發展中文版肺癌曼徹斯特疲憊量表與信效度檢測

本研究目的為發展中文版肺癌曼徹斯特疲憊量表(Lung Cancer Manchester Fatigue Scale Chinese Version, LMFS-C)，並進行信效度檢測。於台灣南部一間醫學中心進行資料收集，計有 312 名肺癌病人；其中住院159名及門診153名。本研究經回覆翻譯及專家效度討論與認可後，以信度檢測量表之內在一致性，在前驅研究與正式研究 Cronbach's α 皆為0.97，兩週後之再測信度為r=0.93(p<0.000)，顯示此量表具有良好之內在一致信度及穩定的再測信度。聚合效度檢測與台灣版簡明疲憊量表(BFI-T)相關係數r值 =0.71(p<0.000)，區別效度以流行病學憂鬱量表(CES-D)檢測，其檢定統計量 t(312)=-9.595(p<0.000)，顯示有憂鬱症狀者疲憊程度較高；效標關聯效度以中文生活品質量表-肺癌(FACT-L)與台灣版安德森症狀量表(MDASI-T)進行相關檢測，其相關係數 r=-0.80(p<0.000) 與r=0.73(p<0.000)；鑑別效度檢測以住院及門診病人進行疲憊程度檢測，其檢定統計量 t(312)=10.557(p<0.000)，證實肺癌住院病人的疲憊程度高於門診病人；顯示本量表具有良好的效標關聯效度、敏感度可準確的評估肺癌病人疲憊程度之評估工具。另以探索性因素分析驗證其建構效度，依據原始量表共分析出生理、認知、心理社會三大構面，可解釋 57.34%變異量，雖各題項歸類與原始量表不相同，但於題項歸類後檢定量表內在一致性 Cronbach's α為0.94，量表與各構面相關性，於生理、認知、心理社會相關係數 r 值依序為 0.92、0.88、0.91 (p<0.000)，顯示此量具有良好之建構效度，可有效的檢測出肺癌病人疲憊，此量表題項簡單易填寫，臨床上約4至7分鐘可填寫完成，且可了解肺癌病人於生理、認知及心理社會層面的疲憊感受，並符合台灣本土的語意，是具有極佳的信度與效度之評估工具可用以檢測病人以及區辨其疲憊症狀。

關鍵字

肺癌；疲憊；疲憊量表；信度；效度

並列摘要

The aim of this study was to develop the Chinese version of the Lung Cancer Manchester Fatigue Scale(LMFS-C) and conduct a reliability and validity test on this scale. Data were collected in a medical center in southern Taiwan, with 312 lung-cancer patients being used as samples:153 outpatients and 159 inpatients. After a thorough translation and expert discussion on the validity, the internal consistency measured. Cronbach's α was obtained at 0.97 in the pilot study and official study, whereas the test-retest reliability was obtained at r=0.93(p<0.000) two weeks later, indicating a stable internal consistency and test-retest reliability. The coefficient of a convergent validity test and the Brief Fatigue Inventory in Taiwan(BFI-T) was read as r=0.71(p<0.000) whilst the discriminant validity was tested by the CES-D, which showed t(312)=-9.595(p<0.000). This indicates that patients with depression are prone to fatigue. The criterion-related validity was obtained using FACT-L and MDASI-T, resulting in r=-0.80(p<0.000) and r=0.73(p<0.000), respectively.The divergent validity was performed on inpatients and outpatients to determine their level of fatigue, resulting in t(312)=10.557(p<0.000). This evinces demonstrates that inpatients with lung cancer were prone to feeling more tired than were outpatients and proves satisfactory criterion-related validity and sensitivity when assessing the patients’ level of fatigue. Exploratory factors were used to test the construct validity of the scale.The physiological, cognitive, and psychological and social constructs were then analyzed, which accounted for 57.34% variances. Even if the categorization of each item differs from that of the original scale, the internal consistency was read as Cronbach's α=0.94, while the relevance in physiological, cognitive, and psychological-social constructs were read as r=0.92, 0.88, and 0.91(p<0.000), respectively. This indicates satisfactory construct validity of the scale, enabling the assessment of the level of fatigue in lung cancer patients. The questions in this scale are easy to understand and requires only 4-7 minutes to complete. Moreover, it is written in comprehensible Taiwanese Mandarin and can be effectively utilized to understand how lung cancer patients feel physiologically, Cognitively, and psychologically and socially. All in all, it is an assessment tool that exhibits satisfactory validity and reliability when applied to patients to determine their level of fatigue.

並列關鍵字

Lung Cancer ； Fatigue ； Fatigue Scale ； Reliability ； Validity

參考文獻

Giuliani, M. E., Milne, R. A., Puts, M., Sampson, L. R., Kwan, J. Y., Le, L. W., . . . Jones, J. (2016). The prevalence and nature of supportive care needs in lung cancer patients. Curr Oncol, 23(4), 258-265. doi:10.3747/co.23.3012

中文部分