Title

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

Translated Titles

Reliability, Validity, and Responsiveness of the Taiwanese Version of QOLBI Questionnaire

Authors

張孟卿

Key Words

創傷性腦部傷害 ; 生活品質 ; 信度 ; 效度 ; 感應度 ; traumatic brain injury ; quality of life ; reliability ; validity ; responsiveness

PublicationName

臺北醫學大學傷害防治學研究所學位論文

Volume or Term/Year and Month of Publication

2005年

Academic Degree Category

碩士

Advisor

邱文達;林茂榮

Content Language

繁體中文

Chinese Abstract

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 摘要 創傷性腦部傷害是許多事故傷害致死及失能的主要原因,這些病患的預後通常承受了生理、認知、行為、情緒和社會適應等問題。腦部傷害病患的預後結果通常是以測量殘疾、失能和社交障礙為主,而他們的健康相關生活品質在國內則是較少被評估,尤其是很少經由病患本身的直接評估。雖然近年來有許多工具用來測量生活品質,但這些量表為一般性問卷之用,並非針對創傷性腦部傷害而設計。特定疾病生活品質問卷是否適合測量健康相關生活品質,是一個值得探討的問題。本研究目的在評估翻譯後中文版「腦部傷害病患生活品質問卷」 (Quality of Life of Brain Injured,簡稱QOLBI ),其包含生理(4題)、智能(7題)、心理(5題)、功能(3題)、社會(9題)和個人(9題)等六大範疇的特定疾病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。內部一致性信度的數值在各範疇中高巴氏α(Cronbach’s α)值皆大於0.7; 再測信度中,內在等級相關係數(Intraclass correlation coefficients) 值皆大於0.45。 收斂效度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、個人範疇的皮爾森相關係數(Pearson’s correlation)大於0.4。在區辨效度方面可以看出有工作者其生活品質分數較無工作者高; 感應度(responsiveness)分析發現有工作對生活品質所產生的變化以生理範疇最明顯,其效應值(effect size) 為0.56; 六個範疇的效應值從0.17 - 0.56,顯示有中度理想問卷感應度。腦部傷害病患生活品質問卷經過驗證,為具有良好的信效度與感應度的量表,是適用於測量國內腦部傷害病患健康相關生活品質的有用工具。 關鍵詞 : 創傷性腦部傷害,生活品質,信度,效度,感應度

English Abstract

Reliability, Validity, and Responsiveness of the Taiwanese Version of QOLBI Questionnaire Abstract In modern industrial countries traumatic brain injury is a common sequel after different kinds of accidents. It is also the major cause associated with significant morbidity and mortality of the accident. The late outcome of patients with traumatic brain injury has been investigated by measuring deficits, disability and social handicap, but their health related quality of life has been less evaluated, and not by a direct analysis of the subjective patient quality of life. Although many instruments has been developed for assessment of quality of life, but most of the instruments are generic not disease-specific, especially not for the patients who suffered from traumatic brain injury. The purpose of this study was to investigate the suitability of the Taiwanese version of Quality of Life of Brain Injured questionnaire (QOLBI). The present investigation examined the psychometric properties of the QOLBI when used in the study of traumatic brain injury (TBI). The Taiwanese version of the 37-item QOLBI is categorized into six domains: physical (4 items), intellectual(7items),psychological (5 items), functional (3 items), social (9 items), personal (9 items). This study examines the practicality, reliability, validity, and responsiveness of the QOLBI in traumatic brain injury. Cronbach’s α coefficients for internal consistence ranged from 0.74 to 0.97. The interclass correlation coefficients ranged from 0.73 to 0.99 for intra-observer variation, and from 0.48 to 0.70 for inter-observer variation. The convergent validity analysis showed Pearson’s correlation coefficients higher than 0.4 in four relating domains: physical, psychological, social, and personal. The scores of the six domains were higher in people who had return to work than in those out of employment.. We used return to work as an external indicator to measure the responsiveness of each QOLBI domain, and the effect sizes of the six domains ranged from 0.17 to 0.56. From this study we conclud that the use of the QOLBI is suitable for the traumatic brain injury. Keywords: traumatic brain injury (TBI), quality of life (QOL), reliability, validity, responsiveness

Topic Category 醫藥衛生 > 預防保健與衛生學
公共衛生學院 > 傷害防治學研究所
Reference
  1. 1. 行政院衛生署統計資料.民91年.
    連結:
  2. 3. 吳敏德.青少年頭部外傷之調查研究.醫學研究J Med Sci 1991;12:104-15.
    連結:
  3. 4. Berger E, Leven F, Pirente N, Bouillon B, Neugebauer E. Quality of Life after traumatic brain injury: A Systematic review of the literature. Restor Neurol Neurosci 1999;14(2-3):93-102.
    連結:
  4. 7. Whiteneck OG: Measuring what matters: Key rehabilitation outcomes. Arch Phys Med Rehabil 1994;75:1073-6.
    連結:
  5. 8. Boswell BB, dawson M, Heininger E: Quality of life as defined by adults with spinal cord injuries. J Rehabil 1998;64:27-32.
    連結:
  6. 9. Robnett RH, Gliner JA: Qual-OT: A quality of life assessment tool. Occup Ther J Res 1995;15:198-214.
    連結:
  7. 10. Jennt B, Bond M. Assessment of outcome after severe brain damage - a practical scale. Lancet 1975;1:480-4.
    連結:
  8. 13. L.E. Pettigrew, J.T. Wilson and G.M. Teasdale, Assessing disability after head injury: improvemed use of the Glasgow Outcome Scale, J Neurosurg. 80(1998), 939-943.
    連結:
  9. 14. Szabo S: The World Health Organization Quality of Life (WHOQOL) assessment instrument. In: Spilker B ed. Quality of life and Pharmacoeconomics in Clinical Trials. 2nd ed. Philadelphia: Lippincott-Raven, 1996;335-62.
    連結:
  10. 15. 姚開屏.健康相關生活品質概念與測量原理之簡介.台灣醫學雜誌2002;6(2):183-91.
    連結:
  11. 16. Ferrans CE, Power MJ: The employment potential of hemodialysis patients. Nurs Res 1985;34:273-7.
    連結:
  12. 18. M. Berger, R.A. Robbit, W.B. Carter and B.S. Gilson, The Sicknesss Impact Profile. Development and Final Revision of a Health Status Measures, Medical Care 19(1981),780-805.
    連結:
  13. 19. Collins R. Lanham RA Jr, Sigford BJ. Reliability and validity of the Wisconsin HSS Quality of Life inventory in traumatic brain injury. J Head Trauma Rehabil. 2000 Oct;15(5):1139-48.
    連結:
  14. 20. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Annals of Internal Medicine 1993;118:622-29.
    連結:
  15. 21. 李登裕:頭部外傷患者健康相關生活品質之探討.台北醫學大學傷害防治學研究所碩士論文.
    連結:
  16. 22. 張彧,王顏和,姚開屏,王榮德.脊髓損傷生活品質問卷之發展.台灣醫學 2002;6(2):209-214.
    連結:
  17. 23. 方啟泰等人.如何設計一份特定疾病所適用之生活品質問卷 - 以愛滋病患為例.台灣醫學 2002;6(2):215-219
    連結:
  18. 24. 季瑋珠,楊志新,許駿,賴佳君.癌症病人特定疾病EORTC生活品質量表簡介.台灣醫學 2002;6(2):220-227.
    連結:
  19. 25. 許嘉純:精神分裂症患者生活品質評量表:中文版信度與效度之研究.國立台灣大學護理學研究所碩士論文.
    連結:
  20. 26. 邱韻寧:世界衛生組織生活品質問卷台灣簡明版在社區老人族群的適用性. 台北醫學大學傷害防治學研究所碩士論文.
    連結:
  21. 28. Deyo RA, Diehr P, Patrick DL.Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Controlled Clinical Trials 1991;12(4 Suppl):142S-158S.
    連結:
  22. 29. Bouchet C, Guillemin F, Dauphin AP, Briabcon S. Selection of quality-of-life measures for a prevention trial: A Psychometric analysis. Control Clin Trials 2002;36(2):310-7.
    連結:
  23. 30. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edn. New York: Lawrence Erlbaum Associates, 1998.
    連結:
  24. 31. David H, Hannah MM. The Effect Size Statistic - Useful in Health Outcomes Research ? Journal of Health Psychology 1998;3(2):163-70.
    連結:
  25. 32. 台灣版世界衛生組織生活品質問卷發展小組, 台灣版世界衛生組織生活品質問卷之發展及使用手冊,1990.
    連結:
  26. 33. O’Neill J, Hibbard MR, Brown M, Faffe M, Sliwinski M, Vandergoot D, Weiss MJ. The effect of employment on quality of life and community integration after traumatic brain injury. J Head Trauma Rehabil. 1998 Aug;13(4):68-79.
    連結:
  27. 參考文獻
  28. 2. Hung CC, Chiu WT, Tsai JC, et al. An epidemiological study of head injury in Hualien County, Taiwan. J Formosan Med Assoc 1991;90:1227-33.
  29. 5. M. Bullinger and the TBI Consensus Group: Quality of life in patients with traumatic brain injury-basic issues, assessment and recommendations. Restorative Neurology and Neuroscience 20(2002) 111-124 IOS Press.
  30. 6. Kozlowski O, Pollez B, Thevenon A, Dhellemmes P,Rousseaux M. [Outcome and quality of life after three years in a cohort of patients with severe traumatic brain injury]. Ann Readapt Med Phys 2002 Nov;45(8):466-73
  31. 11. Runge JW. The cost of head injury [Review]. Emerg Med Clin N Am 1993;11:241-53.
  32. 12. M. Rappaport, K.M. Hall and H.K. Hopkins, Disability rating scale for severe head trauma patients: coma to community, Arch. Phys. Med. Rehabil. 63(1982), 118-123.
  33. 17. M. Bullinger and the TBI Consensus Group: Quality of life in patients with traumatic brain injury-basic issues, assessment and recommendations. Restorative Neurology and Neuroscience 20(2002) 111-124 IOS Press.
  34. 27. 王湘慧:皮巴迪動作發展量表第二版於腦性麻痺兒童的反應性.國立台灣大學物理治療學研究所碩士論文.
Times Cited
  1. 陳怡如(2007)。外傷性腦受傷患者健康相關生活品質之縱貫研究。臺北醫學大學傷害防治學研究所學位論文。2007。1-76。