生活品質之概念分析－於探討癌末病人健康相關生活品質之應用

Concept Analysis of Quality of Life for-to Explore the Health Related Quality of Life of Terminal Cancer Patient

胡文鬱(Wen-Yu Hu) ； 戴玉慈(Yu-Tzu Dai) ； 陳慶餘(Ching-Yu Chen) ； 陳月枝(Yueh-Chih Chen)

《安寧療護雜誌》 8卷1期 (2003/02) Pp. 45-60

https://doi.org/10.6537/TJHPC.2003.8(1).5

摘要

現今臨床醫療照顧與世界衛生組織，已日趨重視健康相關生活品質之議題，評量方式也愈趨多樣化，然而生活品質是一個相當復雜的概念，但卻缺乏清楚明确的定義難以形成共識，以及本土性中文的癌末病人生活品質評量工具極待發展。本文采用Walker and Avant提出概念分析的八個步驟，進行生活品質之概念分析，首先經文獻檢索國內外與生活品質相關之期刊與碩博士論文，廣泛地瞭解國內外各學門領域對生活品質的定義與描述，解析區辯常易與生活品質產生混淆的名詞，再繼而确認生活品質的定義性特質、先決條件與結果，并舉出典型、邊際、相關與相反等案例，來加以說明澄清生活品質的概念；最後，列舉有關生活品質評量的方式，以及已發展之癌末生活品質評量工具，做為生活品質的實證性條件。
本文經概念分析的結果，對癌末病人之健康相關生活品質定義為「一個人在疾病末期時，其所處之文化脈絡以及持有的價值系統，對其生活與環境產生的一種主觀幸福感，此感受是包括身體、心理、靈性及社會多層面之正、負向評價。」若一個人無法主觀感受時，可由重要且有意義的家人代為評估，或用客觀指標加以補充來替代個人主觀之生活品質。期望此概念分析對我國癌末患者健康相關生活品質的內涵與測量特性，做為驗證與建立測量工具之參考，有較深入的了解以形成共識，以有效地評價癌末醫療照護之服務品質，并為發展本土化癌末病人生活品質研究之理論知識基礎。

關鍵字

健康相關生活品質 ； 概念分析 ； 癌症末期 ； 生命品質

並列摘要

Quality of life (QOL) is becoming important health issues and a mandatory outcome measure in WHO and Clinical medical care especially during the cancer patients terminally ill trajectory. However, QOL has so many different interpretations and is so complex. Without an agreed-upon definition of the concept, QOL is difficult to measure. Currently, research with Chinese is scarce, the lack of valid and reliable instruments available in the Chinese language. In order to help health care provider to better understand and to promote the patient's QOL in the end of life. Concept clarification is essential for instrument development and evaluation for future use. The data sources of literature review from Mediline, PubMed, CINAHL and Psych-Info database. Then following the eight steps in concept analysis as proposed by Walker and Avant is employed. To differentiate QOL from other closely related concepts, to identify critical attributes of terminal cancer patients QOL, and to present a model case. Moreover, antecedents and consequences of QOL will be addressed and empirical referents will be delineated. The definition of QOL is primarily the perception of subjective well-being encompassing physical, psychological, social and spiritual dimensions. The multidimensional perception is the positive and negative evaluation of an individual s current life circumstance in the context of the culture and value systems in which they live and the values they hold. In the case of unable to subjectively perceive, objective indicators may supplement serve as a proxy assessment of QOL.

並列關鍵字

health related quality of life ； concept analysis ； advanced cancer ； quality of life