腦部傷害病患生活品質問卷中文版信度、效度與感應度之評估

目標：利用特定疾病生活品質問卷來測量腦部傷害病患的健康相關生活品質的適用性。方法：評估翻譯後中文版「腦部傷害病患生活品質問卷」(Quality of Life of Brain Injured，簡稱QOLBI)，其中包含生理、智能、心理、功能、社會和個人等六個範疇生活品質問卷的信度、效度與感應度等心理計量特性。研究對象是台北地區22家醫院因創傷性腦部傷害而就醫年齡18歲以上的病患，共有100位病患接受電話訪談。結果：內部一致性信度的數值在各範疇中高巴氏α(Cronbach's α)值為0.74~0.97；再測信度中，相同訪員的內在等級相關係數(Intraclass correlation coefficients)值為0.73~0.99。收斂效度方面，QOLBI與世界衛生組織生活品質簡明版問卷(WHOQOL-BREF)，在生理、心理、社會、及個人範疇的皮爾森相關係數(Pearson's correlation)皆高於0.4；鑑別效度方面，QOLBI的六個範疇都能顯著區辨有工作者其生活品質分數較無工作者高；驗證型因素分析之比較適合度指標(CFI)為0.86。感應度(responsiveness)分析發現工作對生活品質所產生的變化以生理範疇最明顯，感應度為0.56，其他範疇為0.17~0.43。結論：「腦部傷害病患生活品質問卷」雖然尚適用於測量國內腦部傷害病患健康相關生活品質，但仍有改善之處。

關鍵字

創傷性腦部傷害；生活品質；信度；效度；感應度

並列摘要

Objectives: The suitability of the disease-specific Quality of Life of Brain Injured questionnaire (QOLBI) was determined in individuals with traumatic brain injury (TBI). Methods: One hundred subjects with TBI aged 18 or older were recruited from 22 hospitals in northern Taiwan. The translated Taiwanese version of the 37-item QOLBI is categorized into six domains: physical, intellectual, psychological, functional, social, and personal. Results: Cronbach's α coefficients for internal consistency ranged from 0.74 to 0.97, while the interclass correlation coefficients for test-retest reliability were from 0.73 to 0.99. For convergent validity, Pearson’s correlation coefficients comparing the QOLBI and WHOQOL-BREF in the domains of physical, psychological, social, and personal were each more than 0.4. When discriminant validity was assessed, all six QOLBI domain scores were significantly higher for subjects who returned to work compared with those who did not return to work. The Comparative Fit Index of the confirmatory factor analysis was 0.86. As the return to work was used as an external indicator to measure the responsiveness of each QOLBI domain, the effect sizes of the six QOLBI domains ranged from 0.17 to 0.56. Conclusions: Results indicate that, although there is room for improvement, QOLBI is an acceptable instrument for assessing quality of life persons with TBI.

並列關鍵字

traumatic brain injury ； quality of life ； reliability ； validity ； responsiveness

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