癌症病人健康相關生活品質之概念與測量工具之評析

The Critical Review of Health-Related Quality of Life (HRQL) Concept and Measure Instrument for Cancer Patients

羅淑芬(Shu-Fen Lo) ； 胡文郁(Wen-Yu Hu)

《安寧療護雜誌》 13卷1期 (2008/02) Pp. 42-57

https://doi.org/10.6537/TJHPC.2008.13(1).4

摘要

本文旨在進行癌症病人健康相關生活品質測量工具之簡介與評析，搜尋1975年至2006年間，八個醫學電子資料庫及六個健康相關生活品質網站，使用「cancer and quality of life」 and 「questionnaire or scale or Instrument or assessment」之檢索策略，總共找出15種癌症病人之健康相關生活品質測量工具。每一個工具本研究者均依據科學諮詢委員會(SAC)提出測量工具的審查標準，針對工具的特性、計分法、心理計量特性、工具敏感性與反應性、工具之可推論性等層面進行工具評析。結果有十一種治癒性醫療處置生活品質測量工具之Cronbach's α大於0.7，且其效度爲可接受，以及部份已進行跨文化量表測試；另有四種測量工具是針對癌症末期病人所發展之生活品質量表，測量工具之易讀性、填表時間及填表時間參考點皆符合癌症末期病人之特性。因此，本文期使在測量癌症病人健康相關生活品時，應就癌症病人處於疾病不同病程、治療或癌症期別，並參考依據測量工具的特性及測量需求與研究目的，選擇適切地生活品質測量工具，方能建立良好的末期臨床照顧與生活品質之臨床實證及本土化資料。

關鍵字

健康相關生活品質 ； 癌症病人 ； 測量 ； 工具

並列摘要

Health-related specialists and policymakers are recognizing the importance of measuring health-related quality of life (HRQL) as a means to improve patient management and policy decisions. The authors reviewed existing measures of HRQL in cancer for research and treatment. Relevant articles were extracted from the eight electronic medical databases and six HRQL website, covering the 30-year period 1975-2006. We carried out searches combining the terms ”cancer”, ”quality of life”, ”instrument”, ”questionnaire”, ”scale”, and ”assessment”. A total of 15 instruments met our inclusion criteria of: (a) report of original research; (b) evaluation of cancer HRQL by self-reporting questionnaires or scales; and (c) publication in English or Chinese. Each instrument was assessed for its general features, feasibility, scoring and interpretation, and psychometric properties. Eleven general cancer-specific QOL instruments and four palliative-specific QOL instruments were found. Most instruments had Cronbach's α＞ 0.7 and acceptable correlation coefficients for convergent/divergent validity. On the other hand, responsiveness, interpretability of the scale score, and validity of test results in cross-cultural settings were either inadequately evaluated or missing. All instruments had a good readability level, an administration time less than 20 minutes, a time horizon of one week or less, and were multilingual. In short, the results of this study provide initial evidence for the reliability and validity of the cancer related HRQL instrument. The findings highlight the diversity that is apparent in the conceptualization among the cancer-related HRQL instruments, suggesting that the potential users of these instruments should base their selection on the characteristics that are most relevant to their particular HRQL measurement needs.

並列關鍵字

health-related quality of life HRQL ； cancer patients ； instrument