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研究生:徐昕妤
研究生(外文):Hsin-Yu Hsu
論文名稱:世界衛生組織障礙評估手冊-認知量表之中文版測試於頭頸癌症病患
論文名稱(外文):Validation of the WHODAS 2.0-Cognition Chinese Version in Head and Neck Cancer Patients
指導教授:賴裕和賴裕和引用關係
指導教授(外文):Yeur-Hur Lai
口試委員:王成平陳淑卿
口試委員(外文):Chen-Ping WangShu-Cing Chen
口試日期:2015-06-11
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:58
中文關鍵詞:頭頸癌放射線治療化學合併放射線同步治療認知功能量表測試
外文關鍵詞:head and neck cancerRTCCRTcognitive functionpsychometric testing
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頭頸癌治療,口腔癌早期以手術治療為首要,侵襲性口腔癌及鼻咽癌以放射線治療或化學同步放射治療為主,治療可能會造成中樞神經系統毒性,引起治療後認知功能缺損。臨床需要簡易、可信賴的評估工具,評估認知功能並可改善認知缺損對其生活品質的衝擊。本研究目的為測試中文版「世界衛生組織障礙評估手冊2.0-認知」(WHODAS 2.0-Cognition)之信度及效度。
本研究採量表測試研究設計,使用結構式問卷進行資料收集,研究工具包括:基本屬性問卷、癌症及治療相關特質、世界衛生組織障礙評估手冊-認知及、歐洲癌症治療與研究組織之癌症患者生命品質測定量表、醫院焦慮憂鬱量表及症狀嚴重度量表。
研究結果顯示:(1)本量表具有良好的內在一致性信度;(2)具有建構效度,萃取一個因素結構,解釋變異量為61.04%;(3)與生活品質、焦慮、疲倦及症狀嚴重度具有同時效度;(4)對接受不同治療方式病人的認知功能具有區辦效度。本研究結果顯示中文版「世界衛生組織障礙評估手冊2.0-認知」具有良好的信度及效度。本量表適用於台灣臨床頭頸癌病人認知功能評估。


Chemoradiotherapy (CCRT) is one of the major treatment modalities for advanced oral cavity cancer and for most nasopharyngeal carcinoma. However, both chemotherapy (CT) and radiation therapy (RT) might also cause the central nervous system toxicity and result in cognition impairment. Thus, an easily and reliable scale for clinical assessment is needed for assessing patients’ cognition function related these treatments. The purpose of the study was to examine the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0-Cognition (WHODAS 2.0-Cognition).
This is an instrument testing study. We used the World Health Organization Disability Assessment Schedule 2.0 –Cognition (WHODAS 2.0-Cognition), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLO-C30), Hospital Anxiety and Depression Scale (HADS), Symptom Severity Scale (SSS), and background information form to measure the psychometrics of WHODAS-cognition Chinese version.
The results showed that: (1) the Chinese-version WHODAS 2.0-Cognition had good internal consistency reliability; (2) clear one factor structure with 61.04% of the variance examined by exploratory factor analysis; (3) had theoretically supported convergent validity between WHODAS 2.0-Cognition scale and quality of life, anxiety, fatigue, and symptom severity; (4) had theoretically supported discriminant validity which can identify the differences of the levels of cognition among various treatment modalities.
The WHODAS 2.0-Cognition is a psychometrically satisfactory instrument. The scale is appropriate in measuring the cognition function of head and neck cancer patients in Taiwan.


中文摘要…………………………………………………………………………..…...i
英文摘要……………………………………………………………………….……...ii
第一章 緒論…………………………………………………………………...…...…1
第一節 研究動機及重要性……………………………………………………..1
第二節 研究目的………………………………………………………………..3
第二章 文獻查證……………………………………………………………………..4
第一節 頭頸癌疾病與治療簡介………………………………………………..4
第二節 認知功能………………………………………………………………11
第三節 治療相關認知功能影響因素…………………………………………12
第四節 癌症相關認知功能影響因素…………………………………………15
第五節 常見認知量表與世界衛生組織障礙評估-認知量表………………...18
第六節 研究假設………………………………………………………………20
第三章 研究方法……………………………………………………………………21
第一節 研究設計及步驟………………………………………………………21
第二節 研究工具………………………………………………………………22
第三節 資料處理與分析………………………………………………………25
第四節 研究倫理考量…………………………………………………………27
第四章 研究結果……………………………………………………………………28
第一節 人口學特性及疾病治療特質…………………………………………28
第二節 認知功能量表分析……………………………………………………29
第五章 討論…………………………………………………………………………33
第一節 量表信度………………………………………………………………33
第二節 量表效度………………………………………………………………35
第六章 結論與建議…………………………………………………………………40

第一節 研究限制與建議………………………………………………………40
第二節 結論……………………………………………………………………41
第七章 參考文獻……………………………………………………………………42

表目錄
表1 資料分析一覽表…………………………………………………….……25
表2 人口學特性及疾病治療特質………………………………………….…53
表3 WHODAS 2.0-Cognition平均值與Cronbach''s α值…………………..…55
表4 WHODAS 2.0-Cognition因素分析……………………………….………56
表5比較病人不同之人口學、疾病與治療特質跟認知差異……………….…57
表6 WHODAS 2.0-Cognition量表與相關變項之Pearson''s correlation…..…58


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