比較血液透析病患生活品質之心理計量值與效用測量值的差異並探討相關因素

Differences between Psychometric and Utility Measures on quality-of-life and Their Associated Factors in Hemodialysis Patients

楊樹昌(Shu-Chang Yang) ； 王榮德(Jung-Der Wang) ； 吳麥斯(Mai-Szu Wu) ； 郭佩雯(Pei-Wen Kuo) ； 蘇喜(Syi Su)

《台灣公共衛生雜誌》 26卷2期 (2007/04) Pp. 99-109

https://doi.org/10.6288/TJPH2007-26-02-02

摘要

目標：觀察及比較血液透析病患世界衛生組織生活品質問卷台灣簡明版[WHOQOL-BREF(TW)]之生活品質分數，以及標準賭博(SG)法及視覺類比尺度(VAS)法效用值；並探討其影響因素。方法：橫斷調查台北和基隆地區13家血液透析中心共506位長期血液透析病患的生活品質。測量工具為：(1)WHOQOL-BREF (TW)，計算整體生活品質(global QOL)及生理、心理、社會及環境等四範疇之分數；(2)標準賭博及視覺類比尺度效用數值。結果：標準賭博值高於其他測量值，視覺類比尺度值和WHOQOL-BREF (TW)各範疇／項目分數相似。標準賭博值和WHOQOL-BREF (TW)各範疇／項目分數之相關值(0.10-0.20)比視覺類比尺度值和WHOQOL-BREF(TW)各項目分數之相關值(0.22-0.53)低。影響標準賭博值之因素為「教育程度」、「信仰狀況」、「有無併發疾病」、「尿素氮下降率」、「施打紅血球生成素之劑量」；此等因素合起來的整體影響（R^2值0.20）反而比影響視覺類比尺度值或影響整體生活品質分數之因素合起來的整體影響（此2者R^2值都是0.42）少。影響整體生活品質的因素有「地區」、「有無併發症」、及「血紅素」三項。影響視覺類比尺度值的因素有「宗教信仰」及「家庭平均月收入」兩項，R^2為0.42。結論：血液透析病患整體性質的生活品質分數以標準賭博法，視覺類比尺度法或WHOQOL-BREF (TW)問卷的整體生活品質所測有不同，且其影響因素較複雜。

關鍵字

生活品質問卷 ； 標準賭博法 ； 視覺類比尺度法 ； 血液透析

並列摘要

Objectives: The aim of this study was to compare quality-of-life (QOL) scores from WHOQOL-BERF (TW) and QOL values from the standard gamble (SG) method or visual analogue scale (VAS) method in hemodialysis (HD) patients. Comparisons were also made among associated factors of global scores, SG and VAS values. Methods: A cross sectional survey of QOL was conducted in 506 HD patients from 13 HD centers in Taipei and Keelung areas. Instruments included: (1) WHOQOL-BREF (TW) from which scores of global QOL, physical, psychological, social relationship and environment domains were calculated; (2) QOL values of SG and VAS methods based on utility theory. Results: In HD patients, SG values were significantly higher than VAS values, global score and four domains. In contrast, VAS values were about the same as psychometric scores. Pearson correlations of SG values and peychometric scores (0.10-0.20) were relatively lower than those of VAS values and psychometric scores (0.22-0.53). Associated factors of SG values were education, religion comorbidity, urea reduction rate, erythropoietin dosage, with total R^2 only 0.20. Associated factor of global QOL scores were area, comorbidity and hemoglobin level, with R^2 0.42. Associated factors of VAS values were education and family monthly income, with total R^2 0.42. Conclusion: Total QOL measures of SG, VAS, and global QOL from WHOQOL-BREF (TW) in HD patients were significantly different and their associated factors were complex.

並列關鍵字

quality of life ； standard gamble ； visual analogue scale ； hemodialysis

參考文獻

Kaplan K M,Staqaet M J,Hay R D,Payers P M(1998).Profile versus utility based measures of outcome for clinical trials.Quality of Life Assessment in Clinical Trials: Methods and Practice.69-90.

姚開屏(2002)。健康相關生活品質概念與測量原理之簡介。台灣醫學。6，183-92。

Gold M R,Patrick D L,Torrance G W,Siegel J E,Russel L B(1996).Identifying and vluing outcomes.Coat-Effectiveness in Health and Medicine.82-134.

Drumond M F,O`Brien B J,Stoddart G L,Torrance G W(1997).Methods for the Economic Evaluation of Health Care Programs.150-65.