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研究生:李佳霙
研究生(外文):Li, Chia Ing
論文名稱:探討中部五縣市民眾的健康狀況與醫療利用間的相關研究:SF-36健康量表的合適性
論文名稱(外文):The Association of Health Status and Medical Utilization in Five Central Conuties in Taiwan: The Suitability of Sf-36 Health Questionnaire
指導教授:賴俊雄, 李采娟
指導教授(外文):Lai Jim-Shoung, Li Tasi-Chung
學位類別:碩士
校院名稱:中國醫藥學院
系所名稱:環境醫學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:1997
畢業學年度:85
語文別:中文
論文頁數:2
中文關鍵詞:健康狀況醫療利用
外文關鍵詞:SF-36健康量表health statussf-36 health questionnairemedical utilization
相關次數:
  • 被引用被引用:70
  • 點閱點閱:559
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:5
摘 要

過去幾年來,由人們自己評估醫療照護的結果,已經被認為是重要資訊,
包括能了解不同國家或地區人民的健康差異,或提供衛生政策制定時,應
該加強或修正的方向。而SF-36健康量表就是一份能由自己衡量健康狀態
,且包含八個健康向量、簡單和簡短的問卷。這份量表目前普遍地使用在
不同國家或族群的研究,故評估不同語言版本的信度及效度,是SF-36健
康量表是否適用在不同語言的重要依據。

本研究目的為評估中文版SF-36健康量表的信度及效度,且評估民眾健康
狀態對醫療利用的影響,醫療利用模式採用1995年Andersen健康行為模式
,以傾向、能力及需要因素為主要的探討變項。使用行政院衛生署於1994
及1995年18到65歲的中部五縣市民眾為研究對象,以1995年資料為探討民
眾健康狀況及醫療利用的橫斷性研究,以1994及1995年民眾健康轉變的情
況為縱斷性研究,樣本數為1993人。

研究對象的平均年齡39.8+/-13.1歲,健康量表的平均分數為67.6分
到94.4分,內部一致性(alpha值)都大於0.70;整體的輻合效度及辨別效
度都為97.14%,經外在變項所測的效度,有達到預期結果;但經因素效度
的分析,相關強度的結果卻與假設的相關情況不大吻合。分析醫療利用的
結果顯示,年齡愈大西醫門診利用次數愈大,女性西醫門診利用次數有大
於男性的傾向,身體疼痛程度和個人評估身體健康程度愈差則西醫門診的
利用會較高。活動功能限制情況愈少者、自覺身體健康狀態愈好者、每萬
人口西藥房數愈高或西醫師數與中醫師數比愈高,其住院利用的傾向愈低
。 因素分析對區分生理及心理層面的因素效度結果不佳,推測可能是訪
視員的誤差、翻譯措辭、或文化及民族性使中國人對於心理健康狀態的表
現和西方人民不同,但此問題還有賴未來研究對此做更進一步的探討。
ABSTRACT

In the past few years, it has been increasing consensus about
the importance of subjective accounts of health in monitoring
medical outcomes. It can be used to compair the health status
among countries or areas and to provide information for health
policy making. SF-36 health questionnaire, which includes eight
dimensions and health transition, is a simple, brief, easy
administration questionnaire. In recent, SF-36 health
questionnaire is used in health related researches of different
countries and populations. To estimate the reliability and the
validity of SF-36 health questionnaire in different languages is
an important issue.

The purpose of this study was to examine the reliability and
validity in Chinese version of SF-36 health questionnaire and to
assess the effect of health status measured by SF-36 health
questionnaire on medical utilization. The medical utilization
model of this study adopted Anderson''''s model including
predisposing, enabling and need characters for this study''''s main
variables. The data for analysis consists 1993 residents of aged
18 to 65 in five central counties in 1994 and 1995, which were
obtained from a study sponsored by Department of Health the
Executive Yuan. Cross-sectional study was applied to probe into
the association of health status and medical utilization in
1995. Longitudinal study was used to examine the validity of
health transition variable.

The subjects'''' mean age were 39.8(13.1 and eight dimension range
from 67.6 to 94.4. Cronbach''''s ( reliabilities were above the
0.70. The overall success rates for convergent validity and
discrimininant validity were both 97.14%. Validation by
independent clinical variable was consistent with theory, but
the factorial validity was not consistent with theory proposed
by John Ware. Our results about medical utilization revealed
that ageing population had higher utilization of outpatient
service than young population, so did female than male. The
higher scores of bodily pain or general health had lower
utilization of outpatient service. The higher scores of vitality
or general health had lower utility of hospitalization. If the
number of local drug stores per ten thousand persons or the
ratio of MD to traditional practitioner was higher, the utility
of hospitalization will be higher.

The possible explanations for the inconsistency between
factorial validity and the results that violating theoretical
factorial validity include the interview bias, translation bias
or differential mental health expression in Chinese and Western
people. But this question needs more studies to search for in
the future.
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