背景：輕度頭部外傷（Mild traumatic brain injury, MTBI）佔所有創傷性腦損傷（TBI）約80%，為相當普遍的公共衛生議題。過去研究顯示約7%至45%的MTBI 患者在受傷後仍面臨顯著的心理、社會及人際困擾，影響其生活品質並增加家庭與社會負擔。儘管MTBI患者受傷後的自我概念變化之討論已相當豐富，但臨床上仍缺乏一個能有效評估其復原歷程的標準化工具。有鑑於此，本研究旨在編製一份可辨識MTBI患者調適歷程中自我概念變化之量表，並檢驗其心理計量特性，以期提供臨床評估之參考依據。
方法：本研究根據四階段歷程理論（衝擊失落、退回保守、探索嘗試、流動平衡）編製輕度頭部外傷患者自我概念歷程量表（Mild Traumatic Brain Injury Self-Identity Scale, MTBI-SIS）之題項，並經三位臨床心理師進行專家效度評估。後續於台灣北部兩間醫學中心共招募40位符合診斷標準之MTBI患者作為樣本，進行項目分析、內部一致性分析、效度檢驗（包含內容效度、建構效度與校標關聯效度）與因素分析。除此之外，納入臨床變項，例如：腦震盪症候群（Post-concussion syndrome, PCS）嚴重程度、PCS對生活影響與恢復歷程時間等，進行差異與相關分析。
結果：MTBI-SIS具良好的心理計量特性。四個分量表中，「衝擊失落」、「探索嘗試」與「流動平衡」之內部一致性良好（α= .74～.84）；「退回保守」分量表則略低（α= .6）。探索性因素分析支持量表結構，累積解釋總變異量達60%以上，具良好之建構效度。MTBI-SIS分數與校標工具，頭部外傷語意差異量表-第三版（Head Injury Semantic Differential Scale, HISDS-III）間亦呈現顯著相關，具良好校標關聯效度。臨床效度方面，MTBI-SIS得分與PCS嚴重程度、生活影響程度及恢復歷程時間等變項皆呈現顯著關聯，具辨識不同復原階段心理特徵之能力。
結論：本研究初步建構並驗證MTBI-SIS，結果顯示該量表具備良好的信效度，能有效反映MTBI患者於不同復原階段中的心理調適特徵。整體而言，MTBI-SIS可作為臨床評估與個別化介入之實用工具，未來建議擴大樣本與進行縱貫驗證，以強化其應用性與理論價值。

Background: Mild traumatic brain injury (MTBI) accounts for approximately 80% of all traumatic brain injuries (TBI), representing a prevalent public health concern. Previous research has shown that 7% to 45% of MTBI patients continue to experience significant psychological, social, and interpersonal difficulties post-injury, impacting their quality of life and placing a burden on families and society. Although the literature has extensively discussed changes in self-concept following MTBI, there remains a lack of standardized tool in clinical settings to effectively assess the recovery process. This study thus aimed to develop a scale to identify changes in self-concept throughout the adjustment process in MTBI patients and to examine its psychometric properties, with the goal of informing clinical assessment.
Methods: Based on a four-stage recovery framework (Loss, Retreat, Exploration, and Fluidification), the Mild Traumatic Brain Injury Self-Identity Scale (MTBI-SIS) was developed. Initial items were evaluated for content validity by three licensed clinical psychologists. Subsequently, 40 MTBI patients who met diagnostic criteria were recruited from two medical centers in northern Taiwan. Analyses included item analysis, internal consistency reliability, validity tests (content validity, construct validity, and criterion-related validity), and exploratory factor analysis. Clinical variables—including post-concussion syndrome (PCS) severity, impact of PCS on daily life, and recovery duration—were also incorporated to examine group differences and related correlations.
Results: The MTBI-SIS demonstrated sound psychometric properties. Among the four subscales, "Loss," "Exploration," and "Fluidification" showed good internal consistency (α = .74–.84), while "Retreat" was slightly lower (α = .6). Exploratory factor analysis supported the factor structure, with a cumulative explained variance exceeding 60%, indicating good construct validity. Significant correlations with the criterion tool, Head Injury Semantic Differential Scale (HISDS-III) further supported criterion-related validity. In terms of clinical validity, MTBI-SIS scores were significantly associated with PCS severity, impact on daily life, and recovery duration, demonstrating the scale’s sensitivity in distinguishing patients at different stages of psychological adjustment.
Conclusion: This study developed and validated the MTBI-SIS preliminarily. Results indicate that the scale possesses good reliability and validity and effectively reflects the psychological adjustment characteristics of MTBI patients across different recovery stages. Overall, the MTBI-SIS offers a practical tool for clinical assessment and individualized intervention. Future studies are recommended to expand the sample size and adopt longitudinal designs to further strengthen its clinical utility and theoretical contribution.

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