視覚障害への心理的適応を測定する尺度 : The Nottingham Adjustment Scale 日本語版の開発 Development and Validation of "The Nottingham Adjustment Scale Japanese Version" which Measures Psychological Adjustment to the Visual Impairment
本研究は, 視覚障害への心理的適応を測定する尺度「The Nottingham Adjustment Scale;NAS」の日本語版(NAS-J)を作成することを目的とした.全国の国立リハビリテーションセンターで訓練を受けている視覚障害者を対象に調査を行い, 計量心理学的な評価を行った結果, 信頼性・妥当性ともに十分な日本語版が作成された.この尺度は, 視覚障害だけでなく, 他の障害や慢性疾患への適用の可能性も考えられる.また, この尺度を使用して, 現在, 視覚障害への心理的適応の構造に関する研究が進行しており, 改めて報告する予定である.
The purpose of this study was to develop the Japanese version of "the Nottingham Adjustment Scale(NAS)" which measured psychological adjustment to the visual impairment, and to assess its validity and reliability. The NAS is composed of 7 psychological subscales including anxiety-depression, self-esteem, attitude to disability, locus of control, acceptance of disability, self-efficacy and attributional style. First, we translated the original questionnaire into Japanese after obtaining the author's approval. Next, We translated the Japanese rendering into English again, and asked the author to confirmed it. This Japanese version was called "the NAS-J(the Nottingham Adjustment Scale Japanese version)". The items of the NAS-J were selected through the pretest with sighted people. Then we conducted a survey of visually impaired people who were engaging in vocational training in 5 national rehabilitation centers. A total of 336 persons were asked to fill out the NAS-J and the SF-36(Health-related QOL scale), and primary diseases inducing visual impairment, eyesight, and the number of years since the present sight became stable were also inquired. As a result of factor analysis, 31 items were retained and 7 factors consistent with the original scale were extracted(51.6% of total variance). Each items contributed 0.5 or more loadings to a supposed factor, and contributed 0.5 or less loadings to the other factors. These results showed the sufficient construct validity, convergent validity and discriminant validity. The subscales of anxiety-depression and self-esteem significantly correlated with most subscales of the SF-36 in sighted people, and thus the concurrent validity was shown. The scores of visually impaired people were lower than those of sighted people in 4 subscales such as anxiety-depression, self-esteem, attitude, and locus of control as the earlier study, and the discriminant validity was confirmed. The reliability coefficients of all subscales were more than 0.7 except that of locus of control. Because the number of items of locus of control was rather small, the reliability coefficients of the subscale was permissible. These results showed the sufficient validity and reliability of the NAS-J as the scale which measures the psychological adjustment to visual impairment. We are constructing the structure model of the psychological adjustment and investigating the effects of the adjustment to handicap. We will publish these results on another occasion.
心身医学 41(8), 609-618, 2001