Cognitive Impairment Screening Test (CIST)에 대한 신뢰도 및 타당도 분석 = Item-Level Psychometrics of the Cognitive Impairment Screening Test (CIST)

다국어 초록 (Multilingual Abstract)

Objective: This study aims to investigate the reliability and validity of Cognitive Impairment Screening (CIST).
Methods: This study used the data of 321 people who responded to the CIST for older adults living in Seoul City. Analysis of this study First, the unidimensionality assumption and local independence were investigated through confirmatory factor analysis. Second, the partial credit model (PCM) among the Rash models was used to investigate the hierarchical structure of item fit and item difficulty. Thirdly, the differential items function was investigated to analyze differences between items due to individual characteristics. Finally, discriminant validity was confirmed using the CIST and depression screening tools (Patient Health Questionnaire-9; PHQ-9).
Results: The mean age of the participant was 8048 (SD = 6.59) years, and there were 45 (14.02) males and 276 (85.98) females. Results of CIST analysis First, as a result of CIST's factor analysis, unidimensionality and local independence were assumed. Second, item fit through Rasch analysis was found to be fit for all six domains (0.6<MnSq<1.4, -2.0<ZSTD<2.0). In addition, the easiest item was orientation, and the most difficult item was executive function. Thirdly, in the differential item function, it was found that there was a differential item function only in the orientation item in sex. Finally, due to the discriminant validity investigation, the correlation coefficient was as low as -.11, showing good discriminant validity.
Conclusion: We reported the reliability and validity results of CIST. Since the reliability and validity of CIST have not been reported until now after the development of CIST, the results of this study are thought to help researchers who want to use CIST.

국문 초록 (Abstract)

목적:본 연구는 인지선별검사(Cognitive Impairment Screening Test; CIST)에 대한 신뢰도 및 타당도를 조사고하자 한다.
연구방법:본 연구는 서울시에 거주하는 일반인 대상으로 CIST에 응답한 321명의 자료를 사용하였다. 총 321명이 응답 완료한 CIST 자료를 활용하여 신뢰도 분석을 위한 첫 번째 단계로 확인적 요인분석을 통해 일차원성 및 지역 독립성(local independence)의 가정을 조사하였다. 두 번째로, 일차원성 및 지역 독립성의 가정을 완료한 항목을 통해 라쉬 모형 중 부분점수모형(Partial Credit Model; PCM)을 적용하여 항목 적합도, 항목 난이도 계층적 구조를 조사하였다. 마지막으로. 항목 간에 개인 특성으로 인한 차이를 분석하기 위해 차등항목기능을 조사하였다.
결과: 대상자의 평균 연령은 80.48세(SD = 6.59)였으며, 남성이 45명(14.02%), 여성이 276명(85.98%)이었다. 본 연구의 신뢰도 분석 첫 번째 단계로 진행한 CIST의 확인적 요인분석 결과, 일차원성과 지역 독립성 가정을 모두 충족 하였다. 두 번째로 진행한 라쉬 분석을 통해 분석된 항목 적합도는 6개 영역 모두 적합(0.6 < MnSq < 1.4, -2.0 < ZSTD < 2.0)하였으며, 가장 쉬운 항목은 지남력, 가장 어려운 항목은 집행기능으로 나타났다. 세 번째로, 성별에서 차등항목기능이 주의집중력 항목에서만 있는 것으로 조사되었다.
결론:본 연구에서는 신뢰도를 분석하여 CIST가 지역사회 노인을 대상으로 시행할 수 있는 인지선별검사도구로 적절한 평가도구임을 확인하였다. 따라서 본 연구 결과를 통해 CIST를 사용하는 연구자 및 임상가들에게 도움이 될 것으로 사료된다.

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