title: Development of a Performance-Based Measure of Executive Functions in Patients with Schizophrenia.
abstract: A performance-based measure for assessing executive functions (EF) is useful to understand patients' real life performance of EF. This study aimed to develop a performance-based measure of executive functions (PEF) based on the Lezak model and to examine psychometric properties (i.e., unidimensionality and reliability) of the PEF using Rasch analysis in patients with schizophrenia. We developed the PEF in three phases: (1) designing the preliminary version of PEF; (2) consultation with experts, cognitive interviews with patients, and pilot tests on patients to revise the preliminary PEF; (3) establishment of the final version of the PEF and examination of unidimensionality and Rasch reliability. Two hundred patients were assessed using the revised PEF. After deleting items which did not satisfy the Rasch model's expectations, the final version of the PEF contained 1 practice item and 13 test items for assessing the four domains of EF (i.e., volition, planning, purposive action, and effective performance). For unidimensional and multidimensional Rasch analyses, the 4 domains showed good reliability (i.e., 0.77-0.85 and 0.87-0.90, respectively). Our results showed that the PEF had satisfactory unidimensionality and Rasch reliability. Therefore, clinicians and researchers could use the PEF to assess the four domains of EF in patients with schizophrenia.
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: En-Chi
authors.initials: EC
authors.lastname: Chiu
authors.affiliation: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.|School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.|Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.|Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Chian-Jue
authors.initials: CJ
authors.lastname: Kuo
authors.affiliation: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
authors.forename: For-Wey
authors.initials: FW
authors.lastname: Lung
authors.affiliation: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Hsueh
authors.affiliation: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D003071:Cognition; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D011795:Surveys and Questionnaires