scale and to confirm the reliability and validity of the S-IADL. METHODS: The 336 controls were included in standardization study. Reliability and validity of S-IADL were tested by 72 Alzheimer's disease patients and 72 controls matched to age, sex, and education. We also conducted Receiver Operating Characteristics curve for sensitivity and specificity of S-IADL. RESULTS: Because of positively skewed distribution of S-IADL, standardization data were presented using 1SD and 2SD value. Internal consistency, test-retest reliability, and interrater reliability were statistically significant. Principal axis factoring analysis revealed two factors that accounted for 59.95% of the total variance, and second factor was items sensitive to sex (3.preparing food/cooking, 4.household chores). S-IADL was correlated significantly with other standardized cognitive measures, demonstrating good convergent validity. With a cut-off point of 8, the S-IADL had a sensitivity of 83.3% and specificity of 93.1% in the diagnosis of dementia. Also, with a 2SD standardized data, sensitivity was 81.9% and specificity was 93.1%. CONCLUSION: Our study showed that the S-IADL could be a reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-IADL had higher sensitivity and specificity than other IADL instruments, suggesting that it is useful to early detection of dementia.

The Standardization of the Ge riatric Quality of Life s cale-Dementia(GQOL-D)

Objectives : We developed the instrument to assess the quality of life(QOL) for demented patients, 'Geriatric Quality of Life-Dementia(GQOL-D)'. The purpose of this study was to standardize the GQOL-D and to introduce administration results in Korean demented patients. METHODS: The normal subjects were 340 elderly people, aged over 55 years old, who were physically and cognitively normal. And the patient group was consisted of 69 demented patients. RESULTS: Both in normal group and in patient group, the internal consistency, Cronbach's = 0.87, 0.90, respectively, and item-total correlation was acceptable. And the test-retest reliability revealed the stability across time by r=0.86, 0.77, respectively. Criterion validity was found to be a high correlation between each itemand overall QOL' item, and adequate correlations between the GQOL-D and scales assessing cognition, psychological wellbeing, behavior and activities of daily living convinced convergent validity. In the result of factor analysis, 2 factors with a variance percentage of 37.7% were extracted. The mean score and standard deviation of items of the GQOL-D for two groups and differences in items such as memory, recreation/leisure, self esteem, general health, and mobility between groups were presented. CONCLUSION: It was confirmed that there is no difficulty for old people to carry out the GQOL-D. As it was suggested that there is enough room for intervening in dementia patients' emotional and behavioral difficulties, the GQOL-D will be useful in research and clinical practice for the patients with dementia.

A Study on the Reliability and Validity of Seoul-Activities of Daily Living(S-ADL)

OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.