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血液透析病人之健康相關生活品質問卷的設計與驗證

The Design and Validation of a Questionnaire for Assessing Health-Related Quality of Life in Patients on Hemodialysis

摘要


健康相關生活品質的測量已逐漸被運用於公共衛生政策的決策分析上。健康相關生活品質的測量問春包括一般性與專一性兩種。一般性測量問卷適用於一般群體,所得的測量結果可用於比較不同群體間的差異,但其可能不適用終特殊群體。專一性測量問春則僅適用終特殊群體,所得的測量結果無法用於比較不同群體問的差異。本研究的目的在於發展一份一般性的中文問春,再針對不同疾病,加入較特定之問題,使其兼具一般性及專一性問春的優點。利用此問卷,向多向度觀點來測量血液透析患者的健康相關生活品質,並對問春的效度及信度進行檢定,希望能夸展出一份適合我國文化背景的健康相關生活品質問卷。 本研究採橫斷研究法,以1993年8月至11月期間,在臺北市三所教學醫院之血液透析中心接受長期血液透析,能夠並願意接受訪問的所有末期腎病息者為研究對象。由標準化訪視員以結構式問卷進行訪視及再劃。共有125名患者完成訪問,回應率為90%。 研究結果發現,本問卷經因素分析顯示包含生理社交功能、生理精神症狀及認知功能三個因素;在複迴歸模式中,生理、心理及社會三個向度所含各臨床量表之得分對於患者主觀自評之健康相關生活品質效用數值的變異量具有33.75%的解釋能力。由因素分析及複迴歸分析的結果顯示本問卷在健康相關生活品質的測量上具有良好的建構效度及不錯的預測效度。對於不同的訪視者、不同的訪視時間、不同的訪視方法或訪視情境,本問卷前後兩次的測量結果間均呈顯著的相關,顯示本問卷在健康相關生活品質的測量上具有良好的信度。 綜合言之,本問卷適合用於評估血液透析患者之健康相關生活品質。未來若能將本問卷中的一般性量表加以簡化,並加重專一性量表的份量,尤其是心理向度方面之量表,將能使本問卷更具效度、信度及接受性。

並列摘要


The measure of health-related quality of life (HRQL) has been used progressively in public health decision making in recent years. HRQL can be assessed by either generic or specific instruments. A generic instrument is applicable to a wide variety of population and allows comparisons among different conditions, but may not be suitable for a specific population. A specific instrument can only be applicable to a specific population with the goal of detecting minimally important changes in condition-specific HRQL, but does not allow comparisons among different conditions. The purpose of this study is to develop a Chinese questionnaire using generic measures with disease- specific supplements based on multidimensional (phsical, mental and social) concept for assessing HRQL in patients and to evaluate its validity and reliability. This is a cross-sectional study. The subjects of this study consisted of all the patients of end-stage renal disease receiving maintenance hemodialysis at the hemodialysis room of three teaching hospitals in the Taipei between August 1993 and November 1993. Interviews were undertaken by standardized interviewers with a structured questionnaire. 125 subjects completed the interview. The response rate is about 90%. The result shows that this questionnaire contains three factors including physical-social function, physical-mental function and cognitive function; In the regression model, this questionnaire can explain 33.75% of the variance of the subjective utility value of HRQL of patients receiving hemodialysis. It implies this questionnaire has good performance in construct validity and predicting validity in the assessment of HRQL of patients receiving hemodialysis. It gets consistent results by different interviewers and methods and at different interviewing time and situations. That is to say, this questionnaire has good reliability in the assessment of HRQL of patients receiving hemodialysis. We conclude that this questionnaire is good enough for evaluating HRQL in hemodialysis patients. However, adding some more supplementary questions over mental dimension in the future will probably further improve its performance.

被引用紀錄


陳彩惠(2008)。醫護人員對肺結核知識、態度、行為 之研究〔碩士論文,元智大學〕。華藝線上圖書館。https://doi.org/10.6838%2fYZU.2008.00085
鍾佩欣(2004)。癲癇病童與非癲癇兒童的頭痛症狀對其生活品質與學習適應影響之探討〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2004.01208
楊梅香(2000)。充血性心臟衰竭患者運動耐力對其生活品質影響之探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714450637

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