直腸癌術後病人的腸道功能量表之信效度檢定

Validition of Reliability and Validity of the Bowel Function Scale for Postoperative Patients with Rectal Cancer

吳惠蘭(Huei-Lan Wu) ； 邱秀渝(Katie C. Shiu-Yu Lee) ； 江美鳳(Mei-Feng Jiang)

《馬偕護理雜誌》 10卷1期 (2016/01) Pp. 7-19

https://doi.org/10.29415/JMKN.201601_10(1).0001

摘要

臨床直腸癌術後病人返家初期，多存有腹瀉、失禁或便秘等狀況不一的排便問題，但對此問題國內缺乏適當工具監測腸道功能變化情形。目的為發展中文版腸道功能量表，進一步驗證其用於測量台灣直腸癌術後病人腸道功能的變化情形。經徵得同意引用後，進行外文量表之中文版發展過程。先經中文翻譯、翻譯後整合、反向翻譯、專家共識及訂版前預試之五個發展步驟後，以北部某醫學中心59位直腸癌術後病人進行量表之信效度檢定，包括內容效度及同時關聯效度之效度檢定，及以內在一致性、再測信度進行量表信度之檢測。結果腸道功能量表在生活品質範疇中除社會/家庭健全狀況外，Bowel Function Score分數與生理健康、情緒穩定、功能健全、結直腸癌相關事項等範疇與整體生活品質的得分呈中高度顯著相關，具同時關聯效度。在信度部分，量表的內在一致性其Cronbach's α值為.843，顯示題目之間有良好的內在一致性。再測信度在排便次數方面，前後二次的Pearson相關係數為.813，排便症狀的Kappa一致性係數值介於.602-1.0，顯示量表在兩次測試間有良好的穩定度。本研究證實翻譯版的腸道功能量表具可接受的信效度，並且可以做為台灣醫療機構直腸癌病人測量腸道功能變化之工具；可廣泛應用於臨床服務或研究，期使病人得到更完善之健康照護。

關鍵字

直腸癌 ； 排便 ； 腸道功能量表

並列摘要

Most patients with rectal cancer have problematic bowel functions after surgery such as diarrhea, fecal incontinence, or constipation. In Taiwan, there is no appropriate tool for assessing and monitoring the changes in the bowel functions for this group of patients. Purpose: The purpose of this study was to develop a reliable and valid scoring system in Chinese language for measuring bowel function changes in the patients after rectal cancer surgery from a teaching adult hospital. Methods: With permission, a Chinese version of bowel function scale was constructed by the following five steps: translation into Chinese, integration, back translation, achievement of expert consensus, and pretest(s) before finalizing the scoring system. Subsequently, 59 patients after rectal cancer surgery in a northern Taiwan medical center were enrolled to test the reliability and validity of the final version, including content validity, concurrent validity, internal consistency, and test-retest reliability. Results: The score of the Chinese version bowel function scale was significantly correlated with the result of Functional Assessment of Cancer Therapy-Colorectal Cancer (FACT-C) in the physical, emotional, functional, additional-concerns domains, and overall quality of life, but not in the concurrent validity of social or familial sections. The Cronbach's α value was 0.843 for the total scale, suggesting a high internal consistency of the scoring system. For the test-retest reliability, the Pearson correlation coefficient was 0.813 and the kappa coefficient of agreement was between 0.602 and 1.0, indicating a good reliability and validity of the scale. Conclusions: A Chinese version bowel function scale was developed with acceptable reliability and validity. The scale can be used to measure the bowel function changes in patients after rectal cancer surgery and assist with clinical research and better care practice.

並列關鍵字

Rectal cancer ； Defecation ； Bowel Function Scale