臺灣博碩士論文加值系統

慢性阻塞性肺疾病為一長期、慢性、且無法完全恢復的呼吸道疾病，不但使身體活動功能受損，造成許多生理上的不適，更會造成負向的心理情緒，對生活品質有很大的衝擊。要照護此類病人除了要控制疾病症狀外，最重要的就是增進其生活品質，而生活品質量表可以讓醫護人員瞭解疾病造成病人的影響程度，進而從中介入，幫助病人增進其生活品質。此外，隨著全球資訊交流頻繁，更應加強不同文化差異的比較，所以，不同語言版本的量表成為研究發展重要的課題。本研究主要目的是發展中文版「聖喬治醫院呼吸症狀問卷－慢性阻塞性肺疾病版（the Chinese version of the St. George’s Respiratory Questionnaire for COPD patients, SGRQ-C）」，並進行信效度檢定。
本研究以翻譯國外量表之兩階段設計進行研究，先經翻譯、反翻譯過程將SGRQ-C量表翻成中文，再進行信效度檢定。以立意取樣方式選取台北某兩間醫學中心胸腔內科門診之慢性阻塞性肺疾病病人為研究對象進行收案，收得有效問卷84份，加上鄭（2009）的66份，共150份有效資料，使用的問卷包括基本屬性、中文版「聖喬治醫院呼吸症狀問卷－慢性阻塞性肺疾病版」及台灣版簡明世界衛生組織生活品質量表，並施測肺功能及六分鐘步行測試，運用SPSS for window17.0作描述性及推論性統計，以百分率、平均值、皮爾森積差相關、t-檢定等方法進行統計，p < 0.05視為達到統計上的顯著意義。
研究結果顯示總量表及三個次量表信度檢定的內在一致性度Cronbach’s α介於0.753-0.930之間，折半信度介於0.687-0.883間，再測信度介於0.517-0.616間。效度檢定結果顯示專家效度CVI值為0.95，與WHOQOL-BREF台灣版之效標關聯效度的相關係數在-0.230~-0.674間(p＜0.05)；區辨效度t值介於-5.501~-8.464，p皆＜0.05，並以疾病嚴重度作比較，顯示中文版SGRQ-C比台灣簡明版世界衛生組織生活品質問卷更適用於測量台灣慢性阻塞性肺疾病病人之生活品質。
綜言之，中文版SGRQ-C量表具有良好的信效度，可提供未來醫護人員評估慢性阻塞性肺疾病病人疾病特定性生活品質的研究工具。

Chronic obstructive pulmonary disease (COPD) is a long-term, chronic, and cannot be fully restored respiratory diseases. Not only the physical activity functions are damaged, causing many physical discomfort, but also negative to the psychological conditions, which in turn impacts on the quality of life. In addition to control the disease symptoms, the most important care is to improve patients’ quality of life. The quality-of-life instruments will help the health care providers to understand the degree of impact on patients, which in turn they can improve the quality of life of the patients using intervention. In addition, the global information exchanges have been increasing, cultural comparison should be emphasized. The purpose of this study tested reliability and validity of the Chinese version of the St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C).
The SGRQ-C had translated into Chinese version using a back- translation procedure. A purposive sample of 84 COPD outpatients were recruited from two medical centers in Taipei. Sixty-six outpatients from Cheng (2009) were included and 150 valid data in total. The question- naires used in this study included demographic characteristics, the Chinese version of SGRQ-C, WHOQOL-BREF Taiwan version. In addition, lung function and 6 minutes walk test were measured. Percentage, mean, score index, Pearson correlation, t-test had used for data analysis. p < 0.05 were considered as the statistical significance.
The result revealed that the Cronbach’s α for total scale and three subscales were between 0.753 and 0.930. The Split-half reliability was between 0.687-0.883, and Test-retest reliability was between 0.517-0.616, CVI=0.95. The Chinese version of SGRQ-C was significantly correlation with the WHOQOL- BREF Taiwan version. The discriminating validity of the Chinese version of SGRQ-C was between -5.501~-8.464 (p＜0.05). According to the disease severely, the Chinese version of SGRQ-C is more applicable to survey the quality of life of chronic obstructive pulmonary disease patients in Taiwan than the WHOQOL- BREF Taiwan version.
In conclusion, the Chinese version of SGRQ-C has internal con- sistency and strong evidence of content, concurrent, and discriminating validity for COPD patient in Taiwan. These findings suggest that it is a useful disease-specific instrument and can be used in the future study.

第壹章 緒論
第一節 研究背景及重要性 …………………………………………1
第二節 研究目的 ……………………………………………………4
第三節 研究問題 ……………………………………………………5
第貳章 文獻查證
第一節 慢性阻塞性肺疾病之相關概念 ……………………………6
一、慢性阻塞性肺疾病的定義 ……………………………6
二、慢性阻塞性肺疾病的致病機轉及病生理變化 ………6
三、慢性阻塞性肺疾病的診斷與分期 ……………………7
四、慢性阻塞性肺疾病造成的身心影響 …………………10
第二節 生活品質的相關概念 ………………………………………13
一、生活品質的內涵 ………………………………………13
二、生活品質的測量 ………………………………………14
第三節 慢性阻塞性肺疾病病人生活品質及其相關因素之相關研究
一、基本屬性……………………………………………… 19
二、症狀 ……………………………………………………20
三、活動 ……………………………………………………21
四、因疾病所受的衝擊 ……………………………………21
第四節 量表翻譯步驟及信效度檢定
一、量表的翻譯步驟 ……………………………………23
二、信效度檢定 ……………………………………………24
第參章 研究方法及過程
第一節 名詞界定 ……………………………………………………29
第二節 研究假設 ……………………………………………………30
第三節 研究設計 ……………………………………………………31
第四節 研究場所及對象 ……………………………………………32
第五節 研究工具 ……………………………………………………34
第六節 研究步驟 ……………………………………………………38
第七節 資料處理及分析 ……………………………………………39
第八節 研究倫理考量 ………………………………………………41
第肆章 研究結果
第一節 基本屬性之分佈 ……………………………………………42
一、年齡與性別 ……………………………………………42
二、工作狀況與宗教信仰………………………………… 42
三、教育程度與婚姻狀況………………………………… 42
四、吸煙狀態、共病及住院、急診經驗………………… 43
五、疾病嚴重度…………………………………………… 43
第二節 中文版SGRQ-C量表信度檢定 …………………………… 44
一、內在一致性…………………………………………… 44
二、折半信度……………………………………………… 44
三、再測信度……………………………………………… 44
第三節 中文版SGRQ-C量表效度檢定………………………………46
一、專家內容效度………………………………………… 46
二、效標關聯效度………………………………………… 46
三、區辨效度……………………………………………… 47
第四節 中文版SGRQ-C與WHOQOL-BREF台灣版適用性之比較… 50
第伍章 討論
第一節 中文版SGRQ-C之信度檢定 ……………………………… 51
一、內在一致性…………………………………………… 51
二、折半信度……………………………………………… 51
三、再測信度……………………………………………… 52
第二節 中文版SGRQ-C之效度檢定…………………………………53
一、專家內容效度………………………………………… 53
二、效標關聯效度………………………………………… 53
三、區辨效度……………………………………………… 53
第三節 中文版SGRQ-C與WHOQOL-BREF台灣版適用性之比較… 56
第陸章 結論與建議
第一節 結論 ………………………………………………………58
第二節 建議 …………………………………………………………59
第三節 研究限制 ……………………………………………………60

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