精神科病人生活品質量表之信效度

Reliability and Validity of the Quality of Life Scale for Psychiatric Patients (QLSP)

鄭若瑟(Joseph J. Cheng) ； 歐陽文貞(Wen-Chen Ouyang) ； 李鳳墀(Sandy F. C. Lee)

《台灣精神醫學》 20卷1期 (2006/03) Pp. 19-31

https://doi.org/10.29478/TJP.200603.0003

摘要

目的：發展一本土性，簡短易用之『精神科病人生活品質量表』，並檢定其信效度。方法：140名急性、半自治、自治病房、社區居家治療及社區久未治療精神病人使用本量表評估，其中31名個案進行錄音會談由3名評估做評估者間信度。結果：評分者間信度ICC(intraclass correlation)0.68~1，平均0.88，90%題在0.7以上，相當良好；各層面之內部一致性，Cronbach's alpha在0.45~0.84之間，7個客觀層面之alpha值0.76，7個主觀層面0.84，全部層面0.82皆在良好範圍。建構效度以因素分析得：「生活感受」、「資源獲得」、「精神功能」、「社會功能」、「身體功能」5組因素，總解釋量68.02%，符合本量表設計所依據之Lehman生活品質概念架構。以GAF(Global Assessment of Functioning)及PANSS(Positive and Negative Scale for Schizophrenia)與本量表檢定聚合和區辨效度頗符合研究假設。五組病人之得分做反應度檢定，effect size都夠大，方向亦如預期，解釋性良好，本量表之使用負荷（30~40分鐘）在可接受範圍。結論：本量表未來可應用在各式精神科病人個別需求評估、治療計畫擬定、預後狀態、治療結果、醫療經濟學研究上的評估。

關鍵字

生活品質 ； 量表 ； 信效度 ； 精神疾病

並列摘要

Objectives: The Quality of Life Scale for Psychiatric Patients (QLSP) is a recently developed instrument which was designed for ease of use and cross cultural adaptability. This study describes the development of this instrument and also the analysis of its reliability and validity. Methods: The QLSP was administered to 140 psychotic patients selected from acute, middle function, high function chronic wards, as well as from the community residents in both treated and non-treated groups. Administration in a subset of 31 cases was audio taped and rated by 3 raters to analyze inter-rater reliability. Results: The ICC of the QLSP ranged from 0.68 to 1 (average 0.88) showing that the inter-rater reliability was good. Cronbach's alpha of each objective and subjective domains ranged from 0.44 to 0.84; with mean alpha among the objective domains of 0.76 and among the subjective domains of 0.84, all indicating good internal consistency. Exploration of construct validity by factor analysis extracted the following 5 factors: life perception, resource assessment, mental function, social function and physical function, all of which explained 68.02% of the variance, supporting Lehman's concept of quality of life. Convergent and discriminant validity were tested against GAF and PANSS, lower objective QLSP were correlated with poorer GAF and PANSS score, meet research assumption. Testing of interpretability and responsiveness among the 5 patient groups by ANOVA and Cohen's d effect size revealed satisfactory results. QLSP assessment took 30~40min, an acceptable scale burden. Conclusion: This study has demonstrated that the QLSP is a reliable and valid instrument for outcome, needs and treatment planning, as well as health economic research in psychiatric patients.

並列關鍵字

quality of life ； scale ； psychometry ； psychiatric disorder

參考文獻

Katschnig H(1997).How useful is the concept of quality of life in psychiatry?.Current Opinion in Psychiatry.10,337-345.

Jacobson A,Barofsky I,Cleary P(1988).Reliability and validity of a diabetes quality of life measure for diabetes control and complications trial (DCCT).Diabetes Care.11,725-732.

Cheatle MD(1991).The effect of chronic orthopedic infection on quality of life.Orthopedic Clinics of North America.22,539-547.

Juniper EF,Buist AS,Cox FM,Ferrie PJ,King DR(1999).Validation of a Standardized Version of the Asthma Quality of Life Questionnaire.Chest.115,1265-1270.

Kaplan RM,Anderson JP,Patterson TL,McCutchan JA,Weinrich JD,Heaton RK(1995).Validity of the Quality of Well-Being Scale for Persons With Human Immunodeficiency Virus Infection.Psychosom Med.57,138-147.