臺灣博碩士論文加值系統

SF-36健康量表為一般性（generic）的測量工具，由36個問題組成八個構面（scale），八個構面又形成兩大面向（PCS與MCS）。目前臺灣SF-36健康量表已應用於臨床研究，卻鮮少有進行嚴謹的心理計量學考驗，若有也是較不嚴謹，或是針對特殊科別或部分地區民眾，未有針對臺灣地區一般民眾進行分析探討；另外一般民眾之常模（norm）建立提供了問卷結果的一個比較基準，可達成與其他種族文化比較的目的，但臺灣過去並未以SF-36做過全國性調查，故無從建立民眾之健康分數常模，將不利國內及國際之比較。
本研究試圖在SF-36健康量表本土化的過程中，瞭解這項工具能否保有原量表應有的穩定性，或者有效的測出臺灣一般民眾的自覺健康狀況。資料來源以18歲以上臺灣民眾為調查之母群體（不包括離島地區之居民），採多階段、PPS的抽樣設計，依等機率抽樣原則分三階段進行，預計調查1500份一般民眾樣本；量表施測方式為受訪者親自填寫問卷後交還給訪員回收，回收資料經標準計分法計算後，一一考驗SF-36健康量表之測量假設，評估其信度及效度表現，並比較採用美國因素權重之計分法與採用臺灣因素權重之計分法的適用性，最後建立臺灣民眾常模。
研究結果發現，首先在量表信度方面，Cronbach’s alpha值都很高（SF構面稍低於標準）；第二，輻合效度考驗成功率幾近百分之百；第三，雖有構面成功率未達100%，但鑑別效度大致表現不錯；第四，除了活力狀況（VT）、社會功能（SF）與心理健康（MH）構面之外，因素分析可以將其他構面的題目完全區別於一個因素之中；第五，從因素分析的結果顯示，兩個因素共可解釋62.34%的變異，與預期結構雖有些出入，但整體來說中文版SF-36健康量表能滿足測量假設（scaling assumption）與心理計量學考驗；第六，常模基礎之效度表現也符合預期之假設，顯示出SF-36健康量表有足夠的區辨能力。不過，社會功能（SF）、活力狀況（VT）和心理健康（MH）三個構面仍要注意，在鑑別效度或因素分析的結果發現，與美國或歐洲其他國家的健康結構有些出入，與同屬亞洲的幾個國家倒是較為接近。
整體來說，臺灣版SF-36健康量表能滿足測量假設與心理計量學考驗，而原始健康構面及身心健康面向之因素效度分析、常模基礎之效度表現，這些結果都顯示出SF-36健康量表具有不錯的穩定性及足夠的區辨能力，不過，鑑別效度或因素分析的結果發現，有幾個構面與歐美國家的健康結構有些出入，因此在解釋時應考慮到這些差異，也因為這些結構上的差異，雖然採用美國因素權重之計分法有跨國比較的優點，但對於其適用性仍應持保留態度，建議若僅為瞭解國內民眾的健康結構，採用臺灣因素權重之計分法可能是較好的選擇。

The short form 36 health survey (SF-36) is a generic health status measurement instrument, which contains 36 items. It yields an eight-scale profile of scores as well as summary physical and mental measures (PCS & MCS). Now the SF-36 is applied in clinical researches, but is rarely going with conscientious psychometric test, and there is no national investigation with the SF-36 in Taiwan, and therefore no SF-36 norm. It would be disadvantaged for comparing in an international context.
This study aims to explore the reliability and validity of the SF-36 Taiwan version. National samples of 1500 general population aged 18 and above are interviewed. After calculating the recycle data by standard scaling, we examined the scaling assumption and evaluated the reliability and validity of the questionnaire. This study also tries to compare the scaling methods between factor score coefficients of Taiwan and U.S.A., and tries to establish Taiwan’s norm score.
The study results includes: (1) internal reliability (Cronbach’s alpha) has reached acceptable level for all scales (α>0.70), except for SF; (2) success rates for discrimininant validity almost ware 100%; (3) convergent validity approximately perform well although the success rates of some scales do not reach 100%; (4) in item level factor analysis, all scale items load cleanly onto separate factors except the VT, SF and MH; (5) factor analysis of the eight scale produce 2 principal components, which both explained 62.34% of total variance, but are slightly differed from hypothesized structure.
In general, SF-36 Taiwan version is consistent with the scaling assumption and can meet psychometric examine; (6) norm-based validity conform to expectable assumptions, and therefore the SF-36 has enough discrimination ability. However, it is valuable to pay attention on three scales (SF, VT, and MH) in application. This study finds that the health construction in Taiwan is different from that in the US and European countries, but is closer to that in Asia countries.
In summary, SF-36 Taiwan version has demonstrated to satisfy the scaling assumption and possess good psychometric properties. According to the item level factor analysis, physical and mental health summary level factor analysis, and norm-based validity test, all the results shows that SF-36 has nice stability and plentiful judgment ability. But the result of discrimininant validity and factor analysis shows some differences from the U.S.A. and European. It is therefore not very suitable to scale the score using U.S.A. factor score coefficients. For realize the health construction of Taiwan’s population only, it will be better to adopt Taiwan factor score coefficients in the scoring process.

第一章 緒論
第一節 研究背景………………………………………………………1
第二節 SF-36健康量表的發展與應用.………………………………2
第三節 研究目的及其重要性…………………………………………3
第四節 論文架構與主要內容…………………………………………4
第二章 文獻探討
第一節 健康的測量………………………………………………….6
第二節 簡短36（SF-36）健康量表之介紹……………………….13
第三節 IQOLA之SF-36翻譯及考驗步驟……………………………26
第四節 簡短36（SF-36）在各國的發展情形…………………….38
第五節 簡短36（SF-36）在臺灣的發展情形…………………….51
第三章 研究設計與方法
第一節 資料來源……………………………………………………54
第二節 測量變數之定義及計分方式………………………………56
第三節 資料分析……………………………………………………58
第四節 主要分析方法摘要…………………………………………63
第四章 研究結果
第一節 人口學資料描述……………………………………………65
第二節 SF-36健康量表之測量假設分析………………………….69
第三節 SF-36健康量表之效度評估及常模……………………….85
第四節 本章結果摘要…………………………………………….102
第五章 討論
第一節 基本資料之探討………………………………………….104
第二節 SF-36健康量表之測量假設探討…………………………104
第三節 SF-36健康量表之效度探討………………………………110
第四節 SF-36健康量表施測及應用相關問題之探討……………113
第六章 結論與建議
第一節 結論……………………………………………………….117
第二節 建議……………………………………………………….118
第三節 研究限制………………………………………………….120
參考文獻………………………………………………………………122
附錄A-1題目與構面之相關情形…………………………………….129
附錄A-2男性題目與構面之相關情形……………………………….130
附錄A-3女性題目與構面之相關情形……………………………….131
附錄A-4 18∼34歲題目與構面之相關情形…………………………132
附錄A-5 35∼64歲題目與構面之相關情形…………………………133
附錄A-6 65歲以上題目與構面之相關情形…………………………134
附錄B 研究問卷……………………………………………………135

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中文部分
內政部統計處 http://www.moi.gov.tw/W3/stat/home.asp
SF-36臺灣版 http://sf36.cgu.edu.tw/main.htm
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